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Patient education: Fever in children (The Basics)

Patient education: Fever in children (The Basics)

What is a fever? — A fever is a rise in body temperature that goes above a certain level.

In general, a fever means a temperature above 100.4°F (38°C). You might get slightly different numbers depending on how you take your child's temperature: oral (mouth), armpit, ear, forehead, or rectal.

Armpit, ear, and forehead temperatures are easier to measure than rectal or oral temperatures, but they are not as accurate. Even so, the height of the temperature is less important than how sick your child seems. If you think that your child has a fever, and they seem sick, your child's doctor or nurse might want you to double-check the temperature with an oral or rectal reading.

What is the best way to take my child's temperature? — The most accurate way is to take a rectal temperature (figure 1).

Oral temperatures are also reliable when done in children who are least 4 years old. The right way to take a temperature by mouth:

Wait at least 30 minutes after your child has had anything hot or cold to eat or drink.

Wash the thermometer with cool water and soap. Then, rinse it.

Place the tip of the thermometer under your child's tongue toward the back. Ask your child to hold the thermometer with their lips, not teeth.

Have your child keep their lips sealed around the thermometer. A glass thermometer takes about 3 minutes to work. Most digital thermometers take less than 1 minute.

Armpit, ear (figure 2), and forehead temperatures are not as accurate as rectal or oral temperatures.

What causes fever? — The most common cause of fever in children is infection. For example, children can get a fever if they have:

A cold or the flu

An airway infection, such as croup or bronchiolitis

A stomach bug

In some cases, children get a fever after getting a vaccine.

Should I take my child to see a doctor or nurse? — Take your child to a doctor or nurse if they are:

Younger than 3 months, and have a rectal temperature of 100.4°F (38°C) or higher. Your infant should see a doctor or nurse even if they look normal or seem fine. Do not give fever medicines to an infant younger than 3 months unless a doctor or nurse tells you to.

Between 3 and 36 months, and have a rectal temperature of 100.4°F (38°C) or higher for more than 3 days. Go right away if your child seems sick, is fussy or clingy, or refuses to drink fluids.

Between 3 and 36 months old, and have a rectal temperature of 102°F (38.9°C) or higher

Children of any age should also see a doctor or nurse if they have:

An oral, rectal, ear, or forehead temperature of 104°F (40°C) or higher

An armpit temperature of 103°F (39.4°C) or higher

A seizure caused by a fever

Fevers that keep coming back (even if they last only a few hours)

A fever as well as an ongoing medical problem, such as heart disease, cancer, lupus, or sickle cell anemia

A fever as well as a new skin rash

What can I do to help my child feel better? — You can:

Offer your child lots of fluids to drink. Call the doctor or nurse if the child won't or can't drink fluids for more than a few hours.

Encourage your child to rest as much as they want. But don't force them to sleep or rest. (Your child can go back to school or regular activities after they have had a normal temperature for 24 hours.)

Some parents give their children sponge baths to cool them down, but that is not usually necessary. Sometimes, people think that they can cool a child down by putting rubbing alcohol on their skin or adding it to a bath. But this is dangerous. Do not use any kind of alcohol to try to treat a fever.

How are fevers treated? — That depends on what is causing the fever. Many children do not need treatment. Those who do might need:

Antibiotics to fight the infection causing the fever. But antibiotics work only on infections caused by bacteria, not on infections caused by viruses. For example, antibiotics will not work on a cold.

Medicines such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) can help bring down a fever. But these medicines are not always necessary. For instance, a child older than 3 months who has a temperature less than 102°F (38.9°C), and who is otherwise healthy and acting normally, does not need treatment.

If you do not know how best to handle your child's fever, call their nurse or doctor.

Never give aspirin to a child younger than 18 years old. Aspirin can cause a dangerous condition called Reye syndrome.

More on this topic

Patient education: Fever in children 3 months to 3 years old – Discharge instructions (The Basics)
Patient education: Fever in children over 3 years old – Discharge instructions (The Basics)
Patient education: Ear infections in children (The Basics)
Patient education: Cough, runny nose, and the common cold (The Basics)
Patient education: Flu (The Basics)
Patient education: What you should know about vaccines (The Basics)
Patient education: Sore throat in children (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: How to take a temperature (The Basics)

Patient education: Fever in children (Beyond the Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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