Fever

A fever can develop when a child is sick. It’s a symptom that tells you your child’s body is reacting to something, such as an infection. Fevers can be scary, especially in a young child, but typically aren’t dangerous. Here’s what you should know about fevers in children and when to call the doctor.

When Is It a Fever?

Normal body temperature is around 98.6°F. Sometimes it’s higher later in the day, or if your child is very active, especially in warm weather.

You can’t truly identify a fever by feeling your child’s forehead. If you suspect a fever, it’s best to check it using a thermometer. The type of thermometer you have will determine how you can measure it:

  • Under the tongue (oral)
  • In the armpit (axillary)
  • On the forehead (temporal)
  • In the ear (tympanic)
  • In the rectum (rectal)

A temperature reading will be slightly different depending on what method you use. In babies and very young children, rectal reading is most accurate. Children over the age of 4 can hold a thermometer under their tongue, so an oral thermometer is best used for this age group.

A temperature over 100.4°F indicates a fever. It’s common for children to get a fever when they have a cold, flu, or other illness, or it can develop after getting an immunization.

Generally, fevers aren’t harmful but actually have beneficial effects as part of the immune system. Therefore, you don’t have to treat it if your child is eating, drinking, and is comfortable. It’s always wise to call your pediatrician if you have questions or concerns. Depending on your child’s age and other symptoms, you may only need advice, not to visit the doctor.

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When to Call The Doctor

If your baby is 3 months old or younger and develops a fever higher than 100.4°F, call the doctor immediately. Infants can’t regulate their body temperature as well as older children, so a fever can pose a more serious problem for them.

Also, call your pediatrician if your child has fever with a seizure, or repeatedly spikes a fever over 104°F, no matter how old they are.

If your child shows any of the following, it warrants a call to your pediatrician’s office:

  • Isn’t drinking well and is showing signs of dehydration, like a dry mouth, no tears, or fewer wet diapers.
  • Is extremely fussy, unusually sleepy, or weak.
  • Has other concerning symptoms, like an unexplained rash, a stiff neck, pulling on or rubbing their ear, or severe vomiting or diarrhea.
  • Complains or shows signs of pain, like a sore throat or pulling on or rubbing their ear.
  • Has been in a very hot place, like in an overheated car.
  • Has another health condition that compromises their immune system.
  • The fever lasts more than 24 hours in a child younger than 2 years or more than three days in a child who’s 2 years old or older.
  • Isn’t feeling better, even though the fever is gone.

How to Treat a Fever in Children

Because fever is a sign of an illness, not an illness itself, the American Academy of Pediatrics recommends treatment only if it makes your child more comfortable. It’s not necessary to give medicine to reduce a fever or maintain a normal temperature.

Your pediatrician may recommend acetaminophen or ibuprofen if your child is in pain or uncomfortable. Make sure you ask which medication to use. Do not give aspirin unless directed by your pediatrician.

Always confirm the medication dosing, especially if your child is under 2 years old. For older children, you can follow the dosing on the label.

You should also do the following:

  • Encourage extra fluids, comfort foods, or even ice pops to keep your child hydrated.
  • Avoid overdressing or wrapping them in blankets.
  • Let your child rest as much as possible. They don’t have to sleep or stay in bed if they’re not sleepy, but encourage quiet play.
  • Keep your child home from school or child care and skip any playdates or activities until they’re fever-free without medication for at least 24 hours. This will keep them from spreading germs and making others sick. Keep in mind those with chronic illnesses or compromised immune systems can get very sick if they’re exposed to a contagious illness.

As a parent or caregiver, noticing that a child is “burning up with a fever” can be frightening. By remembering that fever in children is the body’s way of fighting an illness, that in most cases, the illness will resolve quickly on its own, and that there are many ways you can help your child feel more comfortable, hopefully you will feel less anxious. But don’t ever hesitate to contact your UPMC health care provider with your concerns. We’re always here for you.

Sources

Healthy Children.org American Academy of Pediatrics. Fever Without Fear: Information For Parents. https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-Without-Fear.aspx

Pediatrics. Fever and Antipyretic Use in Children.

https://pediatrics.aappublications.org/content/127/3/580

Children. Fever in Children: Pearls and Pitfalls. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615271/

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.