All kids get a fever from time to time. A fever itself usually causes no harm and
can actually be a good thing — it's often a sign that the body is fighting an
But when your child wakes in the middle of the night flushed, hot, and sweaty,
it's easy to be unsure of what to do next. Should you get out the thermometer? Call
Here's more about fevers, including when to contact your doctor.
What Is a Fever?
Fever happens when the body's internal "thermostat" raises the body temperature
above its normal level. This thermostat is found in a part of the brain called the
hypothalamus. The hypothalamus knows what temperature your body should be (usually
around 98.6°F/37°C) and will send messages to your body to keep it that way.
Most people's body temperatures change a little bit during the course of the day:
It's usually a little lower in the morning and a little higher in the evening and
can vary as kids run around, play, and exercise.
Sometimes, though, the hypothalamus will "reset" the body to a higher temperature
in response to an infection, illness, or some other cause. Why? Researchers believe
that turning up the heat is a way for the body to fight the germs
that cause infections, making it a less comfortable place for them.
What Causes Fevers?
It's important to remember that fever by itself is not an illness — it's
usually a sign or symptom of another problem.
Fevers can be caused by a few things, including:
Infection: Most fevers are caused by infection or other illness.
A fever helps the body fight infections by stimulating natural defense mechanisms.
Overdressing: Infants, especially newborns, may get fevers if
they're overbundled or in a hot environment because they don't regulate their body
temperature as well as older kids. But because fevers in newborns can indicate a serious
infection, even infants who are overdressed must be checked by a doctor if they have
Immunizations: Babies and kids sometimes get a low-grade fever
after getting vaccinated.
Although teething may
cause a slight rise in body temperature, it's probably not the cause if a child's
temperature is higher than 100°F (37.8°C).
When Is a Fever a Sign of Something Serious?
In healthy kids, not all fevers need to be treated. High fever, though, can make
a child uncomfortable and make problems (such as dehydration)
Doctors decide on whether to treat a fever by considering both the temperature
and a child's overall condition.
Kids whose temperatures are lower than 102°F (38.9°C) often don't need
medicine unless they're uncomfortable. There's one important exception: If
an infant 3 months or younger has a rectal temperature of 100.4°F (38°C) or
higher, call your doctor or go to the emergency department immediately. Even
a slight fever can be a sign of a potentially serious infection in very young babies.
If your child is between 3 months and 3 years old and has a fever of 102.2°F
(39°C) or higher, call to see if your doctor needs to see your child. For older
kids, take behavior and activity level into account. Watching how your child behaves
will give you a pretty good idea of whether a minor illness is the cause or if your
child should be seen by a doctor.
The illness is probably not serious if your child:
is still interested in playing
is eating and drinking well
is alert and smiling at you
has a normal skin color
looks well when his or her temperature comes down
And don't worry too much about a child with a fever who doesn't want to eat. This
is very common with infections that cause fever. For kids who still drink and urinate
(pee) normally, not eating as much as usual is OK.
Is it a Fever?
A gentle kiss on the forehead or a hand placed lightly on the skin is often enough
to give you a hint that your child has a fever. However, this method of taking
a temperature (called tactile temperature) won't give an accurate measurement.
Use a reliable digital thermometer to confirm a fever. It's a
fever when a child's temperature is at or above one of these levels:
measured orally (in the mouth): 100°F (37.8°C)
measured rectally (in the bottom): 100.4°F (38°C)
measured in an axillary position (under the arm): 99°F (37.2°C)
But how high a fever is doesn't tell you much about how sick your child is. A simple
cold or other viral infection can sometimes cause a rather high fever (in the 102°–104°F/38.9°–40°C
range), but this doesn't usually mean there's a serious problem. In fact, a serious
infection, especially in infants, might cause no fever or even a low body temperature
(below 97°F or 36.1°C).
Because fevers can rise and fall, a child might have chills as the body's temperature
begins to rise. The child may sweat to release extra heat as the temperature starts
Sometimes kids with a fever breathe faster than usual and may have a faster heart
rate. Call the doctor if your child has trouble breathing, is breathing faster than
normal, or is still breathing fast after the fever comes down.
How Can I Help My Child Feel Better?
Again, not all fevers need to be treated. In most cases, a fever should be treated
only if it's causing a child discomfort.
Here are ways to ease symptoms that often accompany a fever:
If your child is fussy or uncomfortable, you can give acetaminophen
or ibuprofen based on the
package recommendations for age or weight. (Unless instructed by a doctor, never give
aspirin to a child due to its association with Reye syndrome, a rare but potentially
fatal disease.) If you don't know the recommended dose or your child is younger than
2 years old, call the doctor to find out how much to give.
Infants younger than 2 months old should not be given any medicine for fever without
being checked by a doctor. If your child has any medical problems, check with the
doctor to see which medicine is best to use. Remember that fever medicine can temporarily
bring a temperature down, but usually won't return it to normal — and it won't
treat the underlying reason for the fever.
Home Comfort Measures
Dress your child in lightweight clothing and cover with a light sheet or blanket.
Overdressing and overbundling can prevent body heat from escaping and can cause the
temperature to rise.
Make sure your child's bedroom is a comfortable temperature — not too hot
or too cold.
While some parents use lukewarm sponge baths to lower fever, this method only helps
temporarily, if at all. In fact, sponge baths can make kids uncomfortable. Never use
rubbing alcohol (it can cause poisoning when absorbed through the skin) or ice packs/cold
baths (they can cause chills that can raise body temperature).
Food and Drinks
Offer plenty of fluids to avoid dehydration
because fevers make kids lose fluids more rapidly than usual. Water, soup, ice pops,
and flavored gelatin are all good choices. Avoid drinks with caffeine, including colas
and tea, because they can make dehydration worse by increasing urination (peeing).
If your child also is vomiting and/or has diarrhea, ask the doctor if you should
give an electrolyte (rehydration) solution made especially for kids. You can find
these at drugstores and supermarkets. Don't offer sports drinks — they're not
made for younger children and the added sugars can make diarrhea worse. Also, limit
your child's intake of fruits and apple juice.
In general, let kids eat what they want (in reasonable amounts), but don't force
it if they don't feel like it.
Taking it Easy
Make sure your child gets plenty of rest. Staying in bed all day isn't necessary,
but a sick child should take it easy.
It's best to keep a child with a fever home from school or childcare. Most doctors
feel that it's safe to return when the temperature has been normal for 24 hours.
When Should I Call the Doctor?
The exact temperature that should trigger a call to the doctor depends on a child's
age, the illness, and whether there are other symptoms with the fever.
Call your doctor if you have an:
infant younger than 3 months old with a rectal temperature of 100.4°F (38°C)
older child with a temperature of higher than 102.2°F (39°C)
Also call if an older child has a fever of lower than 102.2°F (39°C) but
refuses fluids or seems too ill to drink adequately
Also, ask if your doctor has specific guidelines on when to call about a fever.
What Else Should I Know?
All kids get fevers, and in most cases they're completely back to normal within
a few days. For older babies and kids, the way they act can be more important than
the reading on your thermometer. Everyone gets a little cranky when they have a fever.
This is normal and should be expected.
But if you're ever in doubt about what to do or what a fever might mean, or if
your child is acting ill in a way that concerns you even if there's no fever, always
call your doctor for advice.