A fever is defined as a temperature of 100.4 degrees Fahrenheit or greater, which typically indicates that the body is fighting an infection. Fever in babies under 3 months is a medical emergency.
A fever is an elevated body temperature. It is a response to inflammation and is typically a symptom that the body’s immune system is responding to something, such as a virus or bacteria. However, fever is not an illness, and it does not worsen an existing illness.
As long as you keep your baby or child hydrated, a fever usually isn’t harmful and will eventually go away on its own, when the underlying cause is addressed.
While it may be concerning when your child experiences a fever, find reassurance in the knowledge that a fever indicates their immune system is actively engaged. The heightened temperature can enhance the effectiveness of the immune response by creating an environment less conducive to bacteria and viruses. Additionally, a fever prompts the body to produce increased white blood cells and antibodies, bolstering its ability to combat infections.
How to tell whether your baby or child has a fever
A fever is defined as a temperature of 100.4 degrees F or higher. When your child has a fever, the course of action depends on their age and other accompanying symptoms (refer to the information below).
The method used to measure your child’s temperature can yield slightly different results. The most precise approach is through a rectal reading. If your baby resists a rectal reading, you can initially measure their temperature under the armpit, known as an axillary temperature.
If your baby is under 3 months old and their axillary temperature exceeds 99 degrees F, promptly perform a rectal reading. For babies aged 3 months or older, and if they appear well despite an axillary temperature surpassing 99 degrees F, it’s acceptable to wait and recheck their temperature with another axillary reading later, such as in 15 to 30 minutes. However, if your child seems unwell, take a rectal temperature immediately for accuracy.
Avoid subjecting older children to rectal temperature measurements as they may find it uncomfortable. Instead, opt for alternative methods such as an axillary (underarm) reading, temporal (across the forehead) reading, tympanic (ear) reading, or oral (mouth) temperature.
Although these methods are less precise than rectal readings, they serve well for preliminary screening. When contacting the doctor, specify the method employed for temperature measurement. If your child appears well and is behaving normally, there is no need to contact the doctor unless their temperature surpasses 100.4 degrees F.
Keep in mind that your child’s activity level, exposure to the sun or cold, being swaddled, recent consumption of hot or cold beverages, or having taken a bath can influence their temperature. Additionally, the time of day may affect the reading, with temperatures often being higher in the afternoon.
What’s a normal baby temperature?
A typical baby’s temperature, measured rectally, typically ranges from 97 degrees to 100.3 degrees F, with an average of 98.6 degrees F. Newborns tend to have a slightly higher average temperature of 99.5 degrees F during their first 28 days.
A fever in a baby is identified at 100.4 degrees F. For infants under 3 months old, a fever of this magnitude is considered an emergency. In babies and toddlers aged 3 months to 36 months, a temperature reaching 102.2 degrees F is classified as a high fever.
These temperature benchmarks are established based on the most accurate readings obtained through rectal measurements.
What’s a normal temperature for kids?
Similar to infants, the typical temperature range for kids falls between 97 degrees F and 100.3 degrees F, with an average body temperature around 97.5 degrees F.
A fever in children is identified when the rectal temperature reaches 100.4 degrees F or higher. It’s important to note that alternative measurement methods may yield inaccurate results. When contacting your child’s doctor, provide information about the method used for temperature assessment.
In children aged 36 months and older, a high fever is considered to be 103.1 degrees F or above. A temperature reaching 104 degrees F or higher could indicate the possibility of heat stroke, while temperatures of 105.8 degrees F or higher may pose a risk of damage to organ systems.
Causes of fever
Many conditions can cause a fever, including inflammatory conditions and immune responses. Viral and bacterial illnesses can also cause a fever.
The most common illnesses that cause fever include:
- Colds
- Flu
- Ear infection
- Gastroenteritis
- Croup
- Bronchitis
- Urinary tract infection
- COVID-19
- Sore throat
There’s no scientific evidence confirming that teething causes fevers, though many parents report fevers in their teething babies and toddlers.
No matter the cause, monitor your child closely when they have a fever. Be alert to other symptoms of illness, and report the fever and symptoms to your baby’s doctor when appropriate (see below).
Some childhood immunizations (such as the DTaP, MMR, and COVID vaccines) can sometimes cause a fever as the body mounts an immune response.
When should you treat a fever?
To prevent dehydration, it’s essential to provide fluids to your baby or child regardless of their temperature and overall well-being.
Apart from maintaining hydration, treating your child’s fever is necessary only when they are experiencing discomfort. If your child is over 3 months old, has a rectal temperature below 102 degrees F (38.9 degrees C), and is behaving normally, there is no immediate need for fever intervention.
However, if your baby or child is exceptionally irritable, fatigued, or having difficulty sleeping, it may be beneficial to lower their fever to facilitate rest. Additionally, if your child exhibits lethargy, muscle aches, or a headache alongside the fever, you may consider measures to reduce their temperature.
By the way, it’s not always true that the higher the fever the sicker the child.
How to treat a fever in your baby or child
If your child is uncomfortable due to fever, and the doctor approves, administering fever-reducing medication is an option. Acetaminophen or ibuprofen can effectively lower the fever, but it’s important to note that ibuprofen is not recommended for infants under 6 months old or for children experiencing dehydration or persistent vomiting.
When administering medication:
- Pay attention to the dosage, as your child’s weight determines the appropriate amount. Always use the provided measuring device to ensure accurate dosing.
- Adhere to the recommended frequency. Typically, acetaminophen can be given every four hours (up to five times daily), while ibuprofen can be administered every six hours (up to four times daily).
- Never give your child aspirin, as it can increase the risk of Reye’s syndrome, a rare but potentially fatal disorder.
- Avoid over-the-counter cough and cold medicine for babies and young children, as most doctors do not recommend these products for this age group.
Aside from administering medication, here are some fundamental measures to ensure the comfort of a baby or older child:
- Adjust clothing by removing layers to facilitate heat dissipation through the skin. Dress them in a single, lightweight layer and add an extra layer if shivering until they warm up.
- Place a cool, damp washcloth on your child’s forehead while they rest.
- Provide ample fluids by nursing or bottle-feeding your baby frequently. Older babies and children can enjoy chilled foods like ice pops and yogurt to help cool the body internally and maintain hydration. Pharmacies offer electrolytes formulated for children to aid in rehydration; consult your doctor before giving them to a baby.
- Administer a lukewarm tub bath or sponge bath. As the water evaporates from the skin, it promotes cooling and lowers the temperature. Avoid using cold water, as it may induce shivering and raise the body temperature. Instead, use tepid water (85 to 90 degrees) to wipe down your child’s skin, focusing on the forehead and underarms.
- Avoid using rubbing alcohol, it is an outdated fever remedy. It may lead to a sudden rise in temperature and potentially result in alcohol poisoning.
- Utilize a fan, maintaining it at a low setting and directing it towards your child to circulate the air around them without blowing directly on them, preventing them from getting chilled.
- Opt for indoor spaces with a cool environment. If outdoors, seek shade to ensure a comfortable temperature.
When is a fever dangerous?
Fever is typically a natural part of the body’s healing process, but it’s important to be aware of potential complications, either due to their danger or the anxiety they may cause, so you can be adequately prepared.
Febrile Seizures:
Fevers can sometimes lead to febrile seizures in infants and young children, particularly between the ages of 6 months and 5 years. Although these seizures are often harmless, their manifestation can be alarming. Symptoms may include eye rolling, drooling, vomiting, stiffening of limbs, and body twitching. While the seizure itself is usually limited and not hazardous, it’s crucial for your child’s doctor to assess the underlying cause of the fever.
Recurrent Fever:
Fever-reducing medication provides temporary relief but doesn’t address the root cause of inflammation. Consequently, your child may experience a persistent fever until the body clears the infection, which can take a few days. If the fever persists for more than three days, your doctor may need to evaluate your child, as it could indicate a bacterial infection requiring potential antibiotic treatment.
Fever Without Other Symptoms:
A fever unaccompanied by symptoms like a runny nose, cough, vomiting, or diarrhea can pose a diagnostic challenge. Various viral infections, such as roseola, may cause a fever without additional symptoms. However, more severe infections like meningitis, urinary tract infections, or bacteremia can also manifest with a high fever alone. If your child has a fever of 102.2 degrees F or higher for more than 24 hours or any fever over 100.4 degrees F without a clear cause for more than 3 days, contacting the doctor is advisable, irrespective of other symptoms.
Brain Damage Concerns:
Many parents worry about the potential for high fever to cause brain damage in their child. However, the likelihood of this occurring is extremely low. For fever-induced brain damage, temperatures would need to surpass 107.6 degrees F, a level rarely reached due to infection, which typically doesn’t exceed 105 degrees F.
When to call the doctor for a fever
If your baby is under 3 months old and registers a temperature of 100.4 degrees F or higher, it’s imperative to contact the doctor immediately. Young infants in this age group require prompt assessment for potential serious infections or diseases since they may not exhibit typical symptoms of severe illness.
Similarly, if your baby under 3 months old has a temperature below 97 degrees F, regardless of the direction of the fluctuation, it could signal a serious underlying illness. If the doctor is unavailable, head to the emergency room without administering fever medicine beforehand.
For babies aged 3 months and older, as well as toddlers and children, their appearance and behavior take precedence. If your baby or child seems well, is adequately hydrated, and lacks additional symptoms, there’s typically no need to contact the doctor unless the fever persists or reaches 104 degrees F or higher.
Additionally, contact the doctor if your baby or child has:
- A fever lasting longer than 24 to 48 hours (for those 2 years or younger) or 48 to 72 hours (for those 3 years or older).
- Symptoms indicative of a treatable illness, such as an ear infection, urinary tract infection, or sore throat.
- A recurring fever persisting for more than a week, regardless of the temperature.
- Signs of serious conditions like sickle cell anemia, diabetes, or a compromised immune system.
- Development of a new rash or unexplained bruises, especially if they don’t turn pale when pressed (which may indicate a severe bacterial infection).
- Signs of mild or moderate dehydration, such as decreased urine output, fewer tears during crying, and a dry mouth.
- Experiencing vomiting or diarrhea.
- Breathing difficulties, even after clearing the baby’s nose with a bulb syringe, potentially indicating pneumonia or RSV.
- A brief seizure lasting less than two minutes.
In urgent situations, call 911 or your local emergency number, or take your child to the Emergency Department if your baby or child:
- Exhibits a high fever (nearing 105 degrees) unresponsive to fever medication.
- Displays signs of respiratory distress, like grunting, flaring nostrils, or fast breathing.
- Appears drowsy, confused, and suddenly unable to walk.
- Is difficult to wake or has blue lips, tongue, or nails.
- Experiences a stiff neck or prolonged seizure lasting two minutes or longer.
- Demonstrates signs of serious dehydration, such as sunken eyes, cold hands and feet, excessive sleepiness, fussiness, lightheadedness, dizziness, or delirium.
While fever is a common and normal response to inflammation, your judgment is crucial in determining when something may be amiss. If you have concerns about your child’s temperature, do not hesitate to contact their doctor.
