Parents often become concerned when their child feels warm to the touch or has a slightly elevated temperature. Fever in children signals that the body is actively working to fight off an infection. Understanding what constitutes a fever, how to accurately measure it, and when to seek medical advice is important for parents.
Defining Fever in Children
A fever in a child is generally defined as 100.4°F (38°C) or higher when measured rectally, in the ear, or across the forehead. Oral measurements of 100°F (37.8°C) or above, and armpit temperatures of 99°F (37.2°C) or higher, also indicate a fever. A temperature of 100.7°F (38.1°C) is considered a low-grade fever.
Different temperature measurement methods offer varying levels of accuracy. Rectal temperature is often considered the most accurate, especially for infants and children under 3 years old, as it reflects the core body temperature. Oral thermometers are suitable for cooperative children aged 4 years and older.
Tympanic (ear) thermometers can be used for children 6 months and older, but their accuracy can be influenced by technique and earwax. Forehead (temporal artery) thermometers provide a convenient, non-invasive option, though they may be less accurate than rectal measurements. Armpit (axillary) temperatures are the least reliable method.
Age plays a significant role in determining the seriousness of a fever. In older infants and children, the child’s overall behavior and appearance are often more important indicators of illness severity than the exact temperature reading.
Common Causes and Accompanying Symptoms
Fever is not an illness itself but rather a common symptom, indicating the body’s natural response to fighting off infections. The elevated body temperature creates an environment that makes it more challenging for bacteria and viruses to survive and multiply. This immune response involves the release of chemicals that reset the body’s internal thermostat to a higher setting.
Many factors can cause fever in children, with viral infections being the most frequent culprits, such as common colds, the flu, or respiratory syncytial virus (RSV). Bacterial infections, including ear infections, urinary tract infections, or strep throat, can also lead to fever. Vaccinations can cause a mild, temporary fever as the child’s immune system builds antibodies. While teething can cause a slight temperature increase, it typically does not result in a true fever.
When a child has a fever, other symptoms often appear alongside it. These can include feeling warm, flushed skin, sweating, or chills and shivering. Children might also exhibit irritability, decreased appetite, fatigue, body aches, or a headache. Observing these accompanying symptoms and the child’s general demeanor provides important clues about the underlying cause and how well the child is tolerating the fever.
Managing a Child’s Fever at Home
When a child has a fever, the primary goal of home care is to provide comfort and support their recovery, rather than solely focusing on normalizing the temperature. Ensuring adequate hydration is important, as fever can lead to fluid loss through sweating. Offer plenty of fluids such as water, clear broths, or popsicles, encouraging small, frequent sips. Light clothing and maintaining a comfortably cool room environment can help the child regulate their body temperature and feel more at ease. Rest is also beneficial, as the body needs energy to fight off the infection.
Over-the-counter fever reducers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used to alleviate discomfort. Follow specific dosing instructions based on the child’s weight and age, using the provided dosing device. Acetaminophen can typically be given every 4-6 hours, while ibuprofen is usually administered every 6-8 hours. Ibuprofen should not be given to infants under 6 months of age unless advised by a doctor. Aspirin should never be given to children due to the risk of Reye syndrome.
Certain practices should be avoided when managing a child’s fever at home. Bundling up a child can trap heat and increase their temperature. While lukewarm sponge baths can help some children feel more comfortable, cold baths or ice packs should be avoided as they can cause shivering, which can actually raise the body’s core temperature. The focus remains on making the child feel better, even if their temperature does not return to a completely normal range.
When to Contact a Doctor
Knowing when to seek professional medical advice for a child’s fever is important. Contact a doctor immediately if an infant younger than 3 months has a rectal temperature of 100.4°F (38°C) or higher, as this can signal a serious infection. For children between 3 and 6 months, a rectal temperature higher than 102°F (38.9°C) or a lower temperature with unusual irritability or sluggishness warrants a call. For children of any age, a fever accompanied by specific concerning symptoms warrants prompt medical attention.
These concerning symptoms include:
Difficulty breathing
Stiff neck
Severe headache
A rash that does not fade when pressed
Signs of dehydration (reduced urination, dry mouth, sunken eyes)
Extreme irritability
Unusual drowsiness or difficulty waking up
A bulging or sunken soft spot on an infant’s head
Child looks very ill regardless of temperature
Seizure with fever
Consult a doctor if a fever in a child under 2 years old lasts for more than 24 hours, or if a fever in an older child persists for more than 3 days. Any fever in a child with a compromised immune system or other chronic health conditions should also be discussed with a healthcare provider. If there is strong parental concern about the child’s well-being, contact a doctor for guidance.