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- Fever is the only symptom. Your child has a fever if:
- Rectal, Ear or Forehead temperature: 100.4° F (38.0° C) or higher
- Oral or Mouth temperature: 100° F (37.8° C) or higher
- Under the arm (Armpit) temperature: 99° F (37.2° C) or higher
- Caution: Ear temperatures are not accurate before 6 months of age
- Caution: Forehead temperatures must be digital. Forehead strips are not accurate.
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If not, see these topics
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| Call 911 Now (your child may need an ambulance) If |
- Not moving or too weak to stand
- Can't wake up
- Trouble breathing with bluish lips or face
- Purple or blood-colored spots or dots on skin
- You think your child has a life-threatening emergency
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| Call Your Doctor Now (night or day) If |
- Your child looks or acts very sick
- Hard to wake up
- Not alert when awake
- Acts or talks confused
- Stiff neck or swollen soft spot
- Had a seizure with the fever
- Trouble breathing
- Great trouble swallowing fluids or spit
- Age less than 12 weeks old with any fever. (Caution: Do not give your baby any fever medicine before being seen)
- Fever more than 104° F (40° C)
- Nonstop crying or cries when touched or moved
- Won't move an arm or leg normally
- Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
- Burning or pain when passing urine
- Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
- You think your child needs to be seen urgently
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| Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If |
- You think your child needs to be seen, but not urgently
- Age 3-6 months old with fever
- Age 6-24 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea).
- Fever lasts more than 3 days
- Fever returns after gone for more than 24 hours
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| Call Your Doctor During Weekday Office Hours If |
- You have other questions or concerns
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| Parent Care at Home If |
- Fever with no other symptoms AND your child acts mildly ill
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Causes & Health Information
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Causes
- Main cause: colds and other viral infections.
- Fever may be the only symptom for the first 24 hours. This often occurs with a viral illness. The start of symptoms (runny nose, cough, loose stools) are often delayed. In the case of Roseola, fever may be the only symptom for 2 or 3 days.
- Most often, you won't know the cause of the fever until other symptoms develop. This may take 24 hours.
- Bacterial infections (as with a Strep throat or a kidney infection) also cause fever.
- Teething does not cause fever.
Fever and Crying
- Fever on its own shouldn’t cause much crying.
- Frequent crying in a child with fever is caused by pain until proven otherwise.
- Hidden causes can be ear infections, kidney infections, sore throats and meningitis.
Normal Temperature Range
- Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range.
- By mouth. A reading of 97.6° F (36.5° C) is just the average mouth temp. A normal low can be 95.8° F (35.5° C) in the morning. It can change to a high of 99.9° F (37.7° C) late in the day. This is a normal range.
Return to School
- Your child can go back to school after the fever is gone. Your child should feel well enough to join in normal activities.
- What You Should Know:
- Having a fever means your child has an infection.
- It's most likely caused by a virus.
- Most fevers are good for sick children and help the body fight infection.
- Use the ranges below to help put your child's level of fever into perspective:
- 100°-102°F (37.8° - 39°C) Slight fever: helpful, good range
- 102°-104°F (39 - 40°C) Average fever: helpful
- Over 104°F (40°C) High fever: causes discomfort, but harmless
- Over 106°F (41.1°C) Very high fever: important to bring it down
- Over 108°F (42.3°C) Harmful fever: fever itself can cause brain damage
- Treatment for All Fevers: Extra Fluids and Less Clothing
- Offer your child lots of cold fluids to drink. Reason: Good hydration replaces sweat. It also improves heat loss from the skin.
- For babies, dress in 1 layer of light weight clothing and sleep with 1 light blanket. Do not wrap in too many blankets. This may make the fever higher. Caution: Babies can get over heated easily. They can't take their clothes or blankets off if they are too hot.
- For fevers 100°-102° F (37.8° - 39°C), fever meds are rarely needed. Fevers of this level don't cause discomfort. They do help the body fight the infection.
- Fever Medicine:
- Fevers only need to be treated with medicine if they cause discomfort. Most often, that means fevers above 102°F (39°C).
- Give acetaminophen (such as Tylenol) or ibuprofen (such as Advil). See the Dose Tables.
- Goal of treatment: Bring the temperature down to a comfortable level. Most often, the fever meds only lower the fever by 2° to 3° F (1 - 1.5° C). They do not bring it down to normal.
- Do not use aspirin. Reason: Risk of Reye syndrome, a rare but serious brain disease.
- Do not use both acetaminophen and ibuprofen together. Reason: Not needed and a risk of giving too much.
- Sponging:
- Note: Sponging is an option for high fevers, but not required.
- When to Use: Fever above 104° F (40° C) AND doesn't come down with fever meds. Always give the fever med first.
- How to Sponge: Use lukewarm water (85 - 90° F) (29.4 - 32.2° C). Sponge for 20-30 minutes.
- If your child shivers or becomes cold, stop sponging. Other option: You can also make the water warmer.
- Caution: Do not use rubbing alcohol. Reason: Can cause a coma.
- Return to School:
- Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities.
- What to Expect:
- Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
- They may last for 2 or 3 days.
- They are not harmful.
- Call Your Doctor If:
- Fever goes above 104° F (40° C)
- Any fever occurs if less than 12 weeks old
- Fever without a cause lasts more than 24 hours (if age less than 2 years)
- Fever lasts more than 3 days (72 hours)
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/1/2012
Last Revised: 1/13/2013
Content Set: Child Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.
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