What is a temperature in an infant

Fever (0-12 Months)

Is this your child's symptom?

An abnormal high body temperature
Fever is the only symptom. Your child has a true fever if:
Rectal (bottom), Ear or Forehead temperature: 100.4° F (38.0° C) or higher
Under the arm (armpit) temperature: 99° F (37.2° C) or higher
Caution: Ear temperatures are not accurate before 6 months of age
Caution: Forehead temperatures must be digital. Forehead strips are not accurate.

Causes of Fever

Overview. Almost all fevers are caused by a new infection. Viruses cause 10 times more infections than bacteria. The number of germs that cause an infection are in the hundreds. Only a few common ones will be listed.
Viral Infections. Colds, flu and other viral infections are the most common cause. Fever may be the only symptom for the first 24 hours. The start of viral symptoms (runny nose, cough, loose stools) is often delayed. Roseola is the most extreme example. Fever may be the only symptom for 3 to 5 days. Then a rash appears.
Bacterial Infections. A bladder infection is the most common cause of silent fever in girls.
Vaccine Fever. Fever with most vaccines begins within 12 hours. It lasts 2 to 3 days. This is normal and harmless. It means the vaccine is working.
Newborn Fever (Serious). Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment.
Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can't be consoled. If not treated early, can suffer brain damage.
Overheated. The fever is usually low grade. Can occur during heat waves or from being overdressed. The temp becomes normal in a few hours after moving to a cooler place. Fever goes away quickly with rest and drinking extra fluids.
Not Due to Teething. Research shows that "getting teeth" does not cause fevers.

Fever and Crying

Fever on its own shouldn't cause much crying.
Frequent crying in a child with fever is caused by pain until proven otherwise.
Hidden causes can be ear infections, kidney infections, sore throats and meningitis.

Normal Temperature Range

Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range.

When to Call for Fever (0-12 Months)

Call 911 Now

Not moving
Can't wake up
Severe trouble breathing (struggling for each breath; can barely speak or cry)
Purple or blood-colored spots or dots on skin
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Trouble breathing, but not severe
Great trouble swallowing fluids or spit
Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
Fever over 104° F (40° C)
Shaking chills (shivering) lasting more than 30 minutes
Nonstop crying or cries when touched or moved
Won't move an arm or leg normally
Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Age 3-6 months old with fever
Age 6-12 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea).
Fever lasts more than 3 days
Fever returns after gone for more than 24 hours
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

You have other questions or concerns

Self Care at Home

Fever with no other symptoms and your child acts mildly ill

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Fever

What You Should Know About Fever:
- Having a fever means your child has a new infection.
- It's most likely caused by a virus.
- You may not know the cause of the fever until other symptoms develop. This may take 24 hours.
- For infants more than 3 months old, most fevers are good for sick children. They help the body fight infection.
- Use the ranges below to help put your child's level of fever into perspective:
- 100° - 102° F (37.8° - 39° C) Low grade fever: helpful, good range. Don't treat.
- 102° - 104° F (39 - 40° C) Average fever: helpful. Treat if causes discomfort.
- Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat.
- Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high.
- Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful.
Treatment for All Fevers - Extra Fluids:
- Fluids alone can lower the fever. Reason: being well hydrated helps the body give off heat through the skin.
- For shivering (or the chills), give your child a blanket. Make them comfortable.
- Offer your child extra water or other fluids by mouth. Cold fluids are better. Until 6 months old, only give extra formula or breastmilk.
- For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin.
- For shivering (or the chills), give your child a blanket. Make them comfortable.
- Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: Babies can get over-heated more easily than older children.
Fever Medicine:
- Caution: Do not give a baby under 3 months any fever medicine. Most of these babies will need to be seen.
- For fevers 100°-102° F (37.8° - 39°C), fever meds are not needed. Reason: fevers in this range help the body fight the infection. Fevers turn on the body's imune system. Fevers don't cause any discomfort.
Give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil) if over 6 months old.
Goal of treatment: keep the fever at a helpful level. Most often, the fever meds lower the fever by 2° to 3° F (1 - 1. 5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect.
Do not use aspirin. Reason: Risk of Reye syndrome, a rare but serious brain disease.
Do not use both acetaminophen and ibuprofen together. Reason: Not needed and a risk of giving too much.
Pain: fever does not cause pain. If your child also has pain, it's from the infection. It may be a sore throat or muscle pain. Treat the pain, if it's more than mild.
Return to Child Care:
- Your child can return to child care after the fever is gone. Your child should feel well enough to join in normal activities.
What to Expect:
- Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
- They may last for 2 or 3 days.
- They are not harmful.
Call Your Doctor If:
- Your child looks or acts very sick
- Any serious symptoms occur such as trouble breathing
- Fever goes above 104° F (40° C)
- Any fever occurs if less than 12 weeks old
- Fever without other symptoms lasts more than 24 hours
- Fever lasts more than 3 days (72 hours)
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/02/2022

Last Revised: 09/18/2022

Signs of a Fever, Safe Temperatures, Taking Temperature

In this Article

A fever in babies can be one of the scariest symptoms for parents, especially when that fever is high or the baby is only a few weeks old.

Here's what causes infant fevers and what to do when your baby gets a fever.

What Causes Infant Fevers?

A fever isn't an illness -- it's considered a symptom of one. A fever usually means that the body is fighting an illness and the immune system is working. If your baby has a fever, in most instances it means they have probably picked up a cold or other viral infection. Although they are less common in infants, pneumonia, urinary tract infections, ear infections, or a more serious infection such as a blood bacterial infection or meningitis may be causing a fever.

Other causes of fever in babies include:

Reaction to a vaccination
Becoming overheated from being dressed too warmly or spending too much time outside on a hot day

Fever in Babies: What Are the Signs?

Your baby may act differently, and they may also be crankier and fussier than usual.

Other symptoms of a fever in babies include:

Poor sleeping
Poor eating
Lack of interest in play
Less active or even lethargic
Convulsions or seizures

How Do I Take My Baby's Temperature?

You can take a child's temperature a few different ways, such as via the rectum (rectally), mouth (orally), ear, under the arm (axillary), or at the temples. The American Academy of Pediatrics (AAP) recommends only using digital thermometers in children. Mercury thermometers should not be used because they pose a risk of mercury exposure and poisoning if they break.

Rectal thermometers provide the most accurate temperature readings and can be easiest to take in an infant.

To take a rectal temperature, first make sure the thermometer is clean. Wash it with soap and water or wipe it with rubbing alcohol. Lay your baby on their belly or on their back with legs bent toward the chest. Apply a little bit of petroleum jelly around the thermometer bulb and gently insert it into the rectal opening. Hold the digital thermometer in place for about 2 minutes until you hear the beep. Then gently remove the thermometer and read the temperature.

At What Temperature Does My Baby Have a Fever?

A baby's normal temperature can range from about 97 to 100.3 degrees Fahrenheit. Most doctors consider a rectal temperature of 100.4 F or higher as a fever.

When to Call Your Doctor

According to the AAP, call your doctor if your baby:

Is under age 3 months and has a fever; if your baby is under 2 months and has a fever, it is considered an emergency. Seek immediate medical care.
Is lethargic or not responsive
Has problems breathing or eating
Is very cranky, fussy, or difficult to calm down
Has a rash
Shows signs of dehydration, such as fewer wet diapers, dry mouth, no tears with crying, or sunken soft spot on the head
Has a seizure

It can be hard for doctors to tell whether a newborn has a simple virus (like a cold) or a more serious infection (like a UTI, pneumonia, or meningitis). That's why doctors will sometimes order special tests (such as blood or urine tests, a chest X-ray, or a spinal tap) to pinpoint the cause of an infant's fever.

What Should I Do If My Baby Has a Fever?

If your baby is under age 1 month and has a fever, contact your child's doctor right away. For older babies, try these tips:

Bathe your child with lukewarm water. Always check the temperature of the water on your wrist before washing your baby.
Dress your baby in a light layer of clothes.
Give your baby enough fluids to avoid dehydration. Those fluids should be breast milk, formula, an electrolyte solution, or water, depending on the baby’s age. Ask your baby's doctor for guidelines. A dehydrated baby may have fewer wet diapers, no tears with crying, or a dry mouth.
If your child is older than 6 months and your doctor says it is OK, you can give your baby either children's acetaminophen or children's ibuprofen. Never give babies aspirin because of the risk for a rare but dangerous condition called Reye's syndrome. Also, do not give a baby under age 6 months any medicines that contain ibuprofen. Be sure to ask your doctor about the dosage and read the package instructions before giving your baby a fever-reducing medicine.

If you are concerned about your baby's fever, call your doctor for advice and reassurance.

SOURCES:

Merck Manual: "Fever."

American Academy of Pediatrics: "How to Take a Child's Temperature."

The Journal of the American Medical Association, March 10, 2004.

Kidshealth.org: "Fever and Taking Your Child's Temperature."

Normal values of body temperature in children, measurement of the child's body temperature

It is believed that a healthy child should have a body temperature of 36.6 °C. And its increase over 37 degrees is regarded as a sign of illness. But it is not so.

Body temperature depends on age and measurement area. It can increase after physical exertion, emotional arousal and feeding.

Devices and time for measuring body temperature

To determine the temperature, the following types of thermometers are used:

digital;
mercury;
infrared.

The optimal time for thermometry is 7-9 am and 17-19 pm. As prescribed by the doctor, the determination of the temperature during the day in children can be performed 3-4 times.

What temperature is considered normal for a child?

Immediately after the birth of a newborn, the temperature of his body decreases by 1-2 ° C, then within 24 hours it rises to 36-37 ° C. In the first 3 months of a baby's life, its indicators are unstable and depend on external factors: air temperature in the room, sleep, food intake. Normally, these fluctuations do not exceed 0.6 °C per day. For children of the first year of life, a temperature of 37.7 is the norm.

The average body temperature for a child is 37°C. Usually in the morning - 36.3 ° C, and in the evening it can rise to 37.6 ° C.

In what areas can the temperature of children be taken?

Underarm

The temperature measurement time under the arm is 5-10 minutes and depends on the type of device.

In the rectum

It is used in children under 5 years of age and in debilitated patients. For this method, it is desirable to use medical electronic thermometers with a soft tip. It will take 1-1.5 minutes to determine the rectal temperature.

Oral

The procedure is performed both under the tongue and behind the cheek. Contraindications to the use of this method are: children under 4-5 years of age, increased excitability and impaired nasal breathing. The duration of temperature measurement by the oral method is from 10 seconds to 3 minutes.

In the ear

The temperature in the ear is measured with an infrared sensor. The tip of the thermometer is inserted into the ear canal and the result appears on the display.

On forehead

Forehead temperature can be measured with a contact and non-contact thermometer. It will take 3 to 5 seconds to get the result. If the baby is sleeping or excited, then it is more convenient to use a non-contact method for measuring temperature.

Crotch

Mainly used in infants. The measurement time in the inguinal fold is 5 minutes. The method is inconvenient because the baby is not easy to keep in one position during this time.

Ranges of normal temperature in children depending on age and area of measurement are presented in the following table:

	0-2 years	3-10 years	11-18 years old
In the armpit	34. 7 - 37.2	35.8 - 36.6	35.1 - 36.8
On the forehead	36.7 - 37.5	36.7 - 37.5	36.5 - 37.4
in the ear	36.3 - 37.7	36.3 - 37.7	36.7 - 37.8

If a child has a fever, what should I do?

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Kurilova Alina Petrovna Pediatrician

14.05.2019

Before you start taking antipyretics, you need to answer a few questions:

what is the age of the child?
How does a child tolerate an increase in a particular temperature?
Have there been any family or child history of febrile seizures?
Are there any other symptoms of the disease besides fever?

An increase in temperature or fever is a protective and adaptive reaction of the body in response to the effects of pathogenic stimuli, which results in a restructuring of thermoregulation processes, leading to an increase in body temperature, which stimulates the body's natural resistance.

An increase in temperature affects the child's body both positively and negatively.

The positive effect of is that when the temperature rises in the child's body, the immune system is activated, phagocytosis increases, the production of antibodies increases and the level of interferon increases, which helps to stop the reproduction of pathogenic microorganisms and overcome the infection.

Negative influence high temperature per child is manifested in the occurrence of convulsions (febrile), an increased load on the baby's cardiopulmonary system (heart rate and respiratory rate become more frequent). Therefore, fever is dangerous for children with malformations of the heart and bronchopulmonary system, heart rhythm disturbance. Also, when the temperature rises, the work of the brain, liver, stomach, kidneys and other internal organs suffers, which is dangerous for children with chronic pathologies of internal organs, symptoms of dehydration, developmental disorders and diseases of the nervous system.

Fever varies:

with the flow:
- acute (fever up to 2 weeks),
- subacute (up to 6 weeks),
- chronic (over 6 weeks).
by the degree of increase of the indicator:
- subfebrile (increase to +38.0 degrees)
- febrile (from +38.0 to +39.0 degrees),
- pyretic (from + 39.0 to + 41.0 degrees),
- hyperpyretic (over +41.0 degrees).
according to the type of temperature curve:
- constant (temperature fluctuations during the day are not higher than 1 degree).
- laxative (daily fluctuations up to 2 degrees),
- atypical (fluctuations are chaotic, different and irregular),
- debilitating (a combination of laxative and atypical fever with fluctuations during the day more than 2-3 degrees),
- intermittent (a combination of short periods of temperature increase and decrease to normal numbers),
- return (alternation of periods of temperature increase with periods of temperature normalization from 2 to 7 days).

On the recommendation of the WHO (World Health Organization), antipyretics are prescribed for children according to age:

from the moment of birth to 2 months at a temperature of +38.0 degrees,
children from 3 months to 24 months at a temperature of +38.5 degrees,
children from 1 to 5 years old at a temperature of +39.0 degrees,
children over 5 years old with indicators of + 39.5- + 40.0 degrees.

On the other hand, the approach to each child should be individual.

If a child

restless or feeling weak,
cannot tolerate muscle pain, headache,
have nausea,
no appetite,

then you must first apply physical methods to improve the well-being of the child :

put to bed - so the body will save strength to fight the infection, calm the child;
drink fractionally with water or sweetened warm herbal tea with chamomile, linden, cranberry juice;
provide access to fresh air;
to feed in the presence of appetite in small portions of warm food (for example, soup, liquid porridge on the water, a light breakfast).

Also, according to the clinical variant of the course of fever, apply additional cooling measures.

With "red" or "pink" fever

the child's body feels hot to the touch,
skin red or pink, moist,
the child himself does not complain about his well-being, he is active, his appetite does not disappear.

In this case, child needs

undress,
wipe with a towel soaked in water at room temperature,
apply a cool compress to the forehead,
drink water at room temperature
and be sure to call a doctor.

With "white or pale" fever

the child's limbs and body are cold to the touch,
lips and nail beds become bluish,
pale and dry skin,
there is a violation of well-being: the child is lethargic, delirium is possible.

In this case child needs

warm by rubbing the limbs with hands or using warm water (no other means!),
put on socks,
cover with a blanket
and drink warm tea or water.

The use of antipyretics for such symptoms is ineffective - you need to urgently call a doctor!

An exception is children at risk, who have their temperature reduced above 37.1 degrees. These are children,

with diseases of the nervous system,
convulsions due to fever,
suffering from chronic diseases of the circulatory system, respiratory organs or with hereditary metabolic diseases and other risks (overheating, symptoms of dehydration, etc.).

Febrile convulsions are diagnosed more often in children under 6 years of age with temperatures above +38 degrees, as well as in children with pathology of the nervous system at any temperature. For such children, it is recommended to lower the temperature to febrile levels (not higher than +38.0) or to those values recommended by a neuropathologist.

Usually, against the background of an increase in temperature, the child's heart rate and respiratory rate increase: the respiratory rate increases by 4 respiratory movements for every degree above +37. 0 degrees, and the pulse rate - by 20 beats per minute for every degree. However, against the background of diseases of the cardiovascular system and respiratory organs, such as malformations or cardiac arrhythmias, inadequate increases or slowdowns in heart rate and respiration are possible. Such children, on the recommendation of a cardiologist and pulmonologist, are prescribed antipyretic drugs to febrile numbers (ie, not higher than +38.0 degrees).

Children with hereditary metabolic diseases (diseases of the thyroid gland, kidneys, liver, disorders in the immune system, and others) and children with imperfect compensatory mechanisms of thermoregulation during fever (these are some children from birth to 2 months) are also prescribed antipyretic drugs on the recommendation of related specialists means to febrile digits.

Overheating - increase in body temperature due to additional exposure to heat

prolonged sun exposure,
use of excess clothing,
excessive wrapping of children).

The danger of overheating is associated with the risk of heat stroke. It manifests itself

not only in elevated temperature,
but also in impaired consciousness, convulsions,
disorders of the heart and breathing.

First aid is to call the ambulance "112".

Until the doctor arrives

undress the child,
move to a cool place or shade,
supply fresh air or fan (but not cool air!),
apply a cold compress to the forehead,
Wipe the body with cool water or cover with a sheet soaked in cool water.

Antipyretic therapy for children should be prescribed strictly individually, taking into account clinical and anamnestic data.

It is important to know that taking antipyretic drugs does not shorten the duration of the febrile period. At the end of the drug, the temperature rises again.

Antipyretics have a lot of side effects:

allergic reactions,
bleeding,
stomach injuries (vomiting, regurgitation),
Reye's syndrome (against the background of rash, vomiting, psychomotor agitation occurs).

In addition, the decrease in body temperature should not be critical, it is not necessary to achieve normal performance. It is enough to lower the temperature by 1.0 or 1.5 degrees, which will improve the child's well-being and avoid collapse.