Fevers in Children: When to Worry

Most children experience fevers, but in some cases, they can become serious or life threatening. Even if your child has had a fever in the past, seeing them spike a temperature can be scary.

Katherine Milroy, MD, a pediatrician with Dignity Health Medical Group in San Francisco, says, “Fevers are one of the common reasons for acute visits to pediatricians.” While fevers in children are common, it is still important to know what to do when your child has a fever and when to seek help.

What Is a Fever?

A fever is when body temperature rises above 100.4 degrees Fahrenheit, or 38 degrees Celsius. Dr. Milroy describes a fever as a temporary increase in the body’s temperature, typically in response to an infection.

Fevers are a natural immune response to a bacterial or viral infection. According to Dr. Milroy, “Fever can be caused by either a bacterial or viral infection and can happen in both children and adults. Runny nose, cough, headache, sore throat, or upset stomach often accompany a fever and indicate signs of an infection within the body.”

Infants have a much harder time regulating body temperature than adults; this is because they take longer to begin sweating and sweat less in general than adults do. The normal, baseline body temperatures of newborns and infants are also naturally higher. In fact, newborns have body temps ranging from 97.0 to 99.5 degrees Fahrenheit.

While fevers help the body fight infection, they can also become dangerous if the body’s temperature gets too high or stays elevated for too long.

When Is a Fever Dangerous?

When trying to determine whether a child’s fever is too high, it’s important to take their age and other symptoms into account, as well as how long the fever lasts.

Children under six months old should see a doctor immediately any time they have a fever. Dr. Milroy explains, “Your child should [also] be evaluated by his or her doctor if they are under two years of age, have a fever for longer than 24 hours without any other symptoms, or the fever lasts longer than four or five days.”

In older children, Dr. Milroy says, “Any child with a fever over 105 degrees that doesn’t immediately come down” should be evaluated. Even if their temperature is below 105 degrees, “Fevers that don’t respond to medication should be evaluated by medical personnel as soon as possible.”

You should also call your pediatrician or seek immediate emergency care if your child’s fever is accompanied by any of the following symptoms, since they can indicate a more serious infection:

• Difficulty breathing or swallowing
• Inconsolable, constant crying
• Difficulty feeding or an inability to keep fluids down
• Reduced urination or pain on urination
• Rash
• Stiff neck
• Difficulty waking up
• Seizures or any neurological symptoms

Even if you’re not sure how serious the fever is, your physician can safely advise you on the best course of action to take. Dr. Milroy also encourages parents to take their child to the emergency room if necessary.

The Best Ways to Take a Child’s Temperature

To determine if your child has a fever, Dr. Milroy says the most accurate way to take your child’s temperature is rectally or orally. There are accurate thermometers available over the counter in most drug stores.

For children under two especially, a rectal temperature will yield the most accurate results. However, many children are uncomfortable having their temperature taken that way. Some children also can’t hold the thermometer under their tongue to take an oral temperature. In these cases, it is also possible to take your child’s temperature using a thermometer placed under his or her armpit, via the forehead or using an ear thermometer.

Treating a Mild Fever at Home

Fevers can be treated at home with medications including acetaminophen (Tylenol/Paracetamol) and, if your child is over six months old, ibuprofen (Motrin/Advil). Be sure to read the directions for use on the box, as they indicate age-appropriate dosing instructions. Lukewarm baths, cold compresses, and ensuring your child drinks plenty of fluids can also help ease their fever.

Again, contact your child’s doctor’s office for further assistance on how much medication you should give your child if you have any questions or concerns regarding your child’s fever.