What to Do During Your Baby's First Febrile Seizure
The short answer
If your baby is having their first febrile seizure, stay calm. Place them on their side on a safe surface, do not put anything in their mouth, and time the seizure. Most febrile seizures last less than 5 minutes and stop on their own. Call 911 if the seizure lasts more than 5 minutes. After a first febrile seizure, your baby should always be evaluated by a doctor to confirm it was a febrile seizure and rule out other causes. Febrile seizures affect about 1 in 25 children and almost never cause lasting harm.
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By Age
What to expect by age
0-6 months
Febrile seizures are uncommon before 6 months. A seizure with fever in a baby this young is more concerning and requires immediate emergency evaluation, as it may indicate a serious infection such as meningitis rather than a simple febrile seizure. Call 911 or go to the emergency room immediately. Do not wait to see if the seizure stops on its own. Young babies with fever and seizures typically need blood tests, and possibly a lumbar puncture, to rule out serious bacterial infection.
6-18 months
This is the most common age for a first febrile seizure. During the seizure: lay your baby on their side to prevent choking, move away dangerous objects, do not restrain them or put anything in their mouth, and time the seizure. After the seizure stops, your baby will likely be very sleepy - this is normal (called the postictal state). Bring your baby to the emergency room or call your pediatrician after a first seizure for evaluation. Febrile seizures often occur as a fever is rising rapidly, sometimes before you even realize your child is sick.
18 months - 5 years
Febrile seizures can occur up to age 5. If this is your child's first seizure, follow the same steps: protect them from injury, place them on their side, time it, and do not put anything in their mouth. After it stops, seek medical evaluation. Your doctor will examine your child, determine the cause of the fever, and discuss what to expect going forward. About 30% of children who have one febrile seizure will have another with a future fever. Your doctor can discuss a seizure action plan with you.
What Should You Do?
When to take action
- Your child had a brief (under 5 minutes) seizure involving their whole body during a fever, and has returned to normal within an hour.
- Your child is sleepy and groggy for up to an hour after the seizure - this postictal state is expected.
- Your child had a fever that rose quickly, triggering the seizure - this is the typical pattern.
- Your child's first febrile seizure has occurred and they need evaluation (all first febrile seizures should be seen by a doctor).
- You want to discuss a seizure action plan for future febrile illnesses.
- You have questions about whether fever-reducing medication can prevent future febrile seizures.
- The seizure lasts longer than 5 minutes - call 911.
- Your baby is under 6 months old and has a seizure with fever.
- Your child has difficulty breathing, turns blue, or remains unresponsive after the seizure stops.
- The seizure only affects one side of the body.
- Your child has a stiff neck, bulging fontanelle, rash, or seems extremely ill beyond just the fever.
- Multiple seizures occur within 24 hours.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
My Baby Had a Febrile Seizure
Febrile seizures are frightening to witness but are usually harmless. They affect about 1 in 25 children, typically between 6 months and 5 years, and almost never cause lasting harm. Most children who have one febrile seizure never have another, and they don't increase the risk of epilepsy significantly.
Will My Baby Have Another Febrile Seizure?
About 30-35% of children who have one febrile seizure will have at least one more during a future febrile illness. Risk factors for recurrence include having the first seizure before 18 months, having a lower fever at the time of the seizure, a family history of febrile seizures, and having the seizure early in the illness. Despite the recurrence risk, febrile seizures do not cause brain damage and do not significantly increase the risk of developing epilepsy (the risk rises only slightly, from about 1% to about 2-4%).
Baby Fever: When to Go to the Emergency Room
Any fever (100.4 degrees F / 38 degrees C or higher) in a baby under 3 months requires immediate medical evaluation, as it can indicate a serious infection. For babies 3-6 months, a fever above 102 degrees F (38.9 degrees C) warrants a call to your pediatrician. For babies over 6 months, how your baby is acting matters more than the number on the thermometer. A high fever alone does not mean an emergency, but fever combined with lethargy, difficulty breathing, or other concerning symptoms requires urgent care.
Early Signs of Epilepsy in Babies
Seizures in babies can look very different from seizures in older children or adults. Subtle signs may include repeated eye blinking or deviation, lip smacking, cycling leg movements, brief stiffening episodes, or clusters of head drops (infantile spasms). Infantile spasms are a neurological emergency that requires urgent evaluation. Not all unusual movements are seizures - babies commonly have benign tremors and startle reflexes - but any movement pattern that seems involuntary, repetitive, and cannot be interrupted deserves medical evaluation.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.