Fevers in children are a common concern for parents. While a raised body temperature can be unsettling, it often signals the body’s natural defense mechanisms at work. This article explains fevers, their typical duration, and important considerations for parents.
Understanding Fever
A fever indicates a child’s body temperature has risen above its normal range, typically 98.6°F (37°C). For children, a fever is generally defined by a temperature of 100.4°F (38°C) or higher when measured rectally, tympanically (ear), or temporally (forehead). For oral measurements, 100°F (37.8°C) or higher indicates a fever, while an armpit temperature of 99°F (37.2°C) or higher can also suggest one. The body produces fever in response to infection, stimulating the immune system to fight germs. The elevated temperature also makes it harder for pathogens to grow.
Digital thermometers are recommended for accuracy and speed. Rectal temperatures are considered the most accurate, especially for babies younger than three months. For children aged 6 months and older, temporal artery (forehead) and ear thermometers can also provide accurate readings, while oral temperatures are suitable for children aged 4 years and older who can hold the thermometer properly. Axillary (armpit) temperatures are the least accurate but can be used for screening across all ages.
Typical Duration and Influencing Factors
Fever duration in children varies significantly, depending on the underlying cause. Most fevers, especially those stemming from common viral infections like colds or the flu, typically resolve within two to three days. Some viral fevers may persist for up to five to seven days, and in some instances, even up to 10 days for more severe viral cases. If a fever is the only symptom for the initial 24 hours, it often points to a viral illness, with other symptoms developing later.
A child’s age and overall health influence how long a fever lasts. For example, fevers following immunizations are usually mild and last about a day. Bacterial infections, such as ear infections or strep throat, can also cause fevers, and these may require antibiotics for resolution, potentially leading to a more prolonged fever if untreated. A fever lasting longer than three to five days, regardless of its height, warrants medical attention.
When to Seek Medical Attention
While most fevers are not serious, certain signs indicate a need for medical attention. For infants under three months, any rectal temperature of 100.4°F (38°C) or higher requires an immediate call to a doctor or emergency department visit. For children three months or older, a fever exceeding 102.2°F (39°C) warrants contacting a healthcare provider. Medical consultation is also advised if a fever persists longer than three days in children over two years old, or more than 24 hours for children between three and 24 months.
Seek emergency care if your child exhibits a stiff neck, a rash that does not fade when pressed, difficulty breathing, blue lips, tongue, or nails, extreme irritability or sluggishness, or a seizure. Other concerning symptoms include persistent vomiting or diarrhea, signs of dehydration such as reduced urination or lack of tears, severe headache, or if the child appears very ill or is difficult to wake.
Home Comfort Measures
When a child has a fever, the primary goal is to maintain comfort and ensure adequate hydration. Encourage plenty of fluids like water, clear soups, or oral rehydration solutions. For infants under one year, breast milk or formula should continue to be offered. Popsicles and ice chips can also help with fluid intake.
Dress your child in lightweight clothing and ensure a comfortable room temperature, avoiding excessive bundling that can trap heat. Lukewarm sponge baths can help reduce discomfort. Avoid cold baths or rubbing alcohol, as these can induce shivering, raise body temperature, or cause poisoning.
Over-the-counter fever-reducing medications like acetaminophen (e.g., Tylenol) or ibuprofen (e.g., Advil, Motrin) can alleviate discomfort. Always follow dosage instructions carefully, typically based on the child’s weight.
Ibuprofen is not recommended for infants under six months. Aspirin should never be given to children due to its association with Reye’s syndrome, a rare but serious condition.