Fever and Your Child
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While it is important to look for the cause of a fever, the main purpose for treating it is to help your child feel better if he is uncomfortable or has pain. 
A fever is usually a sign that the body is fighting an illness or infection. Fevers are generally harmless. In fact, they can be considered a good sign that your child’s immune system is working and the body is trying to heal itself. 
Read on to find out more from the American Academy of Pediatrics (AAP) about how to tell if your child has a fever and how to manage a fever. 

About Fevers

Normal body temperature varies with age, general health, activity level, and time of day. Infants tend to have higher temperatures than older children. Everyone’s temperature is highest between late afternoon and early evening and lowest between midnight and early morning. Even how much clothing a person wears can affect body temperature. 
A fever is a body temperature that is higher than normal. While the average normal body temperature is 98.6°F (37.0°C), a normal temperature range is between 97.5°F (36.4°C) and 99.5°F (37.5°C). Most pediatricians consider a temperature 100.4°F (38.0°C) or higher a sign of a fever (see Taking Your Child’s Temperature). 

Signs and Symptoms of a Fever

If your child has a fever, she may feel warm, appear flushed, or sweat more than usual. She may also be thirstier than usual. 
Some children feel fine when they have a fever. However, most will have symptoms of the illness that is causing the fever. Your child may have an earache, a sore throat, a rash, or a stomachache. These signs can provide important clues as to the cause of the fever. 

When to Call the Doctor

The most important things you can do when your child has a fever are to improve your child’s comfort by making sure he drinks enough fluids to stay hydrated and to monitor for signs and symptoms of a serious illness. It is a good sign if your child plays and interacts with you after receiving medicine for discomfort. 

Call your child’s doctor right away if your child has a fever and

  •  
    Looks very ill, is unusually drowsy, or is very fussy.
  •  
    Has been in a very hot place, such as an overheated car.
  •  
    Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, breathing difficulty, an unexplained rash, or repeated vomiting or diarrhea.
  •  
    Has immune system problems, such as sickle cell disease or cancer, or is taking steroids or other medicines that could affect his immune system.
  •  
    Has had a seizure.
  •  
    Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher.
  •  
    Temperature rises above 104.0°F (40.0°C) repeatedly for a child of any age.

Also call your child’s doctor if

  •  
    Your child still “acts sick” once his fever is brought down.
  •  
    Your child seems to be getting worse.
  •  
    The fever persists for more than 24 hours in a child younger than 2 years.
  •  
    The fever persists for more than 3 days (72 hours) in a child 2 years or older.

Treating Your Child’s Fever

If your infant or child is older than 6 months and has a fever, she probably does not need to be treated for the fever unless she is uncomfortable. Watch her behavior. If she is drinking, eating, and sleeping normally and is able to play, you do not need to treat the fever. Instead, you should wait to see if the fever improves by itself. 

What you can do

  •  
    Keep her room comfortably cool.
  •  
    Make sure that she is dressed in light clothing.
  •  
    Encourage her to drink fluids such as water, diluted juices, or a store-bought electrolyte solution.
  •  
    Be sure that she does not overexert herself.
  •  
    See How to Improve Your Child’s Comfort With Medicine.

Taking Your Child’s Temperature

While you often can tell if your child is warmer than usual by feeling his forehead, only a thermometer can tell how high the temperature is. Even if your child feels warmer than usual, you do not necessarily need to check his temperature unless he has the other signs of illness described earlier. 
Always use a digital thermometer to check your child’s temperature (see Types of Digital Thermometers for more information, including guidance on what type of thermometer to use by age). Mercury thermometers should not be used. The AAP encourages parents to remove mercury thermometers from their homes to prevent accidental exposure and poisoning. 
Types of Digital Thermometers
Types of Digital Thermometersa
TypeHow It WorksWhere to Take the TemperatureAgeNotes
 

Digital multiuse thermometer

 

 

 

Reads body temperature when the sensor located on the tip of the thermometer touches that part of the body

 

Can be used to take rectal, oral, or axillary temperature

Rectal (in the bottom)Birth to 1 year
  •  
    The temperature that most pediatricians consider a sign of fever (100.4°F [38.0°C] or higher) is based on taking a rectal temperature.
  •  
    Label the thermometer “oral” or “rectal.” Don’t use the same thermometer in both places.
  •  
    Taking an axillary temperature is less reliable. However, this method may be used in schools and child care centers to check (screen) a child’s temperature when a child has other signs of illness. The temperature is used as a general guide.
Oral (in the mouth)4 to 5 years and older
Axillary (under the arm)Least reliable technique, but useful for screening at any age
 

Temporal artery thermometer

 

 

Reads the infrared heat waves released by the temporal artery, which runs across the forehead just below the skinOn the side of the forehead 

3 months and older

 

Before 3 months, better as a screening device than taking axillary (armpit) temperature

May be reliable in newborns and infants younger than 3 months, according to new research
 

Tympanic thermometer

 

 

Reads the infrared heat waves released by the eardrumIn the ear6 months and older
  •  
    Not reliable for babies younger than 6 months.
  •  
    When used in older children it needs to be placed correctly in the child’s ear canal to be accurate.
  •  
    Too much earwax can cause the reading to be incorrect.
NOTE: Temperature readings may be affected by how the temperature is measured and other factors (see What is a fever?). Your child’s temperature and other signs of illness will help your doctor recommend treatment that is best for your child. 

How to Use a Digital Multiuse Thermometer

Rectal Temperature

If your infant is younger than 1 year, taking a rectal temperature gives the best reading. Here is how to take a rectal temperature. 
  •  
    Clean the end of the thermometer with rubbing alcohol or soap and water. Rinse it with cool water. Do not rinse it with hot water.
  •  
    Put a small amount of lubricant, such as petroleum jelly, on the end.
  •  
    Place your child belly down across your lap or on a firm surface. Hold her by placing your palm against her lower back, just above her bottom. Or place your child face up and bend her legs to her chest. Rest your free hand against the back of the thighs.
  •  
    With the other hand, turn the thermometer on and insert it ½ inch to 1 inch into the anal opening. Do not insert it too far. Hold the thermometer in place loosely with 2 fingers, keeping your hand cupped around your child’s bottom. Keep it there for about 1 minute, until you hear the “beep.” Then remove and check the digital reading.
Be sure to label the rectal thermometer so it is not accidentally used in the mouth. 

Oral Temperature

Once your child is 4 or 5 years of age, you can take his temperature by mouth. Here is how to take an oral temperature. 
  •  
    Clean the thermometer with lukewarm soapy water or rubbing alcohol. Rinse with cool water.
  •  
    Turn the thermometer on and place the tip under your child’s tongue toward the back of his mouth. Hold in place for about 1 minute, until you hear the “beep.” Check the digital reading.
  •  
    For a correct reading, wait at least 15 minutes after your child has had a hot or cold drink before putting the thermometer in his mouth.

How to Improve Your Child’s Comfort With Medicine

Acetaminophen and ibuprofen are safe and effective medicines if used as directed for improving your child’s comfort, and they may also decrease her temperature. A prescription is not needed to use them, and they are available at grocery stores and drugstores. However, keep this in mind. 
  •  
    Acetaminophen should not be used for newborns and infants younger than 3 months unless recommended by your infant’s doctor.
  •  
    Ibuprofen should not be used for newborns and infants younger than 6 months. It should not be given to children who are vomiting constantly or are dehydrated.
  •  
    Do not use aspirin to treat your child’s fever or discomfort. Aspirin has been linked with side effects such as an upset stomach, intestinal bleeding, and Reye syndrome. Reye syndrome is a serious illness that affects the liver and brain.
  •  
    If your child is vomiting and cannot take anything by mouth, a rectal suppository may be needed. Acetaminophen comes in suppository form and can help reduce discomfort in a vomiting child.
  •  
    If your child is taking other medicines check the ingredients. If they include acetaminophen or ibuprofen, let your child’s doctor know.
  •  
    In 2011, manufacturers began replacing infant acetaminophen drops (80 mg/0.8 mL) with infant or children acetaminophen liquid (160 mg/5 mL). In 2017, manufacturers began making only 160 mg–strength acetaminophen chewable pills and tablets for children. Visit www.healthychildren.org/feverpain for more information. If giving acetaminophen, be sure to tell your child’s doctor if you are using infant drops (80 mg/0.8 mL), infant or children liquid (160 mg/5 mL), or chewable pills or tablets for children (160 mg).
NOTE: If your child is younger than 2 years, check with your child’s doctor before giving any medicine. Also, before giving any medicine, read the label to make sure that you are giving the right dose for your child’s age and weight. 

Do Not Use Sponging to Reduce a Fever

It is not recommended that you use sponging to reduce your child’s fever. There is no information that shows that sponging or tepid baths improve your child’s discomfort associated with a fever or an illness. Cool or cold water can cause shivering and increase your child’s temperature. Also, never add rubbing alcohol to the water. Rubbing alcohol can be absorbed into the skin or inhaled, causing serious problems such as a coma. 

About Febrile Seizures

In some children younger than 6 years, fever can trigger seizures. While this can be frightening, these seizures are usually harmless. During a seizure, your child may look strange for a few minutes, shake, and then stiffen, twitch, and roll his eyes. The color of his skin may also change and appear blue. If this happens 
  •  
    Place him on the floor or bed, away from any hard or sharp objects.
  •  
    Turn his head to the side so that any saliva or vomit can drain from his mouth.
  •  
    Do not put anything into his mouth, not even a finger.
  •  
    Call your child’s doctor.
Your child’s doctor will want to check your child, especially if it is your child’s first febrile seizure. It is important to look for the cause of the febrile seizure. 
If your child has had a febrile seizure in the past, treating your child with acetaminophen or ibuprofen when he has another fever will not prevent another febrile seizure from occurring. Discuss this at your child’s next well-child visit. 

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Digital thermometer drawings by Anthony Alex LeTourneau

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