A fever is a body temperature above 100.4°F (38°C) and is usually a sign that the immune system is fighting an infection. Fever itself is rarely dangerous — it is the underlying illness that matters. Call Spring Valley Pediatrics immediately if your child is under 3 months old with any fever, has a fever above 104°F, or develops a stiff neck, severe headache, difficulty breathing, or unusual drowsiness.
As parents we often see it coming – crankiness, sleepiness and loss of appetite followed by a fever. Here Dr. Jessica Long gives advice on when to call the pediatrician.
If there is one complaint or concern that pediatricians get called about the most, it’s fever. They’re rough – kids are miserable with them, parents are worried about them, and there’s a lot of misinformation on the internet about them. However, I’m here to calm your fever phobia and hopefully allow you and your child to sleep a little more soundly, even if her temperature isn’t 98.6 degrees Fahrenheit.
What is a fever?
Doctors consider a fever to be a temperature of 100.4 or higher., A fever is not an illness but instead a sign that your child’s body is fighting an infection – whether a virus or a bacteria – and is actually an important part of your child’s defense against these invaders. How high a fever is does not provide any clues as to what your child is fighting. A common cold can cause a child to have a temperature of 104 while strep throat might raise it to only 100.8. Don’t let a high number alarm you if your child is otherwise doing ok and likewise don’t ignore a slight fever in a child who looks ill.
What to do?
You actually don’t have to do anything. If your child is comfortable, playful, and eating and drinking well despite his 101 temperature, it’s ok to just watch and wait. However, if your child is miserable, then acetaminophen or ibuprofen (in children older than 6 months) is the way to go. Some stubborn fevers may require that you use both of those medications and it is safe to alternate them if needed. Be sure to reference a weight based dosing chart, like the one we have here at Spring Valley Pediatrics, to ensure your child is getting the correct amount of medicine. Giving too small a dose will not reduce the fever as effectively.
When your child has a fever, he will lose fluids more quickly. Be sure to encourage lots of drinking to avoid dehydration and call your doctor if he is crying without making tears, has a dry mouth or lips, or is not urinating frequently.
When to call your pediatrician?
If your baby is under 3 months old and has a rectal temperature of 100.4 or higher, call your pediatrician right away. Fever and illness can be more serious and progress faster in younger infants so do not hesitate to wake your physician in the middle of the night if your baby has a fever.
If your older child has fever as well as other symptoms – a stiff neck, severe headache or sore throat, rash, repeated vomiting or diarrhea, signs of dehydration – or is unusually drowsy or fussy, give your pediatrician a call. If your child’s fever continues for 3 days, it’s worth chatting with your doctor about whether or not your child should be brought in for a visit.
The other time to call is when you’re worried, even if your child is not experiencing any of the symptoms above. We are always happy to talk our families through any concerns. That’s what we are here for.
Frequently Asked Questions
What temperature counts as a fever in children?
A temperature of 100.4°F (38°C) or higher is considered a fever. The most accurate methods for measuring temperature are rectal (most accurate for infants), temporal artery (forehead), and tympanic (ear). Oral temperatures are reliable for children over 4 years who can hold the thermometer correctly. Axillary (armpit) temperatures are the least accurate.
When should I call the pediatrician about my child’s fever?
Call Spring Valley Pediatrics at 202-966-5000 immediately if: your child is under 3 months old with any fever at or above 100.4°F; your child is 3–6 months with a fever above 102°F; your child has a fever above 104°F at any age; your child has a stiff neck, severe headache, difficulty breathing, persistent vomiting, or a rash; or your child appears very ill or is difficult to wake.
Should I always treat my child’s fever with medication?
Not necessarily. A fever helps the immune system fight infection. You should treat fever if it is causing discomfort — acetaminophen or ibuprofen (for children over 6 months) can help your child feel better and be more willing to drink fluids. Do not give aspirin to children under 18.
Does a high fever mean my child has a serious illness?
Not always. The height of the fever does not always indicate the seriousness of the illness. A child with a 104°F fever from a simple viral illness may look relatively well, while a child with a serious bacterial infection may have a lower fever. Fever in a very young infant (under 3 months) is always taken seriously regardless of height.
Can a fever cause brain damage?
Fever from a typical infection does not cause brain damage. Brain damage from heat occurs only when body temperature reaches 107°F (41.7°C) or higher — which does not happen with infection-related fevers. Febrile seizures, while frightening, are also generally not dangerous and do not cause brain damage.
How much fluid does my feverish child need?
Fevers increase fluid loss, so it is important to encourage extra fluids. Offer water, electrolyte solutions (Pedialyte), diluted juice, popsicles, or broth frequently. If your child is refusing all fluids for more than 4–6 hours or shows signs of dehydration (no tears, no urination, dry mouth), call Spring Valley Pediatrics.
