What Do I Need to Worry About if My Child Has a Fever?

A fever is not necessarily bad. It is a way the body fights infection. In fact, many fevers don’t need treatment. By activating your child’s immune system, a fever can actually shorten your child’s illness. 

A normal body temperature is not a specific number; it can actually range from 97 to 100.4 degrees Fahrenheit. Body temperature also varies according to time of day, physical activity and age. 

Health care providers don’t usually consider a fever significant unless it is above 100.4 degrees. When a child does have a fever, it is common for the heart rate and breathing rate to increase. The child will feel warm and may be sweaty. 

There are several ways to check a child’s temperature. If a child is less than 3 years of age, a rectal temperature is the best way. Once a child is 4 or 5 years of age, an oral temperature (taking temperature under the tongue) is a good way to check.Ear thermometers measure the temperature inside the ear canal.  The thermometer must be placed in the correct position and ear wax can cause inaccurate results. This method is good for following fevers, but not good for accuracy. Additionally, an axillary (underarm) temperature is good for following a fever, but not accurate.

A child who is older than 6 months of age with a fever below 101 F doesn’t need to be treated unless uncomfortable with the fever. It is advisable to get the child to drink lots of liquids and rest. Acetaminophen (oral or rectal) for children over 2 months of age or Ibuprofen for children over 6 months of age can be used to make the child more comfortable. It is not necessary to continuously give a fever reducer. Giving the fever reducer as needed (for comfort) is the preferred treatment.

Your child’s health care provider should be contacted if:

  • Your child looks very ill or is fussy, even after the fever is down. 
  • If your child has been in a very hot place (like an overheated car) and has a fever
  • If your child is under 2 months of age, it is prudent to check a RECTAL temp, and if that is over 100.4
  • If you can’t get the fever down below 104 degrees
  • If  the fever has lasted longer than three days and the child still looks ill.
  • If  the fever is over 106 degrees (taken with a reliable thermometer/method).

By Sharon Rink, MD, pediatrician, ThedaCare Physicians-Darboy.