Fevers in children can be concerning. This article provides clear information on understanding and managing a child’s temperature, helping to distinguish between situations manageable at home and those requiring medical attention.
Understanding Fever in Children
A fever indicates an elevation in the body’s core temperature beyond its normal range, often signaling the immune system is fighting an infection. While the average normal body temperature is around 98.6°F (37°C), it can fluctuate throughout the day, typically being lower in the morning and slightly higher in the late afternoon. A temperature of 100.4°F (38°C) or higher is generally considered a fever.
When measuring a child’s temperature, digital thermometers are recommended for their accuracy and speed. Rectal temperatures are considered the most accurate, especially for children under three. Oral temperatures can be reliable for children over four years old who can hold the thermometer properly, while ear and temporal artery (forehead) thermometers offer convenience but may be less accurate, particularly in very young infants. An axillary (armpit) temperature is generally the least reliable.
A temperature of 103.8°F (39.9°C) is considered a high fever for a child. While the temperature reading is important, a child’s overall demeanor is a significant indicator of illness severity. A child with a high fever who is playful and alert may be less concerning than one with a lower fever who appears drowsy or irritable.
Managing a Child’s Fever at Home
When a child has a fever, the goal is to ensure comfort and prevent dehydration. Fevers are a natural response that helps the body combat infection. Providing plenty of fluids is important, as fever can lead to increased fluid loss through sweating. Offering water, clear broths, or oral electrolyte solutions in small, frequent sips can help maintain hydration. For breastfed infants, continued breastfeeding is recommended.
Dressing the child in lightweight clothing and ensuring the room environment is comfortable can also aid in heat dissipation. Avoid bundling them in too many clothes or blankets, which can trap heat and worsen the fever. While sponge baths with lukewarm water can help some children feel more comfortable, it is important not to use cold water or rubbing alcohol, as these can cause shivering and lead to a rapid drop in body temperature.
Over-the-counter fever-reducing medications like acetaminophen or ibuprofen can be given if the child is uncomfortable. These medications should be dosed according to the child’s weight, not age. Follow package instructions or consult a healthcare provider for dosage.
Acetaminophen is generally safe for infants of all ages, but ibuprofen should not be given to infants under six months old. Avoid giving aspirin to children due to the risk of Reye’s syndrome. Do not alternate between acetaminophen and ibuprofen unless specifically advised by a healthcare professional.
When to Consult a Doctor
While many fevers can be managed at home, some situations require medical attention. For infants under three months, any rectal fever of 100.4°F (38°C) or higher requires urgent medical evaluation due to potential serious infection. Do not give fever-reducing medication to infants in this age group before they have been seen by a doctor.
Parents should seek medical advice if a child’s fever is accompanied by concerning symptoms, regardless of the temperature. These include:
Unusual drowsiness
Extreme fussiness or inconsolable crying
Difficulty breathing
A stiff neck
A rash that does not fade when pressed (non-blanching)
Signs of dehydration such as reduced urination, dry mouth, or lack of tears
Persistent vomiting or diarrhea, severe headache, or a child who appears very ill even after their fever has come down are also reasons to contact a healthcare provider. Fever duration is another important factor. A fever lasting over 24 hours in a child under two, or over three days (72 hours) in a child two or older, should be evaluated. Additionally, if the child has underlying health conditions such as a compromised immune system, heart problems, or chronic illnesses, any fever should prompt a call to their doctor. If a child has a seizure with a fever for the first time, immediate medical attention is necessary.