What is it?
The definition of fever is a temperature of 100.4 Fahrenheit or above (38 degrees Celsius).
What You Need to Know:
How do I take my child’s temperature?
In infants less than three month of age, rectal temperatures are essential because they provide the most accurate information about core body temperature. In children older than three months, rectal is still more accurate but many parents prefer to use oral or ear thermometers. Oral is preferred over axillary (under the arm). Ear thermometers are usually acceptable; however, they may be inaccurate if there is too much wax in the canal. Always use a digital thermometer and avoid mercury thermometers.
Why do pediatricians get concerned when babies have fevers?
To pediatricians, there are two main categories of children with fever. The first category is anyone under three months of age. For infants younger than three months, a fever is never considered “normal” and is something that must be urgently evaluated. Infants have immature immune and other organ systems. If an infant gets a fever, it may be difficult to differentiate between the common cold and a serious illness such as a urinary tract infection or meningitis without more testing. If your child is less than three months of age and has a fever, call us right away, even if they are acting normally.
In children older than three months of age, fever is much more common and though it may still be the sign of a serious illness, it is much more likely to be an illness such as the common cold or other viral infection.
What causes fever?
Fever is usually a sign that your child has an infection. Infections are most commonly caused by viruses or bacteria. Fever is not an illness by itself; it is a sign or symptom of the illness. Fever caused by infection is usually beneficial in that it is a signal your child’s body is fighting the infection.
The caveat to this rule is fever caused by heatstroke. In this case, the fever is harmful. Heatstroke is an illness caused by prolonged sun exposure and dehydration. This is a medical emergency. Any child who has a fever after prolonged time outside or in a hot car must be evaluated and treated immediately.
What should I do if my child has a fever?
Try not to panic when your child has a fever. First look for other signs or symptoms that you child may be ill. Signs and symptoms that commonly go with fever are cough, congestion, runny nose, vomiting, diarrhea, and rash. Make sure to make a mental note of any symptoms your child may have as this will help us to make a diagnosis. See below for guidelines on when to call us if your child has a fever.
How can I treat the fever?
A common myth is that fever is bad and all fevers must be treated. Fever in the case of infection can actually be beneficial. It is your child’s brain signaling their body to fight the infection. Even high temperatures are not in themselves dangerous. The reason most pediatricians treat fever is because children typically appear a lot more ill when they have a fever and this makes diagnosis difficult. Children also use up more energy and fluids when they have a fever which can cause them to become dehydrated. The first rule is to offer your child plenty of fluids while they are ill.
The two main medications used to treat fever are acetaminophen (Tylenol) and ibuprofen (Motrin or Advil). Do not use ibuprofen in children less than six months of age, in children with kidney disease, or in anyone who may be significantly dehydrated (child with severe vomiting and diarrhea). If your child is over two years of age, read the label on the bottle. If younger than age two, refer to our dosing guideline.
Call us immediately or take your child to the emergency room if:
- your child has a rectal temperature of 100.4 or greater and is less than three months of age
- your child looks or acts very sick (fever along with severe headache, neck stiffness, confusion, or trouble breathing
- your child has a fever after prolonged exposure to the sun -your child has a fever greater than 105 degrees Farenheit
Call us during the day for an appointment if:
- your child is 3 to 6 months old (unless the fever is due to immunizations) -your child has a fever greater than 104 degrees Farenheit
- your child has had a fever more than 24 hours without an obvious cause or location of infection AND your child is less than 3 years of age
- your child has a fever longer than five days or is looking dehydrated (not urinating, sunken soft spot, no tears when crying).
- your child had a fever that went away for over 24 hours and then returned
- you have other concerns or questions