What is fever?

A fever is an increase in the body’s temperature to assist the body to fight viral or bacterial infections.  A fever is the body’s temperature at or above 101.7 °F.   Studies show that children do not feel sick or tired from a fever until the temperature is over 102 F, yet some infections make a child tired and quiet whether they have fever or not.

An average body temperature is 98.6°F, but body temperature can vary throughout the day due to activity levels, age, and other factors.

How should I take my child’s temperature?

Rectal temperatures will provide the most accurate result for infants and younger children.  Plastic strip thermometers and ear thermometers are less accurate, but these temperatures are quicker and easier to obtain.  These methods measure skin temperature, rather than internal body temperature.

You can take a temperature using the mouth (oral), anus (rectal), armpit (axillary), or ear (tympanic). Temperature readings vary depending on the method used.  It is more important to a physician to know the big picture if an illness: how is the child acting? how long has the child had a fever ? is the child drinking and urinating? does the child act sick all the time or is he playing intermittently?

Generally, temperature results are as follows:

  • A rectal temperature is 0.5°F to 1°F higher than an oral temperature.
  • An ear (tympanic) temperature is 0.5°F to 1°F lower than an oral temperature.
  • An armpit (axillary) temperature is usually 0.5°F to 1°F higher than an oral temperature, but this method requires 5 full minutes to be most accurate.
  • A forehead (temporal) scanner is usually 0.5°F to 1°F lower than oral temperatures.

My child has a fever. What now?

Keep in mind that a higher fever does not equal a more dangerous infection.  The symptoms of a severe bacterial infection may be quite mild early in the illness.  If your child is playful and keeping hydrated, there is no need to treat with Motrin or Tylenol. If your child is uncomfortable, give Tylenol if the temperature is over 102°to encourage intake of fluids and minimize the risk of dehydration.

Never give a child aspirin. It can cause Reye’s syndrome, a condition that swells the brain and liver, especially if you suspect the child has a chickenpox or influenza infection.

Call for an appointment within 24 hours or go to the Emergency Room or Urgent Care Center if:

  • Your child is under 3 months old with a rectal temperature of 101°F or higher
  • Your child’s temperature is over 104°F at any time
  • The fever has lasted longer than 3 days and has not been evaluated by a medical professional
  • Your child was immunized recently and has a temperature over 102.5°F  or for longer than 48 hours
  • There is a fever and a rash

Febrile Seizures

I understand that febrile seizures are scary for a parent to consider. Febrile seizures do not cause brain damage and last less than 5 minutes. A higher temperature does not mean a higher likelihood of febrile seizures.  A rapid change in temperature (going up or down) is most likely to trigger a febrile seizure for children between one and five years old.

Please do not bathe your child in cold water or rubbing alcohol if there is a fever. Both of these practices may be harmful to your child, and can cause a seizure.