Posted on 26 Jul 2017
This content has been clinically reviewed by Tracy Nailor, MD.
It’s easy to lose your cool when your child has an abnormally high temperature. And so many parents do that medical professions have given this exaggerated fear and anxiety provoked by a child’s fever a name: “fever phobia.’’
Most fevers are harmless, though, and parents can take comfort in knowing that some are even helpful—they’re a signal that your child’s little immune system is working to fight infection by turning up the heat.
It’s also important to know that a fever isn’t an illness—it’s a sign or symptom of sickness and will go away on its own once the cause is treated. Most doctors agree that kids don’t even need to be given fever-reducing medicines unless they’re uncomfortable or in pain.
The exception is infants younger than 3 months of age. They should be evaluated by a doctor for any fever that reaches 100.4 degrees F (38 degrees C) or higher. Fevers in infants can indicate a serious illness.
For older children, doctors recommend taking into consideration two things:
- Your child’s temperature
- How your child looks and feels (Does he look or act sick?)
If your child has a fever but is still interested in playing and is alert and smiling at you, his fever probably isn’t serious. Don’t worry too much if he’s not hungry. On the other hand, if he is weak and is having trouble drinking fluids, the cause is more likely to be serious and you should call your pediatrician.
Is it a fever?
If you think your child has a fever, take his temperature. Oftentimes as parents, we touch our child’s head and assume he has a fever if he feels warm, but this is not the best way to measure a temperature at home.
The best way is to use a digital thermometer. There are several types on the market, including:
- Oral – the easiest for older children, and can also be used under the arm, although this doesn’t always offer the most accurate reading.
- Tympanic (ear)
- Rectal – the best way to take a temperature in infants
- Temporal artery (forehead)
Make sure to read the instructions for all thermometer use carefully.
Whatever method you choose, a fever is defined as a temperature greater than 100.4 degrees F (38 C) rectally. Temperatures taken orally typically run about ½ to 1 degree lower.
- 99.5 degrees F (37.5 degrees C) in the mouth
- 100.4 degrees F (38 degrees C) rectally
- 99 degrees F (37.2 degrees C) under the arm
Make sure to let your pediatrician know which method you used if you have to bring him in.
In kids 3 months and 3 years of age, a fever of 102.2 F (39 C) or higher, requires a call to your pediatrician.
Also, be aware that a high fever may not be a good indicator of how sick your child is. A simple cold or viral infection can cause a high fever of 102-104 degrees F (38.9-40 degrees C), but isn’t usually a cause for worry. For infants, serious infections may cause no fever or even an abnormally low body temperature (below 97 degrees F or 36.1 degrees C).
Call your pediatrician right away if your child has a fever and any of these symptoms:
- Has a specific complaint such as a sore throat or earache
- Has lasting diarrhea or repeated vomiting
- Refuses fluids
- Has signs of dehydration (peeing less than usual or not having tears when crying)
- Still has a fever after 24 hours (in kids under 2) or 72 hours (kids over 2)
Seek emergency care if your child has a fever and shows any of these signs:
- Severe headache
- Stiff neck or complains of light hurting their eyes
- Rash or purple spots that look like bruises on the skin
- Problems breathing
- Belly pain
- Sluggishness or trouble waking up
Oftentimes as parents, we touch our child's head and assume he has a fever if he feels warm, but this is not the best way to measure a temperature at home.
A small number of children can have convulsions (seizures) when they have a fever, caused by the rapid rise in body temperature, not the actual number on the thermometer. Just because your child has a fever of 103 or 104 degrees, does not mean they will convulse.
Febrile seizures usually affect kids 6 months to 6 years old, and are most common in toddlers. Although scary, febrile convulsions don’t usually cause other health problems. Having one doesn’t mean a child will have epilepsy or brain damage, and most kids outgrow febrile seizures by the time they’re 5 years old.
If your child has a febrile seizure, gently turn him on his side to prevent choking on saliva. Don’t attempt to put anything in the child’s mouth or give him fever-reducing medication. Call your doctor afterwards. Call 911 if the convulsion lasts more than five minutes or if your child turns blue.
Treating a fever at home
If a fever is making your child fussy or uncomfortable, you can give him acetaminophen or ibuprofen (most fevers don’t cause discomfort until they go above 102 degrees F or 38.9 degrees C). Follow the instructions on the label and measure carefully based on your child’s weight, not age. If you’re little one is under the age of 2, call your pediatrician before giving him any medication. Call right away if your child is under 3 months of age.
Some other ways to treat a fever at home:
- Dress your child in light-weight clothing and cover with a light sheet or blanket. Overdressing or over bundling can cause an infant or child’s temperature to rise.
- Give your child a bath in lukewarm (not cold) water. Do NOT give your child an alcohol bath – this is toxic.
- Make sure your child’s bedroom isn’t overheated. It should be comfortable, not too hot or cold.
- Offer plenty of fluids. Water, soup, ice pops and flavored gelatins are good choices for replenishing fluids lost to fever. Avoid drinks with caffeine since these can make dehydration worse.
- Don’t force your child to eat solid food until he’s ready.
- Never give your child aspirin to treat his fever. This can cause Reye’s syndrome – a serious illness that can result in liver failure.
- Make sure he gets plenty of rest. Most doctors say your child can return to childcare or school when his temperature has been normal for 24 hours.
This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on Children’s Healthcare of Atlanta team are independent providers and are not our employees.