Fever Management in Children: When to Worry and What to Do
Understanding Fever in Children
Fever is one of the most common reasons parents worry about their child's health. While seeing the thermometer climb can be stressful, remember that fever is not an illness itself but a sign that your child's body is fighting off an infection. Most fevers are harmless and actually help your child get better by activating the immune system.
What Is Fever and Why Does It Happen
A fever occurs when your child's body temperature rises to 100.4°F (38°C) or higher. Normal body temperature ranges from 97°F to 99°F, naturally fluctuating throughout the day. The body raises its temperature to create an environment that makes it harder for germs to survive and multiply.
How to Take Your Child's Temperature
Taking an accurate temperature is essential. For babies under 3 months, use a digital rectal thermometer for the most accurate reading. For children 3 months to 4 years, rectal readings remain most accurate, but underarm temperatures work if done correctly. For children 4 years and older, oral digital thermometers work well. Always clean thermometers before and after each use.
When to Worry About Fever by Age
Babies Under 3 Months: Any fever of 100.4°F or higher requires immediate medical attention. Call your pediatrician right away or go to the emergency room.
Babies 3 to 6 Months: Contact your doctor if fever reaches 101°F or higher, or if your baby seems unusually fussy or uncomfortable.
Children 6 Months and Older: Most fevers are not emergencies. However, seek medical care if fever lasts more than 3 days, rises above 104°F, or is accompanied by concerning symptoms.
Red Flag Symptoms Requiring Immediate Care
Parents throughout Princeton, Hamilton, and West Windsor should watch for these warning signs that need urgent medical attention:
- Difficulty breathing or fast breathing
- Severe headache or stiff neck
- Persistent vomiting or diarrhea leading to dehydration
- Unusual rash, especially if it doesn't fade when pressed
- Extreme irritability or inconsolable crying
- Unusual drowsiness or difficulty waking up
- Seizure or convulsion
- Signs of dehydration: no wet diapers for 8 hours, dry mouth, no tears when crying
- Fever after being in a very hot place
Fever Medication Guidelines
Acetaminophen (Tylenol) can be given to children 2 months and older, dosed by weight, typically every 4-6 hours as needed. Ibuprofen (Advil, Motrin) is approved for children 6 months and older, given every 6-8 hours as needed. Always use the measuring device that comes with the medicine. Never give aspirin to children under 18 due to risk of Reye's syndrome.
Home Care for Fever
Along with medication if needed, these comfort measures can help: dress your child in light, breathable clothing, keep the room at a comfortable temperature (68-72°F), offer plenty of fluids to prevent dehydration, let your child rest as much as needed, and give a lukewarm bath if your child is uncomfortable. Never use cold water or alcohol rubs.
When Your Child Can Return to Activities
Children can usually return to daycare or school when they have been fever-free for 24 hours without fever-reducing medication and feel well enough to participate in normal activities.
If you have concerns about your child's fever or symptoms, our pediatric team in Robbinsville is here to help.
Trust Your Parental Instinct
While these guidelines are helpful, you know your child best. If something doesn't seem right, or if you're worried despite the fever being in a safe range, don't hesitate to contact your pediatrician. It's always better to ask questions and get reassurance than to wait and worry.
Frequently Asked Questions
When should I call the doctor for my child's fever?
Call your pediatrician if your baby is under 3 months with any fever, if the fever is above 104°F (40°C), lasts more than 3 days, or if your child shows signs of dehydration, difficulty breathing, or unusual lethargy.
What is the correct dosage of fever medication for my child?
Dosage depends on your child's weight, not age. For acetaminophen (Tylenol), give 10-15 mg per kg every 4-6 hours. For ibuprofen (Advil/Motrin), give 10 mg per kg every 6-8 hours for children over 6 months. Always use the measuring device that comes with the medication.
Should I alternate between acetaminophen and ibuprofen?
While alternating medications can be effective for stubborn fevers, it's generally not necessary and can increase the risk of dosing errors. Stick to one medication unless your pediatrician specifically recommends alternating.
Is it dangerous if my child's fever doesn't respond to medication?
Not all fevers will completely disappear with medication, and that's okay. The goal is to make your child more comfortable, not necessarily to bring the temperature to normal. If your child is acting normally despite the fever, there's usually no cause for alarm.
Can a fever cause brain damage in my child?
No, fever itself does not cause brain damage. Only temperatures above 107°F (41.7°C), which are extremely rare and usually caused by heatstroke rather than infection, can potentially harm the brain. Fevers from common illnesses are the body's natural defense mechanism.
Should I wake my child to give fever medication?
No, sleep is important for healing. If your child is sleeping comfortably, let them rest. You can give medication when they wake naturally.
Need Personal Guidance?
This article provides general information. For questions specific to your child's health, please call our office or book an appointment online.