How to tell if your child has a fever

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

Children’s Health May 18, 2015, 12:00:00 AM CDT Sep 19, 2022, 10:58:35 AM CDT

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. A fever itself usually causes no harm and can actually be a good thing — it's often a sign that the body is fighting an infection.

But when your child wakes in the middle of the night flushed, hot, and sweaty, it's easy to be unsure of what to do next. Should you get out the thermometer? Call the doctor?

Here's more about fevers, including when to contact your doctor.

What Is a Fever?

Fever happens when the body's internal "thermostat" raises the body temperature above its normal level. This thermostat is found in a part of the brain called the hypothalamus. The hypothalamus knows what temperature your body should be (usually around 98.6°F/37°C) and will send messages to your body to keep it that way.

Most people's body temperatures change a little bit during the course of the day: It's usually a little lower in the morning and a little higher in the evening and can vary as kids run around, play, and exercise.

Sometimes, though, the hypothalamus will "reset" the body to a higher temperature in response to an infection, illness, or some other cause. Why? Researchers believe that turning up the heat is a way for the body to fight the germs that cause infections, making it a less comfortable place for them.

What Causes Fevers?

It's important to remember that fever by itself is not an illness — it's usually a sign or symptom of another problem.

Fevers can be caused by a few things, including:

Infection: Most fevers are caused by infection or other illness. A fever helps the body fight infections by stimulating natural defense mechanisms.

Overdressing: Infants, especially newborns, may get fevers if they're overbundled or in a hot environment because they don't regulate their body temperature as well as older kids. But because fevers in newborns can indicate 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 low-grade fever after getting vaccinated.

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

When Is a Fever a Sign of Something Serious?

In healthy kids, not all fevers need to be treated. High fever, though, can make a child uncomfortable and make problems (such as dehydration) worse.

Doctors decide on whether to treat a fever by considering both the temperature and a child's overall condition.

Kids whose temperatures are lower than 102°F (38.9°C) often don't need medicine unless they're uncomfortable. There's one important exception: If an infant 3 months or younger has a rectal temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in very young babies.

If your child is between 3 months and 3 years old and has a fever of 102.2°F (39°C) or higher, call to see if your doctor needs to see your child. For older kids, take behavior and activity level into account. Watching how your child behaves will give you a pretty good idea of whether a minor illness is the cause or if your child should be seen by a doctor.

The illness is probably not serious if your child:

is still interested in playing
is eating and drinking well
is alert and smiling at you
has a normal skin color
looks well when his or her temperature comes down

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

Is it a Fever?

A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature (called tactile temperature) won't give an accurate measurement.

Use a reliable digital thermometer to confirm a fever. It's a fever when a child's temperature is at or above one of these levels:

measured orally (in the mouth): 100°F (37.8°C)
measured rectally (in the bottom): 100.4°F (38°C)
measured in an axillary position (under the arm): 99°F (37.2°C)

But how high a fever is doesn't tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102°–104°F/38. 9°–40°C range), but this doesn't usually mean there's a serious problem. In fact, a serious infection, especially in infants, might cause no fever or even a low body temperature (below 97°F or 36.1°C).

Because fevers can rise and fall, a child might have chills as the body's temperature begins to rise. The child may sweat to release extra heat as the temperature starts to drop.

Sometimes kids with a fever breathe faster than usual and may have a faster heart rate. Call the doctor if your child has trouble breathing, is breathing faster than normal, or is still breathing fast after the fever comes down.

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How Can I Help My Child Feel Better?

Again, not all fevers need to be treated. In most cases, a fever should be treated only if it's causing a child discomfort.

Here are ways to ease symptoms that often accompany a fever:

Medicines

If your child is fussy or uncomfortable, you can give acetaminophen or ibuprofen based on the package recommendations for age or weight. (Unless instructed by a doctor, never give aspirin to a child due to its association with Reye syndrome, a rare but potentially fatal disease.) If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out how much to give.

Infants younger than 2 months old should not be given any medicine for fever without being checked by a doctor. If your child has any medical problems, check with the doctor to see which medicine is best to use. Remember that fever medicine can temporarily bring a temperature down, but usually won't return it to normal — and it won't treat the underlying reason for the fever.

Home Comfort Measures

Dress your child in lightweight clothing and cover with a light sheet or blanket. Overdressing and overbundling can prevent body heat from escaping and can cause the temperature to rise.

Make sure your child's bedroom is a comfortable temperature — not too hot or too cold.

While some parents use lukewarm sponge baths to lower fever, this method only helps temporarily, if at all. In fact, sponge baths can make kids uncomfortable. 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 more rapidly than usual. Water, soup, ice pops, and flavored gelatin are all good choices. Avoid drinks with caffeine, including colas and tea, because they can make dehydration worse by increasing urination (peeing).

If your child also is vomiting and/or has diarrhea, ask the doctor if you should give an electrolyte (rehydration) solution made especially for kids. You can find these at drugstores and supermarkets. Don't offer sports drinks — they're not made for younger children and the added sugars can make diarrhea worse. Also, limit your child's intake of fruits and apple juice.

In general, let kids eat what they want (in reasonable amounts), but don't force it if they don't feel like it.

Taking it Easy

Make sure your child gets plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.

It's best to keep a child with a fever home from school or childcare. Most doctors feel that it's safe to return when the temperature has been normal for 24 hours.

When Should I Call the Doctor?

The exact temperature that should trigger a call to the doctor depends on a child's age, the illness, and whether there are other symptoms with the fever.

Call your doctor if you have an:

infant younger than 3 months old with a rectal temperature of 100.4°F (38°C) or higher
older child with a temperature of higher than 102.2°F (39°C)

Also call if an older child has a fever of lower than 102.2°F (39°C) but also:

refuses fluids or seems too ill to drink adequately
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 24 hours (in kids younger than 2 years old) or 72 hours (in kids 2 years or older)
is getting fevers a lot, even if they only last a few hours each night
has a chronic medical problem, such as heart disease, cancer, lupus, or sickle cell disease
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
infant's 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

Also, ask if your doctor has specific guidelines on when to call about a fever.

What Else Should I Know?

All kids get fevers, and in most cases they're completely 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 if there's no fever, always call your doctor for advice.

Reviewed by: Joanne Murren-Boezem, MD

Date reviewed: September 2018

Children from 0 to 5 years old. 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 with a specialist, but for some reason you postpone the 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 the point of vomiting.
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 whistling 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 were fewer tears, saliva, the skin became 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. Remember that if a child is "teething" - this may be the cause of the child's capriciousness and irritability, but in the vast majority of cases it does not cause a temperature rise above 37.5 * C or severe pain. Therefore, you should not write off the symptoms that have appeared on teething.

How to understand that a child is in pain:

The child cries, does not calm down.
Unmotivated excitability.
Anxiety (the child cannot find peace, a comfortable position).

Head injuries and loss of consciousness

Very often, parents go to the doctor only when the injury leaves traces (hematoma, swelling). If the child fell from a certain height (even if you did not see what exactly he hit), or he hit his head, do not be too lazy to immediately go to a specialist. Not every head injury can pass without a trace, and, most importantly, you may not see the internal damage that occurred during the injury.

An episode of loss of consciousness, "slackness" or convulsions is always a cause for immediate medical attention.

You can read more about the Department of Emergency Pediatrics of the National Medical Research Center for Children's Health on the official website >>>

High fever in a child: causes and treatment

It is very difficult for every parent to watch their child get sick. High fever is just a symptom of the disease, not the disease itself.

The child has a high temperature - Causes

Your child has a fever. What could have caused it?

When we talk about a fever in a child, we are not just talking about being hot or cold, if the temperature exceeds 37. 4 °C, then you are dealing with a fever. ^1.2

Fever in children can be unpleasant. It is very difficult for every parent to watch their child get sick, especially when the baby is very young. Fever is just a symptom of the disease, not the disease itself.

Why is the temperature rising?

Body temperature rises if (non-exhaustive list):

There is an infection (viral or bacterial) in the body.
The child had an allergic reaction to a drug or vaccine.
Your baby is teething.

Symptoms to look out for in children

When an infection occurs inside our body, the immune system releases certain chemicals that raise the body temperature. This helps fight infection, as viruses and bacteria are more easily destroyed at high temperatures. Despite the fact that fever is a traditional reaction of the body, it is quite difficult for your child to endure it. The clinical picture of a fever may include:

Sweating
Chills
General lethargy, irritability, crying or apathy
Redness on the skin
Nausea, dizziness
Headache
Body pain
General weakness
Convulsions due to fever (in a small percentage of children, especially between the ages of 6 months and 5 years). Seek medical attention as soon as possible.

What can help a child cope with a fever?

It is important to keep a thermometer handy at all times. If you find that the temperature of the child is above normal, you should contact the first aid kit at home to help him. But if the temperature of the baby exceeded 39°C, or just stays at 38 °C long enough, you should see a doctor immediately.

Simple ways to bring down the temperature without medical intervention:

Let the child lie quietly for a while.
The child needs to drink a lot if possible. This will help avoid dehydration.
Wear light clothing to your child to avoid overheating. Lay bed linen and blankets made from light, natural fabrics.
A feverish child should be opened, wiped with water at T° 25-30°C.

Children's medicines

There are many different medicines on the market today to help you and your child manage a fever. Drugs to reduce fever are called antipyretics. Their action is aimed at reducing the amount of certain compounds produced by our body, called prostaglandins. In order to reduce the temperature in children, it is permissible to use 2 drugs - paracetamol or ibuprofen.

Nurofen® for children is one of the proven remedies for fever. Its active ingredient is ibuprofen, which reduces the production of prostaglandins, thereby helping to relieve pain and lower fever.

Ibuprofen is one of the drugs recommended as antipyretic therapy in children, including for COVID-19 - according to the following recommendations approved by the Russian Ministry of Health:

Clinical guidelines "Influenza in children", 2017 Russia)
Guidelines "Peculiarities of clinical manifestations and treatment of the disease caused by a new coronavirus infection (COVID-19) in children. Version 2 (07/03/2020)" (approved by the Russian Ministry of Health) ^*

^* Regular (course) intake of antipyretic drugs is not indicated, a second dose is administered only after a new increase in temperature. Paracetamol and ibuprofen can be taken orally or as rectal suppositories, and intravenous paracetamol is also available. The alternation of these two antipyretics or the use of combined drugs is not recommended due to the greater incidence of side effects.

Some important facts about Nurofen® for children:

Nurofen® for children begins to act after 15 minutes and is active up to 8 hours.
The product complies with all applicable requirements and quality standards.
The drug has an optimal safety profile.
Easy to use:
- Possibility of dosage depending on the age of the child
- Nurofen® Oral Suspension for Children has a pleasant taste (strawberry or orange) and odor and is easy to swallow

On our website you can learn about children's drugs to reduce fever, as well as get additional important tips on what to do if your child is sick.

If your child has a fever, don't panic.