Febrile Seizures: What to Do Step by Step
A febrile seizure is a convulsion triggered by fever in a young child — and it is one of the most frightening things a parent can witness. The good news, which I tell every panicked parent in the ER: simple febrile seizures are common, they look far worse than they are, and they do not cause brain damage.
Key takeaways
- Lay your child on their side, note the time, and never put anything in their mouth.
- Call 911 if the seizure lasts more than 5 minutes, breathing is affected, or your child doesn't wake up afterward.
- Simple febrile seizures don't cause brain damage, and most children outgrow them by age 5–6.
- A first febrile seizure always needs medical evaluation to find the cause of the fever.
What is a febrile seizure?
A febrile seizure is a seizure that happens with a fever (100.4°F / 38°C or higher) in children between 6 months and 5 years old, without another cause like an infection of the brain. They affect about 2–5% of young children — most commonly toddlers between 12 and 18 months.
They often happen during the rapid rise of a fever, sometimes before you even knew your child was sick. A typical febrile seizure involves the whole body shaking or stiffening, lasts less than 5 minutes (most last 1–2 minutes), and is followed by a sleepy period.
What should I do during a febrile seizure?
- Stay as calm as you can and look at a clock. Time the seizure — doctors need to know how long it lasted, and seconds feel like minutes when you are scared.
- Lay your child on their side on a flat, safe surface like the floor, away from hard or sharp objects.
- Do NOT put anything in your child's mouth — no fingers, no spoons, no medicine. They will not swallow their tongue.
- Do not try to hold them still or restrain the shaking.
- Loosen tight clothing around the neck if you can do so easily.
- Do not give fever medicine during the seizure — wait until it is over and your child is awake enough to swallow safely.
Call 911 if:
- The seizure lasts longer than 5 minutes
- Your child has trouble breathing or turns blue/gray and stays that way
- Another seizure follows soon after the first
- Your child does not start waking up within a reasonable time after the shaking stops
What happens after the seizure?
Afterward, your child will probably be very sleepy or confused for a while — this is normal and called the post-seizure (postictal) period. Keep them on their side, stay with them, and let them rest. Once they are awake and alert, you can offer fluids.
A first febrile seizure should always be evaluated — call your pediatrician right away or go to the emergency department, because doctors need to find the cause of the fever and rule out more serious infections.
Will it happen again? Will my child develop epilepsy?
About 1 in 3 children who have a febrile seizure will have another one with a future fever. That is unsettling to hear, but the long-term outlook is excellent: the vast majority of children outgrow febrile seizures by age 5–6, and having simple febrile seizures does not meaningfully raise the risk of epilepsy or cause brain damage or developmental problems.
Fever-reducing medicines do not reliably prevent febrile seizures, so aggressive fever treatment is not an effective prevention strategy — treat for comfort as usual.
Related reading: fever in children and what to do when your child has a febrile seizure (blog).
Sources
This guide was reviewed against guidance from:
Frequently asked questions
Are febrile seizures dangerous?
Simple febrile seizures (brief, whole-body, one in 24 hours) are not dangerous and do not cause brain damage. Any first seizure still needs prompt medical evaluation to find the fever's cause.
Should I put something in my child's mouth during a seizure?
Never. Do not put fingers, spoons, or anything else in the mouth — it can injure your child, and children do not swallow their tongues during seizures.
Can I prevent febrile seizures by keeping the fever down?
Unfortunately, no. Febrile seizures often happen as the fever is rising, before medicine could work, and studies show fever reducers do not reliably prevent them.
Does a febrile seizure mean my child has epilepsy?
No. Simple febrile seizures are not epilepsy, and they do not meaningfully increase epilepsy risk. Recurrent or prolonged seizures need a neurologist's evaluation.
When should I call 911 for a seizure with fever?
Call 911 if the seizure lasts more than 5 minutes, your child has trouble breathing, turns blue and stays blue, has back-to-back seizures, or does not wake up afterward.
Reviewed by Ali Ozcan, MD, MBA
Board-certified pediatric emergency medicine physician and creator of ER4Kids. This guide reflects the same trusted, evidence-based guidance Dr. Ozcan provides to families in the emergency department.
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