While it’s completely normal to worry when a child has a fever, it’s also completely normal for a child to have a fever when they have an illness. Unfortunately, because many parents do not understand the role of fever, they become increasingly worried and fearful when their child has a fever.

Common Myths

  • All fevers are bad.
  • A temperature of 99°F is a fever.
  • Fevers will cause brain damage.
  • Fever always needs to be treated, otherwise the temperature will just keep getting higher.
  • Anyone can have a seizure if they have a fever.

Important Facts

  • Fever is a temperature of 100.4°F or higher.
  • Fever alone is not considered an illness; rather, it is a symptom, or sign, of illness or infection.
  • Fever is a normal, healthy response; fever turns on the immune system so that the body can fight off the infection.
  • Fever protects the body.
  • A fever between 100°F-104°F may actually help sick children.
  • Febrile seizures (which often occur between the ages of 6 months and 3 years) do not cause brain injury.
  • Fevers with infections do not cause brain damage.
  • Although infections can cause problems, fever itself usually does not.
  • The brain has a “thermostat” (called the hypothalamus) which typically keeps the temperature from going above 104°F.
  • Fevers only need to be treated if the child appears uncomfortable (often when the temperature is above 102°F).

Checking a Temperature

It’s important to accurately check the child’s temperature in order to determine whether or not a fever is present.

  • Rectal (in the bottom): A rectal temperature will most accurately evaluate the body’s core temperature. This is the best place to take an infant’s temperature.
  • Axillary (under the arm): An axillary temperature is acceptable after the infant is 2 months of age or older.
  • Oral (in the mouth): An oral temperature is acceptable after the child is 2 years of age.
  • Tympanic (in the ear): A tympanic temperature is acceptable after the child is 2 years of age.

* Unfortunately, because temporal (forehead) thermometers are often inconsistent and inaccurate, this route is discouraged for temperature assessment.

Evaluate Before You Medicate

  • If your child has a fever, but is active, alert, and drinking well, it isn’t necessary to give a fever-reducing medication, such as acetaminophen or ibuprofen.
  • If your child has a fever, but refuses to drink any fluids, appears glassy-eyed, or seems uncomfortable, give a fever-reducing medication, such as acetaminophen or ibuprofen, based upon your child’s weight.
  • The goal when giving fever-reducing medications is not to bring the temperature down to 98.6°F; the goal is to help your child feel less uncomfortable so that he/she will continue drinking adequate fluids.
  • Our bodies know what to do; in understanding that fever plays a very important role in fighting infection, giving acetaminophen or ibuprofen for every fever may not allow our bodies to fight the infection as well.

Fever Management

  • Do not give aspirin to a child under the age of 18.
  • It isn’t necessary to wake your sleeping child to give fever-reducing medication; let your child rest as needed.
  • Sponging/cooling baths are unnecessary; they can often make your child more uncomfortable.
  • Avoid bundling. Light clothing and a blanket are adequate.
  • Encourage fluids.
  • Ibuprofen (Motrin, Advil) is safe when your child is 6 months of age or older.
  • Acetaminophen (Tylenol) is safe when your child is about 4 months of age or older.
  • Never give medication to an infant 90 days or younger before checking with the doctor.
  • The American Academy of Pediatrics recommends that parents use either acetaminophen or ibuprofen, rather than alternating both medications.

When to Call the Doctor

  • Fever for more than 72 hours
    • Usually, the body stops fighting the virus within 72 hours. If the fever lasts longer, call your child’s doctor for advice.
  • Fever greater than 104 degrees
    • A fever greater than 104 degrees might indicate a more serious illness. Call your child’s doctor for advice.
  • Fever that returns after 48 hours
    • Fevers that come back after being gone for at least 48 hours might indicate a bacterial infection (sinus, ear, or lung). Call your child’s doctor to make an appointment.

When to Seek Emergent Care

  • Temperature equal to or greater than 100.4°F in an infant 3 months of age or younger.
  • Fever in a difficult-to-wake child.
  • Fever in a child with a chronic health condition or impaired immune system.
  • Fever after spending extensive time in the heat.
  • Fever in a child with a purple rash.

*Remember: Your child’s doctor is there to help. If you have concerns, you can always call.


Credit: Laura Weber, RN, BSN, DNP Candidate