Fever

I get calls about parents concerned about their child’s fever, how high is too high, and what they can do for it.  Here is a brief outline of elevated temperatures and fever.

Body temperature varies a degree or so over the course of a normal day.  Fever develops when the immune system detects an infectious agent, like bacteria or viruses, and mounts a response to fight it off .  In addition to infection, some vaccines can also cause fever.  Bundling a child in too many clothes or blankets can increase the child’s temperature slightly, but does not cause fever.

This is the biggest distinction:  elevated temperature does not always mean “fever”.   Fever is:  

  • Rectal temperature above 100.4ºF
  • Oral temperature above 99.5ºF
  • Axillary (armpit) temperature above 99ºF
  • Ear temperature above 100.4 

Rectal temperatures are the most accurate.  Temperatures measured in the armpit are the least accurate.

Next question is:  Do you treat a fever?  In most cases, a child with a fever can be monitored and treated at home. However, you should consult your doctor if:

  • Your infant less than three months has a temperature of 100.4ºF or greater
  • Your child older than three months has a temperature of 100.4ºF or greater for more than three days or who are fussy, clingy, refusing to drink fluids
  • Your child is 3-36 months and has a temperature of 102ºF or greater
  • Your child has a temperature of 104ºF or greater
  • Your child has a febrile seizure.
  • Your child has a fever and a chronic medical problem like heart disease, cancer, lupus, or sickle cell anemia

Treatment of fever is recommended if a child has an underlying medical problem, or if the child has had febrile seizures in the past.

Treatment is helpful, but not necessary, if the child is uncomfortable.  Acetaminophen (eg, Tylenol®) or ibuprofen (Advil®, Motrin®) are the most effective at reducing fever by2 to 3ºF, and  reducing the child’s discomfort.  Do not give a child aspirin, as it can cause a rare condition known as Reye syndrome.  Acetaminophen and ibuprofen are given on a weight-based scale.  Call your doctor for this information. 

Having a fever can increase a child’s risk of becoming dehydrated.  To reduce this, encourage your child to drink fluids.  If they refuse to drink, offer popsicles.  As mentioned above, if you child doesn’t drink fluids, call your doctor. 

Having a fever causes most children to feel tired and achy.  Rest is the best treatment.  Once they get to feeling better and their fever comes down, you can slowly reintroduce activity.

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About cschaffer78

I'm a family practice physician in Evansville, IN. My practice is described as "full-spectrum" family practice, meaning I see patients "from cradle to grave". I care for men and women of all ages, I deliver babies, and even follow my patients when they are hospitalized. Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider
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2 Responses to Fever

  1. Jennifer Rogers says:

    Are fevers ever caused by teething in an infant or toddler? Or is that an example of “elevated temperature”?

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