How to tell if child has fever

What to Do When Your Child Has a Fever – Children's Health

Children’s Health May 18, 2015, 12:00:00 AM CDT Dec 1, 2022, 7:28:01 AM CST

Know the signs of a fever, how to bring down fever and when to see a doctor

When your child has a fever, it is a sign that their immune system is fighting off an infection. Reducing the fever will not get rid of the infection, but it can relieve some discomfort and allow for an opportunity to re-evaluate your child's symptoms.

Learn what temperature is considered a fever for a child, the best ways to reduce fever, and when to see a doctor or go to the emergency room (ER).

What temperature is a fever for a child?

A normal body temperature is about 98.6°F. A temperature of 100.4°F or higher is considered a fever for a child. Look for these signs that your child may have a fever:

Feels warmer than usual
Sweating
Shivering
Loss of appetite
General body aches
Fussiness or irritability

If you suspect your child has a fever, use a thermometer to take their temperature.

Which thermometer is the most accurate?

When choosing a thermometer, consider your child's age and your comfort level using the thermometer. When calling the doctor's office, be sure to mention the type of thermometer used, the body area from which the temperature was taken and the exact reading.

The American Academy of Pediatrics advises parents to stop using mercury thermometers to prevent accidental poisoning. It is easy to drop and break a glass/mercury thermometer and tempting for children to touch the exposed mercury.

Three recommended types of digital thermometers

Digital multiuse thermometer: Reads body temperature when the sensor on thermometer's tip touches the body. It can be used for rectal, oral or under the arm readings. Recommended for infants up to 3 years old (rectal) and 4 to 5 years and older (orally).
Temporal artery (forehead thermometer): Reads the infrared heat waves released by the temporal artery, which runs across the forehead. Recommended for children 3 months and older.
Tympanic (ear thermometer): Reads the infrared heat waves released by the eardrum. Readings are obtained by insertion in the ear. Recommended for 6 months and older.

How do you bring down a child's fever?

If your child has a fever, there are ways to provide relief and help reduce the fever:

Fluids: Offer plenty of fluids to drink. Prolonged fever can lead to dehydration.
Sponge bath: Apply a lukewarm sponge bath to help lower your child's temperature. Do not put your child in cold water or use rubbing alcohol to try to cool them off. Rubbing alcohol, inhaled or absorbed through the skin, can be toxic.
Dress: Remove unnecessary clothing to make your child feel comfortable. Dress your child in lightweight, breathable clothing.
Comfort: Cover with a light sheet if your child appears chilled.
Medicine: Consider using fever-reducing medication such as infant acetaminophen (Children's Tylenol) or infant ibuprofen (Children's Motrin). Check the label or call your pediatrician for the correct dosage for your child. Ibuprofen is not safe for infants under 6 months of age. Do not give aspirin to children 18 or younger.

When should you worry about a fever?

Call your primary care physician if your child is:

Younger than 3 months of age with a temperature of 100.4°F or higher
Age 3 to 6 months with a temperature up to 102°F and appears very lethargic or irritable (also, if the fever is higher than 102°F, without other symptoms)
Age 6 to 24 months with a temperature above 102°F, lasting more than a day.

If a fever does not respond to acetaminophen or ibuprofen and continues to persist, that is also a good time to seek medical care.

If your child has a fever and you are concerned they may have COVID-19, contact your health care provider for guidance. See advice for caring for a child with COVID‑19..

When should you take your child to the ER for a fever?

There is no one set temperature that a parent should worry about, as each child's body can react differently to a fever. While a high fever on its own may not warrant a trip to the ER, there are a variety of other symptoms to watch for. You should visit the ER if your child's high fever is accompanied by:

Difficulty breathing
Unresponsiveness
Dry lips or sunken eyes
Excess vomiting
Dehydration with increased urination

It can be scary when your child spikes a fever. However, fever alone is not a reason to panic. See 5 fever reducing tips from experts @Childrens.

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Childrens Health

Fevers (for Parents) - Nemours KidsHealth

All kids get a fever from time to time. Usually, a fever isn’t dangerous or bad for kids. It can even be a good thing because it can help the immune system fight infection.

Still, parents might be unsure about how to handle a fever at home and when to call the doctor. Here are some tips.

What Is a Fever?

In general, a fever means the body’s temperature is 100.4°F (38°C) or higher. Different ways of measuring a temperature — rectal, armpit, ear, forehead, mouth — get a slightly different number, so the number that means a child has a fever is a little different too.

What Causes Fevers?

Fevers in kids are usually caused by an infection. A fever helps the body by stimulating the immune system to fight the infection. Doctors also think the higher temperature makes it harder for the germs to grow.

A few other reasons kids can have a fever:

Overdressing: Infants, especially newborns, may get fevers if they're overdressed, wrapped in a blanket, or in a hot environment because they don't regulate their body temperature as well as older kids. But because fevers in newborns can be a sign of a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations: Babies and kids sometimes get a mild fever that lasts about a day after getting vaccinated.

A child who is teething might have a slight rise in body temperature, but it's probably not the cause if the temperature is higher than 100°F (37.8°C).

When Is a Fever a Sign of Something Serious?

In most healthy kids who are acting well, a fever isn’t serious.

But a fever can be serious for:

Infants younger than 3 months: If an infant younger than 3 months has a rectal temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department right away.
Kids with some health conditions: If your child has an ongoing health issue, make sure you know if the doctor should be called for fever.

A fever is probably not serious if your child is 3 months or older and:

is still interested in playing
is drinking well
is alert and smiling
has a normal skin color
looks well when their temperature comes down

Don't worry too much about a child with a fever who doesn't want to eat. This is common with infections that cause fever. For kids who still drink and urinate (pee) normally, not eating as much as usual is OK.

What Are the Signs of a Fever?

Kids with a fever might:

feel warm
act differently (they might be fussy or cranky, or quieter than usual)
breathe a little faster or have a faster heart rate than normal
have a headache
have chills or sweating
have red or flushed skin

For any of these signs, take your child’s temperature to know if they really have a fever.

If your child feels warm or is acting unwell, use a digital thermometer to confirm a fever. Different ways of taking the temperature are more accurate than others at measuring the true body temperature.

The best way to take a temperature:

for kids 3 years old and younger: a rectal temperature
for kids 4 or older who can cooperate: an oral temperature (by mouth)
for any age: under the armpit (axillary) and temporal artery (forehead) are easiest but less accurate. Tympanic (in the ear) is OK for kids 6 months and older.

It's a fever when a child's temperature is at or above one of these levels:

rectal (in the bottom), tympanic (in the ear), or temporal artery (across the forehead): 100.4°F (38°C)
oral (in the mouth): 100°F (37.8°C)
axillary (under the arm): 99°F (37.2°C)

How Can I Help My Child Feel Better?

No treatment is needed if a child is still playing and drinking normally and doesn’t have pain.

Treating a fever with medicine isn't needed if a child is still playing and drinking normally and doesn’t have pain. Give medicine only when a fever causes a child discomfort or keeps them from drinking.

While kids have a fever, keep an eye on them, help them to rest, and keep offering fluids to drink. They need to drink a little extra to make up for the fluids they lose from sweating.

Home Care Measures

Medicines

If your child is uncomfortable from a fever or not drinking fluids well, you can give one of these medicines:

acetaminophen (such as Tylenol or a store brand)
or
ibuprofen (such as Advil, Motrin, or a store brand). Do not give to children under 6 months old.

Follow the package directions for how much to give and how often. If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out what to use and how much to give.

If your child has any medical problems, check with the doctor to see which medicine to use.
Unless instructed to by a doctor, never give aspirin to a child. Such use is linked to Reye syndrome, a rare but serious illness.

Do not give any medicine for fever to infants younger than 3 months old unless instructed to by a doctor.

Staying Comfortable

If your child has a fever:

Have them wear lightweight clothing and stay covered with a light sheet or blanket. Heavy clothes and blankets can keep the body from cooling, which can make your child uncomfortable.
Keep the room at a comfortable temperature — not too hot or too cold.
Make sure they get plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.
They should stay home from school or childcare until their temperature has been normal for 24 hours.

Lukewarm sponge baths to lower a fever generally are not recommended. In fact, sponge baths can make kids uncomfortable from shivering. Never use rubbing alcohol (it can cause poisoning when absorbed through the skin) or ice packs/cold baths (they can cause chills that can raise body temperature).

Food and Drinks

Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids faster than usual. Oral rehydration solutions (like Pedialyle, Enfalyte, or store brands) are a good choice. You also can give water, soup, ice pops, and flavored gelatin. Avoid drinks with caffeine, including colas and tea, which can make dehydration worse by making kids pee more often.

Let kids eat what they want (in reasonable amounts), but don't force it if they don't feel like eating much.

When Should I Call the Doctor?

The temperature that should trigger a call to the doctor depends on a child's age, the illness, and whether they have other symptoms. You might ask if your doctor has specific guidelines on when to call about a fever.

In general, call the doctor if your child is:

younger than 3 months old with a rectal temperature of 100. 4°F (38°C) or higher
3 months or older with a temperature higher than 102.2°F (39°C)
any age but has a health problem like cancer or sickle cell disease and has a fever

Also call if a child 3 months or older has a fever and:

refuses fluids or seems too ill to drink enough
has lasting diarrhea or repeated vomiting
has any signs of dehydration (peeing less than usual, not having tears when crying, less alert and less active than usual)
has a specific complaint (like a sore throat or earache)
still has a fever after 2–3 days
has a rash
has pain while peeing

Get emergency care if your child shows any of these signs:

crying that won't stop
extreme irritability or fussiness
sluggishness and trouble waking up
a rash or purple spots that look like bruises on the skin (that were not there before your child got sick)
blue lips, tongue, or nails
in an infant, the soft spot on the head seems to be bulging out or sunken in
stiff neck
severe headache
limpness or refusal to move
trouble breathing that doesn't get better when the nose is cleared
leaning forward and drooling
seizure
moderate to severe belly pain

What Else Should I Know?

All kids get fevers, and in most cases they're back to normal within a few days. For older babies and kids, the way they act can be more important than the reading on your thermometer. Everyone gets a little cranky when they have a fever. This is normal and should be expected.

But if you're ever in doubt about what to do or what a fever might mean, or if your child is acting ill in a way that concerns you even with no fever, always call your doctor for advice.

Reviewed by: Melanie L. Pitone, MD

Date reviewed: November 2022

REMINDER FOR PARENTS

Child has fever. What to do?

1 If your child's temperature suddenly rises (he was still healthy an hour ago), do not panic. As a rule, this is an acute respiratory disease, because it is ARI that makes up about 90% of childhood infections.

2. If the day before the child already had symptoms of infection (malaise, runny nose, sore throat, cough, voice change, moderate pain in the abdomen), then this is most likely a manifestation of the child's body's protective reaction to this infection .

3. If the child tolerates elevated body temperature well up to 39-39.60, is older than 6 months, and does not have serious concomitant diseases, then do not rush to reduce it. Make sure your child has enough to drink for adequate perspiration (drinking temperature should be around body temperature for rapid absorption). The air in the room should be cool (18-200) to cool the upper respiratory tract, as well as the entire body of the child. Under no circumstances should babies be wrapped.

4. If the child does not tolerate fever or has a severe concomitant pathology, we begin to reduce the temperature, or rather, we strive to improve the child's well-being. For this, a decrease in temperature to the norm is not required (remember the protective role of elevated temperature). We use drugs ibuprofen and paracetamol (trade names may be different) approved for children in the Russian Federation in the form of syrups, drops, suppositories and tablets. The main thing is not to exceed the recommended daily dose of the drug. To improve well-being, the minimum dose of the drug indicated in the instructions may be sufficient. Typically, drug-resistant fevers are associated with the child's inability to sweat (drinks little or the child has a "pale" type of fever).

What should not be done when the temperature is high?

• Do not wrap up the child

• If he is pale and his extremities are cool ("pale" type of fever), do not use ice and cold water for cooling

• Do not use aspirin, analgin, etc., to reduce body temperature, drugs not approved for fever in children

How soon should the child be seen by a doctor?

If the child's health does not suffer (especially after the temperature drops), you can see a doctor the next day. The best option would be to go directly to the clinic at the place of residence, then the doctor will have the opportunity to timely conduct laboratory and instrumental examinations. Call an ambulance if your child has the following symptoms:

• Severe pallor, discoloration of the skin pattern, acute bluish-purple rash

• The child is very lethargic and refuses to drink, the child loses fluid with vomiting or loose stools

• The child has heavy groaning breathing, difficulty inhaling or exhaling

• A child under 3 years of age has no other symptoms of the disease, and the state of health suffers

• Severe pain in the abdomen, especially if they are accompanied by pallor and sweating

• The child has confusion, delirium, convulsions, headache with vomiting

• Fever of 400 and above, which cannot be reduced by 1-2 degrees after the use of antipyretics at the recommended dose and physical cooling methods

• The child's condition worsens, does not looking at the decrease in temperature

Children from 0 to 5 years. When should you urgently take your child to the doctor?

We are all very worried when a child gets sick; including the fear that he will certainly be sent to the hospital. And the children's hospital, as you know, is like this: you get in with one, you leave with another. That is why mothers often refuse hospitalization or postpone a visit to the doctor, hoping that the disease will recede on its own, others prefer online consultations on forums and advice from grandmothers and girlfriends.

Fortunately for all mothers, in most cases modern medicine makes it possible to diagnose and provide the necessary assistance very quickly, resorting to hospitalization only as a last resort. Something like in the famous series with Hugh Laurie - and MRI, and all the necessary tests, and CT scans, and, most importantly, competent pediatricians and highly specialized specialists. Unfortunately, not all polyclinics have such a set, but in one place in Moscow they definitely have it - in the department of emergency pediatrics of the Federal State Autonomous Institution "NMIC for Children's Health" of the Ministry of Health of Russia, where doctors usually need no more than 2 hours to establish an accurate diagnosis, taking all the necessary analyzes and quickly receive their results, stabilize the child and send him home if there is no threat to life and indications for emergency hospitalization.

If you understand that your child needs a prompt consultation of a specialist, but for some reason you postpone a visit to the doctor, if you are afraid that the child will be immediately sent to the hospital ward “to clarify the diagnosis”, or he will not be given due Attention, just come to the pediatric emergency department of the Federal State Autonomous Institution "NMIC of Children's Health" of the Ministry of Health of Russia. Here they immediately do all the necessary research and provide the child with assistance as efficiently and quickly as possible. Every year, more than 3,000 children receive care in the department, and only 2% of them are hospitalized by doctors in a round-the-clock hospital. The rest are sent home after all the necessary procedures with appropriate recommendations, or will be observed for several days in a day hospital. The department accepts children without an appointment, works on CHI, VHI and on a commercial basis.

If your child is between 0 and 5 years old, do not neglect visits to the doctor because your child is at risk. It is this age that accounts for most of the serious diseases that are well studied by medicine, are well treated, but require prompt medical intervention. Tatyana Vladimirovna Kulichenko, Head of the Department of Emergency Pediatrics, FGAU "NMIC of Children's Health" of the Ministry of Health of Russia, Doctor of Medical Sciences, pediatrician of the highest category, WHO expert, spoke about the cases in which it is worth immediately contacting specialists for young children (we are talking about children first 5 years of life).

High temperature (fever)

First, it is important to define what a fever is from a doctor's point of view. Fever is an increase in body temperature greater than 38°C if measured rectally (preferred as this is the most reliable way to determine body temperature in any person) and greater than 37.5°C if measured axillary depression.

Not every fever is a very bad sign, but with children under three years old it is better to play it safe and see a doctor as soon as possible. There are no legislative "terms of patience"; there is no need to wait three days, as pediatricians usually say: all the most severe infections develop very quickly and can be threatening from the first hours of the illness. The sooner you contact a specialist, the better. Examination of the child, instrumental and laboratory studies will help to understand the cause of the fever and quickly stabilize the child's condition.

If just a high temperature seems to you not enough reason to see a doctor, then pay attention to the symptoms of intoxication:

The child refuses to drink (not to eat, namely to drink).
There is lethargy and drowsiness, it is difficult to establish eye contact with the child (some pediatricians say about such patients "the child looks into himself").

If a child develops a rash on the skin along with an increase in body temperature, then you should go to the doctor immediately.

Cough

Cough is a fairly common symptom in children. Precisely because it seems to be a common, “understandable” sign of illness, parents often miss the moment of timely visit to the doctor. Cough can be caused not only by problems with the organs of the respiratory system. It can signal a malfunction in the cardiovascular or digestive systems. It can even be caused by a sulfur plug in the ear. Until you eliminate the cause, the symptom will not disappear!

Take your child to the doctor immediately if:

The child is less than 6 months old (whether or not he has a fever or other symptoms).
The child has a nocturnal cough.
The child has a cough to vomit.
Cough does not go away for more than 3 weeks.
Barking cough, often accompanied by hoarseness and noisy breathing.

Difficulty breathing

Any difficulty in breathing can be a life-threatening symptom, especially in infants. How to understand that breathing is difficult in an infant: when inhaled, retraction is visible along the edge of the costal arch (the child, as it were, strongly draws in the stomach when breathing). Difficulty in breathing in older children can be noticed if there is no fluency of speech: the child cannot speak in long sentences (as a rule, these are obstructive bronchitis or asthmatic conditions).

Take your child to the doctor immediately if you notice signs of difficulty breathing, especially if the breath is grunting, groaning or you hear wheezing or wheezing when breathing even from a distance.

Vomiting, diarrhea (diarrhea, loose stools)

These symptoms are often associated with simple and well-known conditions that are caused by extremely unpleasant, but in modern conditions, with proper treatment, non-life-threatening intestinal infections. But if the child is not fed with special solutions for rehydration, if the volume of fluid losses is not replenished correctly, then vomiting and liquefied stools are dangerous because they lead to rapid dehydration and electrolyte disturbances due to loss of water and salts.

It happens that loose stools are not a serious problem if it happened, for example, once. If you observe it more often 3 times a day, this is a reason to sound the alarm, especially if you notice the first signs of dehydration:

Decreased frequency and volume of urination. If your child has not peed for 5 hours, see a doctor immediately!
Dryness of the skin and mucous membranes: there are fewer tears, saliva, the skin has become dry and unusually flabby.
Thirst.

When to take the child to the doctor immediately:

The child refuses to drink (does not want to drink despite being very dehydrated).
The child stops urinating (break more than 5 hours).
The child is lethargic, capricious, not interested in toys (even if there is no temperature).
"Sink" eyes or fontanel (this is rare, but it is a formidable symptom).
There is blood in the stool (even if there is no diarrhea).

Skin rashes

Skin rashes are not always normal. If the rash is accompanied by fever, this is always a reason for urgent medical attention. There are children diagnosed with skin diseases (for example, atopic dermatitis or psoriasis), in which case the parents are usually already trained on how to behave when the rash increases or the skin process worsens. Then you need to go to the doctor if the measures taken previously recommended to you turn out to be ineffective - and you will most likely go to an allergist or dermatologist, i.e. to a specialist you know. But if the rash appeared for the first time, if the rashes are not associated with understandable provoking factors, this is an occasion to consult a doctor. Not all rashes are a sign of a serious illness, but a clear diagnosis by a specialist will calm you down and allow you to quickly deal with the problem.

Pain

Pain is always a symptom of anxiety, which the human body signals about danger. An intense and growing pain symptom is always a reason to consult a specialist.