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Fever

Your child has a fever as part of his/her illness.  A fever is a symptom, not a disease.  It is the body’s normal response that helps to fight infections. The following temperatures are considered fever:

  • a rectal temperature of 100.4 degrees Fahrenheit or 38 degrees Celsius and higher.
  • an oral temperature of 100 degrees Fahrenheit or 37.8 degrees Celsius and higher
  • an axillary (armpit) temperature of 99 degrees Fahrenheit or 37.2 degrees Celsius and higher

Please note that ear temperatures are NOT reliable prior to 6 months of age. A rectal temperature is more accurate in this age group.

To take a rectal temperature in an infant, gently insert the rectal thermometer about ½ inch into the rectum, just until the silver tip disappears.  Stop if there is any resistance and never force a thermometer. Refer to Way to  Grow handout #0426 Taking a Temperature with a Digital Thermometer for more information.

Signs and symptoms of fever

Children with fevers may become more uncomfortable as the temperature rises. You may notice one or several of the following symptoms in your child:

  • Your child may be less active and talk less.
  • He may seem fussy, thirsty, and less hungry.
  • Your child may feel warm or hot. Remember that even if your child feels like he is “burning up," the actual temperature may not be that high. Children feel warm because their bodies are trying to give off the excess heat through the skin.
  • Children often get temperatures as high as 104 degrees F to 105 degrees F with viral or bacterial infections.

Treatment

The fever should go down as the cause for the fever resolves. Medicine may be used to treat discomfort caused by fever. Generally only fevers above 102 degrees Fahrenheit need to be treated with acetaminophen, but you may seek the advice of your health care provider.

Home Care Instructions

Until your child’s illness and fever is over there are several things that you can do to make your child more comfortable:

  • Dress your child lightly. Too much clothing will trap body heat and cause the temperature to rise.
  • Give your child plenty of fluids to drink. Offer Pedialyte®, electrolyte solutions, watered-down juice or Popsicles.
  • Your doctor may tell you to give non-aspirin medications to bring down the fever. Check the bottle label for the correct dose of acetaminophen or ibuprofen or ask your doctor. Do not give more than one product that contains acetaminophen at the same time. Read the package labels of all your child’s medications or ask your doctor or pharmacist to be sure that none of the other medications contain acetaminophen.  You may also refer to Way to Grow handout #0268 Acetaminophen for more information.
  • We do not recommend alternating acetaminophen with ibuprofen.  Children less than one year may use acetaminophen, and children over one year may use either ibuprofen or acetaminophen. You may seek your health care provider’s or pharmacist’s advice if you have questions.
  • Give a sponge bath if the temperature remains high, or if your child remains uncomfortable after giving acetaminophen or ibuprofen. The water should be lukewarm (85-90 degrees F). Sponge bathe your child for 20-30 minutes and allow your child to play in a shallow tub of lukewarm water. Stop the bath if your child begins to shiver as this increases the body temperature. Do not use alcohol in the bath water.  Alcohol is absorbed through the skin and can be harmful or fatal to your child.

Call your child’s doctor immediately if your child:

  • Is less than three months old
  • Is 3-6 months old with fever above 102 degrees F
  • Is 3-6 months old with fever and acts sick  
  • Has a fever over 105 degrees F (or 40 degrees C)
  • Is crying and won’t stop
  • Is difficult to awaken
  •  Has a stiff neck 
  • Has a seizure
  • Has any purple spots on his skin
  • Is having difficulty breating AND does not get better after his nose is cleared 
  • Is unable to swallow anything and is drooling
  • Looks or acts very sick (Sometimes children look better one hour after they receive a dose of acetaminophen.)
  • Won’t move an arm or leg normally
  • Has burning pain with urination
  • Has signs of dehydration: weakness, dry lips, no urine for longer than 8 hours

Within 24 hours if:

  • The fever is between 104 degrees F and 105 degrees F, or 40 degrees C to 40.6 degrees C (especially if your child is less than 2 years old).
  • Your child has had a fever for more than 24 hours without a known cause.

During office hours if:

  • Your child has had a fever more than 72 hours.
  • The fever went away for more than 24 hours and then came back.
  • Your child has a history of seizures caused by fever.

Your child can return to school or child care after he is without fever for 24 hours and feels well enough to resume normal activities.

Call your pediatric office with any further questions or concerns


Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 10/2011