Fever in Children

 What temperature constitutes a fever?

The definition of fever varies based on the age of a child. If your child is under 3 months, a fever is considered any temperature over 100.4°F (40°C). Over 3 months, the definition is any temperature over 101°F (38.3°C).

 What should I do if I think my child has a fever?

First, take his temperature. For infants under 6 months of age, the only accurate way is with a rectal thermometer. There are many thermometers on the market, including ones that resemble pacifiers and others that you can rub on the child’s forehead. But for babies under 6 months, the only medically accurate thermometer is rectal.


Some children older than 6 months can cooperate during an oral thermometer reading. For those who can’t sit still long enough, the most accurate method is still rectal.

Other options for this age group are thermometers that measure the child’s temperature in the ear or under the armpit. If you choose an armpit thermometer, make sure that the child hasn’t been bundled up to the point that he or she is sweaty, because this can cause an inaccurately high temperature reading.


By age 4 or 5, most kids will cooperate when having their temperatures taken orally. Avoid mercury thermometers.


It’s important to wait a few minutes after your child eats or drinks hot or cold foods or drinks, or after your child has a warm bath, to avoid a false reading. After you’ve taken your child’s temperature, clean the thermometer with rubbing alcohol or wash it in warm, soapy water.


If my child does have a fever, should I call the doctor?

There are no hard rules.  Observe your child’s behavior and use common sense. Here are some general guidelines:


  • If your child has a fever and is difficult to wake up, call the doctor.
  •  If your child has a fever and is 3 months of age or younger, call the doctor  - just to be on the safe side.


If your child is between 3-6 months old, call your doctor if his or her temperature is 101°F (38.3°C) or higher and if there are no other symptoms indicating the source of the fever. For example, a stuffy nose or cough suggests a virus, meaning it isn’t necessary to call the doctor.


For a child of any age, call the doctor if the fever persists daily for more than four or five days.



What other symptoms warrant calling the doctor?

Call right away if your child has any of these symptoms along with a fever:


  • Persistent vomiting or diarrhea
  •  Earache or pulling at ears
  •  Severe headache
  •  Stiff neck
  •  Severe sore throat
  •  Unresponsiveness or limpness
  •  Trouble breathing
  •  Sore or swollen joints
  •  Pain when urinating, or urinating more than usual
  •  Refusal to drink liquids


 Should I treat my child’s fever with over-the-counter medications?

If it doesn’t seem to be bothering your child, there’s no reason to give medication. Certainly, don’t wake him up if he’s sleeping, just to administer fever-reducing medication.


You can, however, make your child more comfortable with an over-the-counter medication without consulting a doctor beforehand.


Common children’s fever reducers include acetaminophen (Tylenol) and ibuprofen (Motrin or Advil). Only give ibuprofen to children 6 months of age or older. Be sure to read the instructions or talk to your doctor about the correct dosage and frequency of treatment for your child. Never give aspirin to your child or teen because of the risk of Reye’s syndrome. 



Is there anything else I can do to help my child feel better?

There are several things you can do:


  • Provide plenty of fluids to prevent dehydration. Try water, juice, broth and popsicles.
  •  Ensure that your child gets plenty of rest.
  •  Keep the room temperature at a comfortable 70°F to 74°F.
  •  If your child feels warm, remove excess clothing.
  •  If your child has the chills, cover her with a blanket.


Nancy (Barnett) Zises, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation’s Santa Clara Center. Advice is not intended to take the place of an exam or diagnosis by a physician.



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