Fever is an important defense against infection and disease. Contrary to popular belief, it is not dangerous. A high fever does not necessarily mean a serious infection, nor does a low fever insure that a serious infection is not present. When your child is ill with fever, direct your efforts at determining the cause of the fever, not at heroic measures to bring it down. Fever causes discomfort, requires a great deal of the child’s energy and occasionally indicates an illness requiring medical attention. This section will discuss what you should do, when to call the office and safe measures to make your child comfortable.

Presence of fever is sometimes difficult to define. In children, temperatures vary rapidly and widely even in health. The normal temperature is influenced by activity, eating, emotion and environment. Body temperature is normally higher in the evening than in early morning. Following afternoon play activity a child’s temperature would be expected to be over 100°F.

Measuring a fever has become more complex with increasing technology. However, the older methods are still quite accurate. We recommend a rectal temperature in children under the age of two, using a simple digital rectal thermometer. An oral or ear temperature may be measured in older children. Ear (otic) thermometers are somewhat inaccurate especially under age two years and are not recommended for two and under. Forehead or temple scanning thermometers are reasonably accurate. Under the arm (axillary) temperatures are not as accurate.

Once you know your child has a fever repeated measurements are usually unnecessary as treatment will be dictated by the appearance of the child, not temperature. Fevers between 101°F and 106°F are treated the same so the exact number is typically meaningless. It is also not necessary to “add a degree” or any amount for that matter to a measured temperature – simply let us know what temperature was measured and where.

Symptoms of fever include loss of appetite, fatigue and irritability. Headache, other aches, pains and nausea are also common. Chills occur as a means of elevating temperature and delirium may occur with fevers above 104°F.  Breathing rate and heart rate will be elevated with fever. Sleeping habits are altered with some children sleeping more and others sleeping fitfully and for shorter periods of time than usual.

The dangers of fever are much exaggerated. Children are able to tolerate temperatures of 104°F and above with much greater ease than adults. Fever alone will not damage a child’s brain. Even convulsions with fever, which occur in 3% of all children regardless of measures taken to control fever, are relatively harmless, especially if of short duration as they usually are. More children are harmed by excessive measures to control fever than are harmed by fever itself. Temperature approaching 107°F, especially in an adolescent, may be a sign of heat stroke and those children should be seen in the Emergency Room immediately.

What to do for fever: for the child who does not act ill and who has a temperature below 102°F, no treatment is necessary. For children acting ill with a temperature above 101°F, dress lightly (DO NOT bundle up or try to “sweat it out”). Follow the instructions in the table for use of medications. Offer cool liquids. Although rarely necessary a bath in tepid or lukewarm water will usually help bring a temperature down, or sponging the face and neck. Do not use alcohol for sponging – this causes shivering which increases temperature.

Please refer to the Tylenol® and Ibuprofen dosing tables on the following page for further information.