Facts about Fever in Children

March 7, 2011

published in Citizen News January 26, 2011

Some Guidelines for Parents

A child with a fever causes worry for most parents. Please allow me to provide some advice to ease your mind when a young person in your household has a fever. First, remember that almost all fevers are caused by infections. If you have a fever, it means your body is fighting an infection. Teething in infants probably does not cause fever. It’s best to focus on the fever rather than the teething so you are not distracted from what is really going on with your child.

How Sick is My Child?

First, get an accurate temperature reading. Keep in mind that the height of the fever does not determine how sick your child is. A serious illness can occur with either a low fever or a high fever. A mild viral illness can also occur with either a high or low fever. When evaluating a fever, carefully look at your child’s behavior for signs of serious illness. Is your child paying attention to you and to what is going on in the room? Is your child active and interested in playing? Check your child’s color. Also, carefully look at his or her breathing pattern. Is your child breathing fast or working hard to breathe? This assessment is as important, if not more important, than how high the fever is.

What type of thermometer shall I use?

Newborns and Young Children – Use a rectal, non-mercury thermometer only. Never use a mercury thermometer. If the glass breaks, toxic mercury will be released and inhaled by anyone standing nearby.
Children Over Age One – Axillary, or under the arm-pit, thermometers are acceptable and are almost as accurate as rectal thermometers.
Older Children – Oral mouth thermometers can be used. Your child should be able to comfortably hold the thermometer in his or her mouth with closed lips. Use a simple digital thermometer. Ear and forehead thermometers are not reliable and should not be used in children.

What kind of medicine should I give my child, and how much?

Fever medications may be given to make the child more comfortable. Either acetaminophen or ibuprofen may be used. Do not give any medicine to babies who are younger than 3 months of age without first talking to your doctor.
Acetaminophen (one brand name: Children's or Infants' Tylenol) relieves pain and lowers fever. The correct dosage depends on your child’s weight and age.
Ibuprofen (two brand names: Children's Advil, Children's Motrin) is another medicine that can be used to lower a fever in children older than 6 months of age. Talk to your doctor before giving ibuprofen to your child. Again, the correct dose depends on your child’s weight and age.

Can I give my child aspirin to lower his or her fever?

No. In rare cases, aspirin can cause Reye's syndrome in children. Reye's syndrome is a serious illness that can lead to death. We recommend that parents not give aspirin to children younger than age 18

What else can I do to help my child feel better?

In older children, a warm sponge bath is also a great way to both lower the temperature and to observe the child for signs of serious illness. The child must be old enough to sit unassisted in the tub and always be observed by a parent.

  • Give your child plenty of fluids to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself. Water, clear soups, popsicles and flavored jell-o are good choices.
  • If your child is getting enough fluids, don’t force him or her to eat if he or she doesn’t feel like it.
  • Make sure your child gets plenty of rest.
  • Keep the room temperature at about 70°F to 74°F.
  • Dress your child in loose cotton clothing. Overdressing can trap body heat and cause your child's temperature to rise.
  • If your child has chills, give him or her an extra blanket. Remove it when the chills stop.

When should I call the doctor or make sure that my child is seen?

If your child has any of the following warning signs:

  • Constant vomiting or diarrhea
  • Dry mouth
  • Earache or ear pulling
  • Fever comes and goes over several days
  • High-pitched crying
  • Irritability
  • No appetite
  • Pale appearance
  • Seizures
  • Severe headache
  • Skin rash
  • Sore or swollen joints
  • Sore throat
  • Stiff neck
  • Stomach pain
  • Swelling of the “soft spot” on an infant’s head
  • Unresponsiveness or limpness
  • Wheezing or problems breathing
  • Whimpering

3 months of age or younger - call or be seen right away if your baby's rectal temperature is 100.4°F (38°C) or higher even if your child doesn't seem sick. Babies this young can get very sick quickly.
3 to 6 months of age - call or be seen if your baby has a temperature of 101°F (38.3°C) or higher, even if your baby doesn't seem sick.
6 months and older and has a fever of 102°F (38.8°C) to 102.9°F (39.4°C), watch how he or she acts. Call or be seen if the fever rises or lasts for more than 2 days.
6 months and older and has a fever of 103°F (39.4°C) or higher, call or be seen even if your child seems to feel fine.
Trust your instincts as a parent. If you think something is wrong, call you doctor or go to your local urgent care center. You and your doctor will be glad you did.

Son kissing mother
I wanted to take a moment to thank you for the attention you gave me last week. My son was started on antibiotics and ear drops. Within 24 hours he began to feel better. The poor kid had been going to school in tears because he was afraid of missing any more days, but feeling (and looking) just awful! He's not been able to even think about lacrosse practice, but thanks to starting him on antibiotics, he was thrilled to return to practice today.
Somers, NY
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