Fever - Facts for Families

How do you measure a fever?

By feeling your child’s forehead, face or chest you may know if he or she has a fever, but taking his or her temperature is the only way to know for sure. Although temperature measurement in children seems simple, the choice of method is complicated. It depends on your child’s age, simplicity of use, cost, accuracy and choice of technology.

Ways to measure a fever

• By mouth (oral method)—recommended for children older than 4 years.
• In the armpit (axillary method)—recommended for infants and toddlers, but also reliable for older children.
• Rectally—not recommended for safety reasons.
• In the ear (tympanic method)—requires special thermometers and training.

When should you get medical help?

Despite our concerns, fever is a common symptom for young children that is rarely harmful and usually does not require treatment. Mild or short-term higher temperature is common with minor infections and many other things including exercise, time of the day and environment (such as a hot room or hot day). High fevers (temperatures of 103° F and up) or those rising rapidly can signal a potentially dangerous infection.

In seeking medical help, the child’s age and appearance are two major factors. While fever in newborns is rare and often indicates a serious problem, for older infants and children it depends on how the child looks and behaves.

Call the health care provider immediately if:

• The infant is 4 months of age or younger and has fever.
• A child between 4 months and one year of age has a fever lasting more than 24 hours.
• The child’s fever is 104° F or more.
  • The child looks very sick, is not eating or playing, is unresponsive, or is having difficulty breathing unrelated to a stuffy nose.
  • The child has other signs of illness such as stiff neck, rash or a sore throat that has lasted for 2 to 3 days.
  • The fever remains above 103° F after an hour or two of home treatment.
  • The fever lasts more than two days.

How do you manage a fever at home?

Without medicine: Fever doesn’t always need to be treated. If active, playful and showing no other symptoms, the child may not need medication. Dress in light clothing to allow heat loss through skin, but use a light blanket if the child feels cold. Give extra fluids to prevent dehydration or extra loss of water.

With medicine: Medication is only needed to make a child more comfortable or when the child has seizures with fever. If you wish to treat a fever, acetaminophen (Tylenol) can be used to lower a fever. The child’s health care provider can suggest the recommended pediatric dose. If the health care provider recommends ibuprofen (Motrin/Advil), it can be used every 6 to 8 hours. Always avoid aspirin because of its association with the sometimes deadly Reye’s syndrome.

Temperature tips

Take young children’s temperature in the armpit.

• Don’t use temperature strips or pacifiers; they are not accurate.
• Do not use glass thermometers with mercury; they are dangerous.
• Wash the thermometer after use with warm (not hot) soapy water or swab with rubbing alcohol.