Ultimate Guide to Kids' Fever
As a parent it can be scary to see your child who normally bounces off the walls, now looking sad and sleeping for 5 hours and not wanting to eat.
There are also a lot of myths and worries out there
Click on the Table of Contents below to jump right to your fever question
Also check out some of our common posts on fever questions like:
- How much Acetaminophen (TylenolⓇ)and Ibuprofen (MotrinⓇ) do I give to my kid?
- What is a virus?
- What is RSV?
- What is a “fever seizure” or febrile seizure?
Table of Contents
Keep it simple when treating your child's fever
There are so many MYTHS on how to treat a fever and what it means,
We aim to keep things simple and provide some great references and tips you can use at home.
However, I have seen that majority of the anxiety parents face when their child has fever centers around two things:
- Wanting their kid to feel better and not miss anything serious
- Great instinct, that probably means you are a great parent who loves their kid
- A “fear” of fever or how to properly manage it at home. Read below for some common questions and check out this great article from the American Academy of Pediatrics about fever.
My kid is always sick
Your child will get a fever. This does not mean they are broken or weak. Here are some fun facts!
- Kids under 5 years old can have a cold virus for almost 50% of the year
- It is normal for a child to have a different virus up to 12 times a year!
- Kids can cough for almost 4-6 weeks after their cold, so they may be getting over one virus and then get another!
Why do we treat a fever?
To make kids feel better – that’s it.
- Treating a fever does not mean that you are treating the infection.
- Fever is a symptom that your body produces when it is in a state of inflammation and fighting off an infection (often a virus).
Fever truths
- Fever will come back after you give medicine (such as Acetaminophen or Ibuprofen), so long as there is an infection their body is still fighting, your child will still have fever.
- 5 to 7 days is a common length of time for a child to have a fever while fighting an illness. (including common viruses)
Why don't we start antibiotics for my kid's fever?
Most kids with fever, especially in the first few days, likely have a virus.
Antibiotics do NOT make viruses go away faster.
Parents hate the V word (Virus), because there are just so many viruses.
However, when you are frustrated with your child being sick AGAIN, remember:
- It is common for children to get 10-12 viruses in a year. Especially if they are in daycare or have a lot of children in the home
- A child more than 3-4 months can easily have at least one fever every month
- A fever is a sign that your child’s immune system is trying to make it very uncomfortable for viruses and other infections to keep reproducing. That’s a good thing.
- Fever does make your child uncomfortable. We treat their fever so they can sleep and drink better, not because we expect the fever to go away once a virus starts.
- Five to seven days is a common length of time for fever with many viruses.
How do I check a child's temperature?
Simple rules (Thermometers 101 from the AAP)
- 3 years or less : Use a rectal thermometer (it goes in ½ an inch, until the end of the thermometer is in the rectum)
- LABEL this thermometer as for the rectum. Even if cleaned we never recommend it being used for the mouth
- 4 years and older: (Preferred method) Most kids can hold the thermometer in their mouth (oral)
- Under the arm: I generally don’t love this method until kids are at least 4 years old (technically it is approved for as young as 3 months)
- Forehead and Ear: More expensive devices and can be complicated to use.
- I never recommend either before 6 months of age.
Again – for most kids, we simply want to know if there is fever or not so we can treat their symptoms and make them feel better.
See below about for what counts as a fever.
What temperature do you call it a fever in a child?
Quick and important rule: When discussing normal temperatures and fevers, we are focusing on children without other medical problems or conditions (such as sickle cell, leukemia, immunodeficiency or even prematurity) that may put them at higher risk for serious infections even at lower temperatures.
This is surprisingly a controversial question, but I’ll tell you what we do in the hospital.
- Less than 4 months: Fever is (greater or equal to) ≥ 38C (100.4 F)
- More than 4 months: Fever is (greater or equal to) ≥ 38.3C (101 F) and fever can absolutely get higher.
After 4 months (see when to go the emergency room below), the degree of fever is not the only thing we ask when deciding if a child needs more care.
It is all about how your child is feeling and if they are able to drink, breathe and feel better. So how do we make them feel better?
How much Acetaminophen (TylenolⓇ) or Ibuprofen (MotrinⓇ) do I give my child with fever?
This is one of the most common questions we get EVERY day in the ER
Check out this post here, including a table you can use at home to figure out the dose for your child
What else can I do when my child has fever?
Again – the goal here is comfort. Not to magically make it so the fever never comes back (it’s going to come back so long as they are sick).
- Put children in loose comfortable clothing.
- Do not over bundle or wrap them. If the child is having the “chills” – please put a blanket on them so they are comfortable.
- What are chills? When a child has a fever, their thermostat has reset so that their body wants to be at a high temperature. Chills are involuntary shaking of their muscles that actually help increase their temperature (it’s why a lot of kids say they feel cold right before their chills or shakes start)
- Cool wash clothes are fine, but make sure they are not too cold. Take them off if your child starts to feel cold
- Yes – drink plenty of fluid. When your child has a fever they do need more fluids
- You don’t need to wake up your child to give fever medicine on a schedule. Let them rest
What should you NEVER do when your child has a fever?
NEVER do any of the following when your child has a fever:
- Give your child aspirin
- Never use alcohol baths
- Treat a fever for a child less than 4 months without calling or talking to your pediatrician (we care more in this age because these infants don’t have their full set of vaccines yet, have an immature immune system to fight illnesses and because signs of them being more sick can be subtle)
When should I go to the emergency room for my child with fever?
Consider calling your pediatrician immediately or going to an emergency room when:
- A child who is unable to keep down or drink any liquids
- A child who is so sleepy all day that it is hard to wake them up
- A child who describes severe neck pain and can’t move their head even after you’ve given them medicine for fever and pain
- A child who is having trouble breathing, even after you treat the fever
- Seizure with fever: Although relatively common in the ages between 6 months and 5 years (3% of all kids less than 5 will have one) – we recommend a visit to the ER and calling 911 when you see and are dealing with your first one.
- Your parent “instinct” says they are not acting right even after you’ve done all the things above
References
1. Crocetti et al, Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?, Pediatrics, June 2001
2. American Academy of Pediatrics, Fever without Fear: Information for Parents, Healthychildren.org, Accessed 11/20/2023
3. Teoh et al., Burden of Respiratory Viruses in Children Less Than 2 Years Old in a Community-based Longitudinal US Birth Cohort, Clinical Infectious Diseases, Volume 77, Issue 6, 15 September 2023, Pages 901–909, https://doi.org/10.1093/cid/ciad289
4. Godoy, Maria., Your Kids are Adorable Germ Vectors,https://www.npr.org/sections/health-shots/2023/01/26
5. Wycof, Alison., American Academy of Pediatrics, Thermometer Use 101, AAP News 2009
6. American Academy of Pediatrics, Fever: When to Call the Pediatrician, Healthychildren.org, Accessed 11/20/2023