When your child has a fever, he is miserable, and you are concerned. Fever can occasionally mean a serious illness, but most often, it is the body's way to fight off infection.
Follow these guidelines for when to contact us if your child has a fever. If you decide to treat the fever first with acetaminophen or ibuprofen, make sure you visit our dosing charts for the proper dosages by weight.
You think the child needs medical attention
The child is younger than 3 months old with a rectal temperature of 100.4 degrees F or higher
The child is 3 to 6 months old with a temperature of 101 degrees F or higher or has had any fever for more than one day
The child is older than 6 months and younger than a year with a temperature of 103 degrees F or higher or has had any fever more than one day
The child is 1 to 2 years old with a high fever lasting more than 24 hours
The child is any age with a temperature of 104 degrees F or higher
The soft spot on the child’s skull is bulging
The child vomits repeatedly or has severe diarrhea
The child has signs of dehydration, such as not wetting diapers, crying without tears, dry mouth or mucous membranes, or sunken soft spot
The fever triggers a seizure
The child has a fever and a rash
Is limp or unresponsive
Is having trouble breathing
Is vomiting and has a headache or a stiff neck
Has blue lips or skin
Has a seizure
No other symptoms are present
Child is not complaining of feeling ill
Fever does not go over 100.4 for a child younger than 3 months
Fever does go above 101 for a child 3-6 months old
Fever does not go above 103 for children older than 6 months
Let the following facts help you put fever into perspective:
MYTH: All fevers are bad for children.
FACT: Fevers turn on the body's immune system. Fevers are one of the body's protective mechanisms.
Most fevers between 100°F and 104°F (38°C to 40°C) are good for sick children and help the body fight infection. The exception is babies less than 3 months of age. They should be seen by a healthcare provider right away.
MYTH: Fevers cause brain damage or fevers over 104°F (40°C) are dangerous.
FACT: Fevers with infections don't cause brain damage. Only body temperatures over 108°F (42°C) can cause brain damage. The body temperature goes this high only with extreme environmental temperatures.
MYTH: Anyone can have a febrile seizure (triggered by fever).
FACT: Only 4% of children have a febrile seizures.
MYTH: Febrile seizures are harmful.
FACT: Febrile seizures are scary to watch, but they usually stop within 5 minutes. They cause no permanent harm. Children who have had febrile seizures do not have a greater risk for developmental delays, learning disabilities, or seizures without fever.
MYTH: All fevers need to be treated with fever medicine.
FACT: Fevers need to be treated only if they cause discomfort. Usually that means fevers over 102°F or 103°F (39°C or 39.4°C).
MYTH: Without treatment, fevers will keep going higher.
FACT: Wrong. Because the brain has a thermostat, fevers from infection usually top out at 103°F to 104°F (39.4°C to 40°C).
MYTH: With treatment, fevers should come down to normal.
FACT: With treatment, fevers usually come down 2° or 3°F (1.1° or 1.7°C).
MYTH: If the fever doesn't come down (if you can't "break the fever"), the cause is serious.
FACT: Fevers that don't respond to fever medicine can be caused by viruses or bacteria. Whether the medicine works or not doesn't relate to the seriousness of the infection.
MYTH: Once the fever comes down with medicines, it should stay down.
FACT: The fever will normally last for 2 or 3 days with most viral infections. Therefore, when the fever medicine wears off, the fever will return and need to be treated again. The fever will go away and not return once your child’s body overpowers the virus (usually by the fourth day).
MYTH: If the fever is high, the cause is serious.
FACT: If the fever is high, the cause may or may not be serious. If your child looks very sick, the cause is more likely to be serious.
MYTH: The exact number of the temperature is very important.
FACT: How your child looks is what's important, not the exact temperature.
MYTH: Temperatures between 98.7°F and 100°F (37.1°C to 37.8°C) are low-grade fevers.
FACT: These temperatures are normal variations. The body’s temperature normally changes throughout the day. It peaks in the late afternoon and evening. A actual low-grade fever is 100°F to 102°F (37.8°C to 39°C).
MYTH: Feed a cold, starve a fever.
FACT: This old saying should be ignored. Fevers cause the body to lose fluids through sweating and breathing. Children with fevers need extra fluids. Children with a fever may or may not be hungry for food. If they are hungry, offer the food that they choose. It is helpful to do so.
Summary: remember that fever is fighting off your child’s infection.
Written by B.D. Schmitt, MD, author of "Your Child's Health" Bantam Books. Published by RelayHealth. Last modified: 2010-02-02. Last reviewed: 2010-06-02