KIDS’ FEVERS: HOW HIGH IS TOO HIGH?

Fevers often get a bad rap, particularly when it comes to children. Although they leave many parents worried, in most people, a fever is rarely dangerous. In fact, they are actually a good thing. Fevers are a natural way that our bodies fight off infections by increasing the body’s temperature in order to make it more difficult for germs to live and multiply.  When it comes to kids’ fevers, here is some helpful information to help you determine how high is too high:

When to Check for a Fever

A child’s temperature can change slightly during the day, depending on the time of day and how active your child is. The normal range for body temperature taken orally (by mouth) ranges from 97.7°F to 99.5°F. Parents should take their child’s temperature if they notice any of the following symptoms:

  • Excessive sweating
  • Dry, hot skin
  • A rash
  • Very pale or very red face
  • Changes in breathing such as unusually fast, slow, noisy or strained
  • Cold symptoms such as runny nose, cough, sneezing, sore throat or hoarseness
  • Mood changes such as irritability, crankiness, fatigue
  • Vomiting
  • Diarrhea
  • Pain in any part of your child’s body
  • Your child says, “I feel sick”

How to Take Your Child’s Temperature

Your first inclination may be to feel your child’s forehead to determine if he or she has a fever. But, a digital thermometer is the best method to take both oral and rectal temperatures quickly and accurately. Despite their appeal, tympanic (ear) and temporal artery (forehead) thermometers that are available for home use often aren’t as high quality or accurate as those used in physician’s offices.

There are three ways to check your child’s temperature:

  • Oral: Suitable for children age 5 and older. Be sure your child has not had anything to drink in the 10 minutes prior to taking their temperature.
  • Rectal: The most accurate method to take a temperature for children under the age of 5.
  • Axillary (Armpit): Not quite as reliable, armpit temperatures are generally used for infants. This method is also used when older children aren’t cooperative or can’t close their mouth due to congestion.

How High is Too High?

Whether or not a visit to your child’s physician for a fever is necessary depends on a variety of factors, including age. Call your pediatrician if:

  • Your child is under 3 months old with a fever of 100.4 °F or higher
  • Your child is 3 to 6 months old with a fever of 101.0 °F or higher
  • Your child is 6 months or older with a fever of 103.0 °F or higher
  • Your child has a fever 104.0 °F or higher regardless of age

You should see a physician for any fever under the following circumstances:

  • Lethargy that persists after taking fever-reducing medication
  • Lasting more than 3 consecutive days with or without an obvious source of infection, such as cold symptoms
  • In conjunction with severe pain
  • In conjunction with sore throat lasting more than 24-48 hours
  • Accompanied by pain when urinating
  • Accompanied by headache, stiff neck or red or purple-colored patches on the skin
  • In a child with compromised immunity
  • Occurrence following a trip overseas

Caring for a Child with a Fever

Children with fevers who aren’t uncomfortable typically don’t need treatment, and for fevers under 102°F medicine is usually not necessary.

Ways you can care for a child with fever include:

  • Keeping them home from daycare, school or extracurricular activities until he or she has had no fever or symptoms for 24 hours without the use of fever-reducing medications.
  • Avoiding clothing that’s too warm. You should also refrain from covering your child with extra blankets, as they stop the heat of the fever from escaping.
  • Keeping your child hydrated by giving them plenty of cool, clear liquids. Pedialyte and water are preferable, but if it encourages your child to drink more you can also offer fruit juices, popsicles or sports drinks like Gatorade.
  • Checking for early signs of dehydration such as dry mouth, lack of tears when crying, decreased urine output or decreased frequency of urination. If you have an infant younger than 6 months old with less than 6 to 8 wet diapers per day or an older child that urinates fewer than three times a day or once every 8 hours, call your child’s doctor immediately.
  • Helping reduce discomfort with acetaminophen (Tylenol) or ibuprofen for children 6 months and older. Infants age 2 to 6 months may be given Tylenol, but you should consult with you his or her doctor prior to use. Our dosage calculator can be used for guidance here as well.
  • Lowering the fever with lukewarm baths. You should never use cold baths.

Schedule an Appointment

HealthPark Pediatrics offers sick visits by appointment Monday through Friday from 8:30 a.m. to 5:20 p.m. and Saturday and Sunday from 9 a.m. to noon. Urgent visits may be scheduled after hours on weekdays between 5:30-6:30 p.m. To schedule an appointment, call 919-896-7066. This number can also be used after hours to reach our dedicated nurse triage line.