Febrile seizures — what to do

If you've never seen a febrile seizure, the first time is genuinely terrifying. Your child's eyes roll back, their body stiffens or jerks, they go silent or unresponsive — sometimes for several minutes.

Here's the reassuring bit: febrile seizures are common and almost always harmless. They affect about 1 in 20 children between 6 months and 5 years. Most last under 5 minutes. Most kids never have another one.

Here's what to do — and what NOT to do — if it happens.

What a febrile seizure looks like

It usually happens early in a fever, sometimes before you'd even noticed they were ill. The classic signs:

• Eyes rolling back, staring blankly, or looking far away
• Body goes stiff and rigid
• Arms and legs twitching or jerking rhythmically
• They might lose consciousness, go limp, or wet themselves
• Skin might go pale or slightly blue around the lips
• Lasts usually under 5 minutes

After it ends, they're usually drowsy and sleepy for 30-60 minutes. They may not remember it.

What to DO

1. Stay calm. Hard, but the seizure will end on its own.
2. Note the time. Look at a clock. Most last 1-3 minutes; if it goes past 5, you need help fast.
3. Lay them on their side on a soft, safe surface. Floor is safest.
4. Move dangerous things away — anything sharp or hot they could hit.
5. Loosen tight clothing around their neck.
6. Stay with them. Talk softly. They probably can't hear you, but you'll feel better, and they're safer with you watching.

What you should NOT do

• Don't put anything in their mouth. Old wives' tale — they cannot swallow their tongue. You can choke them or break their teeth.
• Don't try to hold them down or restrain them. You can hurt them. Let the seizure happen.
• Don't try to give paracetamol mid-seizure. They can't swallow safely.
• Don't put them in a cold bath or rub them with cold water — this is dangerous and doesn't help.
• Don't drive them to A&E mid-seizure. Call 999 if it's prolonged.

When to call 999

Call 999 if:

• The seizure lasts more than 5 minutes
• It's their first ever seizure
• They have multiple seizures in a row without recovering between
• They're injured during the seizure
• They have difficulty breathing afterwards
• They look very unwell after the seizure (more than just sleepy)
• They're under 6 months old

For a typical short febrile seizure (under 5 mins, child recovers, this is a known thing for them) — book a same-day GP appointment but you don't need 999.

After the seizure — what to expect

• They'll be sleepy, sometimes confused, for 30-60 minutes
• They may want to sleep — let them, but check on them often
• Once they're alert, give paracetamol or ibuprofen for the fever
• Encourage drinks to prevent dehydration
• The fever caused the seizure, but lowering the fever doesn't prevent another one — the research is clear on that

Will it happen again?

About 1 in 3 children who have a febrile seizure will have another one. Risk factors:

• First seizure under 18 months old
• Family history of febrile seizures
• The seizure happened at a relatively low fever
• Short time between fever onset and seizure

Most kids stop having them by age 5. Febrile seizures don't increase the long-term risk of epilepsy, and don't cause brain damage.

Practise this on a manikin

Knowing the steps in your head and doing them when your child is convulsing are very different things. We cover seizures, the recovery position, and post-seizure care in detail in my 2-Hour Parent First Aid course. Two hours, in your home, £150 for up to 6.

Eva Levinson is a Postnatal Midwifery Assistant for the NHS, a Doula UK trained doula, and an Ofsted/HSE compliant first aid instructor. She runs And Chillax in Anerley, South London.