If your child is having a febrile seizure, the most important thing you can do is keep them safe, time the seizure, and call 911 if it lasts longer than 5 minutes. Febrile seizures happen in children between 6 months and 5 years old during a fever, typically above 100.4°F (38°C). They look terrifying, but the vast majority end on their own within a few minutes and cause no lasting harm.
What to Do During the Seizure
Your instinct will be to hold your child or try to stop the convulsions. Resist that urge. Restraining a seizing child can injure both of you. Instead, gently ease your child to the ground if they’re not already there, and turn them onto their side with their mouth pointing toward the floor. This keeps the airway clear so saliva or vomit can drain rather than block breathing.
Clear the area around them of anything hard or sharp. Place something soft and flat, like a folded towel or jacket, under their head. Loosen any clothing around the neck. Then start timing. Knowing exactly how long the seizure lasted will be one of the first things a doctor asks you.
Do not put anything in your child’s mouth. Children do not swallow their tongues during seizures, and placing objects between their teeth can break teeth or injure the jaw. Do not attempt mouth-to-mouth breathing while the seizure is happening. Children almost always resume normal breathing on their own once the seizure stops. Do not offer food or water until your child is fully awake and alert.
When to Call 911
Call emergency services if the seizure lasts longer than 5 minutes. A simple febrile seizure typically lasts under 10 minutes, and most are much shorter, but anything beyond 5 minutes warrants immediate medical help because longer seizures are harder for the body to stop on its own.
You should also seek emergency care if your child has trouble breathing, their skin turns blue, the seizure affects only one side of the body, or the seizure repeats within 24 hours. After the seizure ends, watch for vomiting, a rash, unusual drowsiness, confusion that doesn’t clear, or coordination problems. Any of these are reasons to contact your child’s doctor or head to the emergency room.
Even if the seizure is brief and your child recovers quickly, a first-time febrile seizure should always be evaluated by a doctor. The main reason is to confirm that the fever isn’t caused by a serious infection like meningitis, especially in younger children or those with incomplete vaccinations.
Caring for Your Child After the Seizure
Once the seizure stops, your child will enter a recovery phase where they may be drowsy, confused, or irritable. This is normal and can last anywhere from a few minutes to about an hour. Keep them on their side in a safe, comfortable position and stay with them. Watch their breathing closely. Most children begin breathing normally right away, but shallow or irregular breaths in the minutes after a seizure are worth monitoring until they return to a more alert state.
Once your child is fully awake and responsive, you can offer water and, if appropriate, a fever reducer like acetaminophen or ibuprofen. Comfort them calmly. Young children won’t understand what just happened, and your tone matters more than your words.
Simple vs. Complex Febrile Seizures
Doctors classify febrile seizures into two categories, and the distinction matters for what happens next. A simple febrile seizure is generalized (affecting the whole body), lasts less than 15 minutes, occurs only once within a 24-hour period, and is followed by full recovery within one hour. The large majority of febrile seizures fall into this category.
A complex febrile seizure lasts longer than 15 minutes, involves movements on just one side of the body, or recurs within the same 24-hour window. Complex seizures may prompt additional testing. Your child’s doctor might order an EEG (a test that measures brain wave activity) or an MRI to get a closer look at the brain. For simple febrile seizures, these tests are generally not needed. The diagnosis is usually made based on what you describe and a physical exam.
Do Fever Reducers Prevent Febrile Seizures?
This is one of the most common questions parents ask, and the answer is mostly no. A systematic review of the available research found very limited evidence that giving acetaminophen during a fever episode might reduce the chance of a second seizure within that same illness. One study showed a recurrence rate of about 9% with acetaminophen compared to 24% without it, but this was a single study, and the overall evidence is weak.
More importantly, giving fever reducers during future illnesses does nothing to prevent febrile seizures from happening again. Four studies examined whether routine use of fever-lowering medication during later fevers could ward off seizures, and none found a benefit. Fever reducers are still useful for making your child more comfortable when they’re sick, but they should not be relied on as a seizure prevention strategy. Each child has their own temperature threshold for triggering a seizure, and there’s no defined fever level that reliably predicts when one will happen.
Chances of It Happening Again
About 15% of children who have a febrile seizure will have another one within the following year. The single biggest predictor of recurrence is age: the younger your child is at the time of their first seizure, the more likely they are to have another. A child who has their first febrile seizure at 12 months has a meaningfully higher recurrence risk than one who has it at age 4. The duration of the first seizure also plays a role, with longer initial episodes slightly increasing the odds of recurrence.
Interestingly, peak fever temperature works in the opposite direction you might expect. Children whose seizures occurred with very high fevers were actually less likely to have a recurrence, possibly because a lower seizure threshold (meaning the brain reacts at a lower temperature) signals greater susceptibility.
Long-Term Outlook
Febrile seizures do not cause brain damage, and most children outgrow them entirely by age 5 or 6. The question parents worry about most is whether their child will develop epilepsy. A large study following children for 23 years found that about 7% of children who had febrile seizures went on to develop epilepsy, compared to a roughly 1% baseline risk in the general population. That means the vast majority of children with febrile seizures never develop epilepsy.
The risk is higher in certain subgroups: children with a family history of epilepsy, those with neurological conditions like cerebral palsy, and those who had complex rather than simple febrile seizures. For a child with a single simple febrile seizure and no other risk factors, the long-term outlook is excellent.