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Keep Your Cool: A Parent’s Guide to Managing Fevers in Children

This article was previously published on Atrium Health's Daily Dose

​Fevers are a common childhood occurrence, but watching those numbers on the thermometer creep up can be a scary experience for parents. While they can sometimes be a sign of a more serious issue, not all fevers are something to fret about. Our experts at Atrium Health Levine Children's share how you can keep your cool when your child's temperature starts to rise, and when you should seek medical attention.

Fevers are a common childhood occurrence, but watching those numbers on the thermometer creep up can cause parents to go into panic mode. While they can sometimes be a sign of a more serious issue, not all fevers are something to fret about. Fevers are a natural response to infections and illnesses, but it can be distressing for parents to see their little ones under the weather.

Dr. Alexa Ernst with Atrium Health Levine Children's Rock Hill Pediatrics explains what fevers are, what you can do to treat them at home, and when you should seek medical attention.

Understanding fevers

Often a symptom rather than an illness itself, fevers are the body's natural response to infections, such as the flu, colds or teething issues. It serves as the body's alert system, indicating an ongoing battle with unwelcome pathogens.

A child's "normal" body temperature hovers around 98.6°F (37°C), and a fever is generally considered to be present when the temperature reaches 100.4°F (38°C) or higher. Everyone's body temperature can vary a bit throughout the day, and age, activity level and other factors can impact our body temperature.

"Most fevers that are mild, last fewer than five days, and don't impact the child's daily activities aren't typically cause for concern and can be left to run their course," Ernst says.

Getting an accurate read

Your child's age and ability to be still combined with the type of thermometer you use and where it is placed can all have an impact on the results. With a wide variety of thermometer options on the market, it's easy to be overwhelmed. But here are a few of the most common types, and what you should know about each one.

Digital thermometers are the standard go-to because they're multifunctional and easy to use. These thermometers read the body's temperature using a small metal tip at the end, which can be placed under your child's tongue, in their armpit (axillary) or by inserting it rectally. For children ages 3 and younger, a rectal reading is the most accurate for a standard digital thermometer. An oral reading is most accurate for children ages 4 and up.

Digital ear thermometers use infrared technology to capture the temperature of the eardrum. Though this method is less invasive than a rectal reading, you'll want to make sure your child's ear is clear of any ear wax or buildup so you can insert the tip of the thermometer effectively. An ear thermometer is most helpful if your child is between 6 months-1 year of age.

Digital forehead thermometers also use infrared technology and measure heat waves coming off your child's temporal artery, which runs across the middle of your forehead just below the surface of your skin. This method is not as reliable as a rectal or oral reading, but it can be used for children ages 3 months and older. Keep in mind if a child has been outside or is sweating, the accuracy of the reading could be impacted.

How to treat a fever

Ensuring your child remains well-hydrated is paramount during a fever. Encourage them to drink water, electrolyte solutions, or diluted 100% fruit juices (with no added sugars).

Adequate rest is equally important for the body to recover efficiently. Employing comfort measures, such as light clothing, cool compresses and a comfortable sleeping environment, can contribute to regulating their body temperature.

"Over-the-counter medications like acetaminophen and ibuprofen can be effective in reducing fever and alleviating discomfort," Ernst says. "It is crucial, however, to follow proper dosage instructions and consult with your child's health care provider if you have any questions."

How high is too high?

For infants under 3 months old: Contact a health care provider if they have any fever (a temperature of 100.4°F or higher) or if their temperature drops below 97.7°F (36.5°C) rectally.

In babies and children over 3 months of age: Contact a health care provider if their fever is higher than 104°F (40°C), or if the fever doesn't come down with a fever-reducing medication.

When to worry

If your child has any of the following signs or symptoms, Ernst says to contact their health care provider.

  • Not acting like themselves
  • Difficult to arouse
  • Not consuming enough liquids
  • Babies who aren't wetting at least four diapers in 24 hours
  • Older children who aren't urinating every 8-12 hours
  • Fever lasting longer than five days
  • Fever doesn't come down with fever-reducing medicine
  • Difficulty breathing
  • Signs of dehydration (dry mouth, lethargy)

Can fevers cause seizures?

Although rare, children experiencing fevers can also have seizures. Some seizures may look like your child is passing out, some may cause jerking movements in the body. If your child develops a seizure, put them on their side, do not put anything in their mouth and seek medical attention immediately.

By being informed about treatment strategies and recognizing worrisome signs, parents can confidently care for their child when a fever strikes. If something doesn't feel right, trust your parental instincts and consult with your child's pediatrician for personalized guidance based on your child's specific circumstances.

Have a sick kid? We're here to help. Find access to our symptom checker, nurse chat, eVisits and more.

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