Febrile Seizures in Children: What to Do in the Moment and When to Call the Doctor
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This health information is reviewed by board-certified pediatricians and follows current American Academy of Pediatrics (AAP) guidelines.
Nothing prepares a parent for watching their child have a seizure. For families in Robbinsville, Hamilton, Princeton, Bordentown, and throughout Mercer County who have been through a febrile seizure, the first words they often say afterward are "I thought my child was dying." It is one of the most frightening experiences in parenthood.
The truth, and it's genuinely reassuring, is that febrile seizures are the most common neurological event in young children, affect 2–5% of all children, are almost always harmless, and do not cause brain damage.
At Hummingbird Pediatrics, we want every family to know exactly what to do in the moment, what to expect, and what the event actually means for your child's health.
What Is a Febrile Seizure?
A febrile seizure is a seizure triggered by fever in a child who does not have epilepsy. They occur most commonly between the ages of 6 months and 5 years, with the peak around 14–18 months. The brain of a young child is especially sensitive to rapid temperature rises, and in some children a spike in fever triggers brief abnormal electrical activity: a seizure.
Febrile seizures are not caused by epilepsy. The vast majority of children who have febrile seizures never develop epilepsy.
Simple vs. Complex Febrile Seizures
- Last less than 15 minutes (most last 1–3 minutes)
- Involve the whole body (generalized): shaking of arms and legs, stiffening, eyes rolling back
- Occur only once in a 24-hour period
- Child returns to normal within an hour
- Last longer than 15 minutes
- Affect only one side of the body
- Occur more than once within 24 hours
Complex febrile seizures warrant prompt medical evaluation to rule out other causes.
What to Do During a Febrile Seizure
It is very hard to stay calm during those minutes. Here is exactly what to do:
- Time the seizure from the start. Use your phone. This is important information for your doctor.
- Lower your child to the floor. Place them on their side (the recovery position) to prevent choking if they vomit. Clear away any hard or sharp objects nearby.
- Do not put anything in your child's mouth. This is a myth, children cannot swallow their tongue during a seizure. Putting fingers, a spoon, or any object in the mouth is dangerous and serves no purpose.
- Stay with your child and observe. Watch what the body is doing. One side or both? Shaking or stiffening? This helps your doctor categorize the seizure.
- Do not try to hold the child down or stop the shaking. You cannot stop a seizure by restraining the limbs.
- Call 911 if the seizure lasts longer than 5 minutes or if your child is not breathing after the shaking stops.
After the Seizure: What to Expect
After the seizure ends, your child will likely be limp, confused, and very drowsy, this is called the postictal phase. It is normal. Most children fall asleep immediately afterward. They may not recognize you briefly. Within 30–60 minutes, most children are back to their normal selves.
This phase can be nearly as alarming as the seizure itself. It does not mean anything is wrong.
Do Febrile Seizures Cause Brain Damage?
No. This is one of the most important things we tell families at Hummingbird Pediatrics: simple febrile seizures do not cause brain damage, do not lower intelligence, and do not increase the risk of learning disabilities.
Risk of Recurrence
After a first febrile seizure, roughly 1 in 3 children will have at least one more febrile seizure during subsequent febrile illnesses. The risk is higher if the first seizure occurred before age 18 months, if the temperature was relatively low at the time of the seizure, or if there is a family history. Most children outgrow febrile seizures by age 5.
Risk of Epilepsy
The risk of developing epilepsy after a simple febrile seizure is only slightly higher than the general population, approximately 1–2%. For context, the baseline risk of epilepsy in the general population is about 1%. This is not a reason for alarm.
When to Call Hummingbird Pediatrics
Call our office at (609) 808-3123 or seek care the same day if your child has a febrile seizure. We will want to evaluate the underlying cause of the fever and assess the seizure.
- The seizure lasts longer than 5 minutes
- Your child is not breathing after the seizure stops
- Another seizure begins shortly after the first
- Your child does not return to normal within 1 hour
- Your child is under 6 months old
- Your child has a stiff neck, unusual rash, or seems extremely ill beyond the fever
We know how terrifying this experience is. We are here to walk you through exactly what happened, what it means, and what to watch for going forward.
Frequently Asked Questions
Will my child develop epilepsy after having a febrile seizure?
Almost certainly not. The risk of developing epilepsy after a simple febrile seizure is only about 1–2%, only slightly above the 1% baseline risk in the general population. The vast majority of children who have febrile seizures never develop epilepsy. The risk is somewhat higher after complex febrile seizures (those lasting more than 15 minutes, involving only one side of the body, or recurring within 24 hours), which is why those warrant more thorough evaluation. Simple febrile seizures, which are the large majority, carry very minimal long-term neurological risk.
Should I call 911 every time my child has a febrile seizure?
If it is your child's first seizure and you don't know what is happening, calling 911 is entirely reasonable; never hesitate in an emergency. However, for subsequent febrile seizures in a child with a known history, the general guidance is to call 911 if the seizure lasts longer than 5 minutes, if your child is not breathing after the seizure stops, or if another seizure begins shortly after the first one ends. A brief seizure (under 5 minutes) that stops on its own in a child with a prior febrile seizure history warrants a same-day call to your pediatrician rather than necessarily 911. When in doubt, always call.
Can I prevent febrile seizures by giving fever medication early?
Unfortunately, no. Research has shown that giving acetaminophen or ibuprofen at the first sign of fever does not prevent febrile seizures. This was carefully studied and the result was clear: fever medication reduces fever and makes children more comfortable, but it does not prevent seizures in children who are prone to them. Many febrile seizures occur as the temperature rises rapidly, before parents even know the child has a significant fever. This is not a failure on your part; it is simply how febrile seizures work.
Does a febrile seizure cause brain damage?
No. This is one of the most important things to know, and it is genuinely reassuring: simple febrile seizures do not cause brain damage, do not lower IQ, and do not cause learning disabilities. Large studies following children for many years after febrile seizures have found no difference in cognitive function, academic performance, or neurological outcomes compared to children who never had a febrile seizure. Even though a febrile seizure looks terrifying, the brain comes through it without lasting harm.
What is the risk my child will have another febrile seizure?
After a first febrile seizure, approximately 1 in 3 children will have at least one recurrence during a subsequent fever. The risk is higher if the first seizure occurred before age 18 months, if the temperature was relatively low at the time of the first seizure, or if there is a family history of febrile seizures. The risk decreases as children get older, and most children outgrow febrile seizures by age 5–6. Having a recurrence plan (knowing what to do if it happens again) can significantly reduce the anxiety around future fevers.
Need Personal Guidance?
This article provides general information. For questions specific to your child's health, please call our office or book an appointment online.