What is a fever?

A fever is the way the body fights an infection. A temperature of 100.4 degrees Fahrenheit or higher is considered a fever. Fevers can be caused by viruses, like the cold and flu, or by bacterial infections, like strep throat. Fevers are a sign your child’s immune system is working well.

Ways to take temperatures

There are a few ways to take a temperature.

Rectal temps are the most accurate. For children under 12 months, rectal is the preferred method of taking a temperature.
Forehead and temporal temperatures are the next most accurate. Temporal thermometers measure the temperature across the temporal artery in the forehead. Temporal thermometers are appropriate for all ages.
Oral (under the tongue) and tympanic (ear) temps are also accurate if done properly. Oral temperatures are recommended for 4 years and older. Ear temperatures are most appropriate for ages 6 months and older.
Axillary temperatures (under the armpit) are the least accurate but can still be used to check for a fever. When taking an axillary temperature, add 1 degree when reading the thermometer.
“Tactile” means feeling if your child is warm or feverish and should only be used for children older than 3 months.

How to treat a fever at home

You can treat a fever at home for most age groups by giving antipyretics (medicines that reduce fevers), pushing fluids, and promoting rest.

Use antipyretics, like Tylenol or ibuprofen, to bring fevers down. Ibuprofen can only be used in children 6 months and older.

While your child may be eating less when they aren’t feeling well, it’s important to make sure they are well-hydrated. For babies, make sure they tolerate their feeds and have 4-6 wet diapers every 24 hours. For older children, make sure they go to the bathroom to urinate 4-6 times every 24 hours.

Once your child’s fevers have resolved for 24 hours with no medication and they feel better, they can return to school or daycare.

When to call about a fever

A fever is considered a temperature of 100.4 F for all children. When to call your doctor about a fever depends on your child’s age, medical history, and symptoms.

Age considerations

Your child’s age is an important factor in when to call about a fever. Call our office for the following:

Your child is younger than 3 months with a temperature of 100.4 F rectally (or higher).
Your child is younger than 2 years with a fever that persists for more than 24 hours.
Your child is 2 years or older, with a fever lasting more than 72 hours (3 days).
Your child has a temperature of 104 F or higher.

Medical history

Call your doctor if your child has a fever with a medical history of an immunosuppressant condition. Conditions that suppress the immune system inhibit your child’s ability to fight infections. Children with sickle cell disease and cancer, or other conditions that affect their immune system or heart, are at an increased risk. Additionally, children taking immunosuppressant medications like steroids are also at risk.

Symptoms

There are certain symptoms to watch out for if your child has a fever. Oftentimes, a fever by itself is treatable at home. Watch out for a fever that is paired with other symptoms, like ear pain, repeated vomiting, or a rash. Call your doctor if your child has any of the following:

Lethargy, a stiff neck, severe headache, or trouble breathing.
Is drinking a lot less and going 6 hours without urinating.
Your child still “acts sick” once their fever is brought down.
The fever persists longer than 3 days.
The fever persists despite giving Tylenol or ibuprofen.
Your child seems to be getting worse.

Resources:

This article was written by Katie Taibl, BSN, RN, CPN. Katie has over nine years of experience working in pediatrics, with a background in travel nursing and clinical writing. As Roslindale Pediatric Associates’ Patient Outreach Educator, she writes articles on relevant pediatric health topics to help RPA patients and their families access user-friendly health content.