Fevers in Children: When to Worry

All children get fevers from time to time. They can be frightening for parents, but most fevers do not cause harm. In fact, a fever is a sign your child’s immune system is working. It’s important to know when to seek help for a fever. In this blog we go over what a fever is, when you should call the doctor, the best thermometers for certain situations, and things you should know about a scary side effect of fevers. 

Body Temperature 

A normal body temperature is 98.6 F, but this number varies from person to person. Time of day, age and activity level are some of the factors that affect body temperature. A fever is defined as a body temperature over 100.4 F. This increase is temporary and is often caused by an illness or an infection. It can be one of the first signs something is wrong inside your body.medication-5185733_1280

 When to Call the Doctor

Most fevers are harmless and only last a few days, but fevers in infants and toddlers may be a sign of a serious infection. Call your child’s doctor if your child: 

  • Is less than 3 months old and has a rectal temperature of 100.4 F or higher.
  • Is 3 to 6 months old and has a rectal temperature of 102 F or higher. 
  • Is 6 to 24 months old and has a rectal temperature higher than 102 F that lasts longer than one day. If your child has other symptoms you might want to call sooner.
  • Is less than 3 years old and has a temperature over 105 F.
  • Is more than 3 years old and has a temperature over 105 F and the temperature has not dropped within 45 minutes of administering acetaminophen or ibuprofen, or after sponging.
  • Looks or acts very sick for any period of time.
  • Has a fever after being left in a hot car. (In this case, seek immediate medical attention.)
  • Will not respond to you or make eye contact.
  • Has a fever that lasts more than three days.
  • Has a fever that went away for over 24 hours, but then returned.

If your child is responsive -- making eye contact with you and responding to your voice -- and is drinking fluids and playing, there is probably no cause for alarm. 

Febrile Seizures

Fevers can cause seizures in a small percentage (2 to 4%) of children between the ages of six months and five years old. Most febrile seizures are convulsions, but sometimes the child will lose consciousness but not noticeably shake. They can be scary, but according to the National Institutes of Health (NIH), most febrile seizures are short and do not cause any long-term damage. If your child experiences a seizure:

  • Note the time the seizure began. If it lasts for more than five minutes, call an ambulance.
  • Carefully place your child on the ground to prevent accidental injury. Position your child on his or her side or stomach to prevent choking.
  • Do not put anything in your child’s mouth. If possible, remove food or other objects from his or her mouth.
  • If it is your child’s first febrile seizure, take your child to the doctor immediately after the seizure to determine the cause of the fever.

The NIH estimates that 40% of children who have one febrile seizure will have another one.

Best ways to take a temperature

You can find a variety of thermometers in stores, including oral, rectal, ear and forehead thermometers. Oral and rectal thermometers are the most accurate. Doctors generally recommend using a rectal thermometer for infants, and an oral thermometer for an older child. Ear and forehead thermometers are less accurate, but they are convenient and a good choice if you have a wiggly or sleeping child.   When reporting a fever, let your child’s doctor know what method you used to take the temperature.

The road to recovery

Fevers generally go away after a few days.  If your child is uncomfortable, you can use an over-the-counter medication, like acetaminophen and ibuprofen, to lower the fever. Check the dosage carefully because it changes based on weight. You do not have to treat every fever.  A fever is the body’s way of fighting off infections and it’s a sign the immune system is working. 

The bottom line: you know your child best. If your child seems sick and is acting in a way that concerns you, do not hesitate to call your doctor.

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