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Fever

By Kelli Shidler, M.D.

A fever occurs when your child’s body temperature is elevated. Pediatricians diagnose a fever when the temperature is above 100.4 degrees Fahrenheit. A fever is a symptom, not a disease. It is the body's normal response when fighting an illness or an infection. Most fevers are caused by a viral illness, such as the common cold. Some are caused by bacterial illnesses, such as strep throat or an ear infection. Fevers are generally harmless. They are considered a good sign that your child’s immune system is working and the body is trying to heal itself.

Normal body temperature varies with age, activity level, and the time of day. Children’s temperature is highest between late afternoon and early evening, and lowest between midnight and early morning. When children have a fever, they may feel warm, breathe faster than usual, shiver, appear flushed or sweat more than usual. They may also be more thirsty than normal. Some children feel fine when they have a fever and continue to be active and playful.

Thermometer Guide

A fever cannot always be detected by feeling your child’s forehead. It is usually necessary to take the temperature with a thermometer. There are numerous thermometers on the market that measure temperature in different areas.

Digital thermometers are recommended to check your child’s temperature. The American Academy of Pediatrics encourages parents to remove mercury thermometers from their homes to prevent accidental exposure and poisoning.

Below are three types of digital thermometers. While other methods for taking your child’s temperature are available, such as pacifier thermometers or fever strips, they are not recommended at this time.

  1. Digital multiuse thermometer: This thermometer reads body temperature when the sensor located on the tip of the thermometer touches the part of the body. This type can be used rectally, orally or axillary (under the arm) and may be used at any age, including newborns. Rectal temperature is considered to be the gold standard and most accurate method of taking a baby’s temperature from birth through 3 months of age.
  2. Temporal artery: This thermometer reads the infrared heat waves released by the temporal artery, which runs across the forehead just below the skin. The reading is obtained by swiping the thermometer across the forehead. New research shows this type of thermometer may be reliable in all ages, including newborns.
  3. Tympanic: This thermometer reads the infrared heat waves released by the eardrum. This type is most reliable in babies over 6 months of age. It must be placed correctly in your child’s ear canal to give an accurate reading. Too much earwax can cause the reading to be incorrect.

Fever Care

While a fever is never pleasant for a child, there are steps you can take to help your child during their illness.

  • Extra fluids. Encourage your child to drink extra fluids as children lose fluids from their body when sweating and breathing rapidly during a fever.
  • Clothing. Clothing should be kept to a minimum because most heat is lost through the skin. When your child is shivering from chills, use a light blanket.
  • Medicine. Remember that a fever is helping your child fight an infection. Medicine is used to help reduce the fever and the discomfort associated with it.
    • Acetaminophen (Tylenol): If your child is younger than 2 years of age, ask your doctor for dosing instructions. Acetaminophen may be given to your child every 4-6 hours.
    • Ibuprofen (Motrin, Advil): If your child is younger than 2 years of age, ask your doctor for dosing instructions. Ibuprofen may be given to your child every 6-8 hours.
    • Aspirin is not advised for children of any age.

When to Call the Doctor

Most fevers may be easily treated at home. However, Boys Town Pediatrics recommends calling your doctor if:

  • Your infant is 3 months old or younger and has a temperature of over 100.4 F.
  • Your older child’s fever lasts longer than 72 hours.
  • Your child is lethargic, unresponsive, refuses to eat, has a rash or is having difficulty breathing.
  • Your child has signs of dehydration, such as a dry mouth, sunken soft spot or significantly fewer wet diapers.