What are the signs of fever in infants under 12 months. How to measure temperature accurately in babies. When does infant fever require immediate medical attention. What are common causes of fever in babies under 1 year old. How to care for an infant with fever at home.

Understanding Fever in Infants: Definition and Measurement

Fever in infants is defined as an abnormally high body temperature. For babies under 12 months old, a true fever is considered to be:

• Rectal, ear, or forehead temperature of 100.4°F (38.0°C) or higher
• Armpit (axillary) temperature of 99°F (37.2°C) or higher

It’s important to note that ear temperatures are not accurate for infants under 6 months old. Additionally, forehead temperatures must be taken with a digital thermometer, as forehead strips are not reliable for accurate readings.

How to Measure Temperature in Infants

Accurately measuring an infant’s temperature is crucial for determining if they have a fever. What’s the most reliable method for babies? Rectal temperature is considered the gold standard for infants, especially those under 3 months old. Here’s a quick guide on taking a rectal temperature:

1. Clean the thermometer with soap and water or rubbing alcohol
2. Lubricate the tip with petroleum jelly
3. Gently insert the tip about 1/2 inch into the rectum
4. Hold in place until the thermometer beeps or signals it’s done
5. Remove and read the temperature

For older infants, armpit or ear temperatures can be used as alternatives, though they may be slightly less accurate.

Common Causes of Fever in Babies Under 12 Months

Fever in infants is usually a sign that the body is fighting an infection. While there are numerous potential causes, some are more common than others:

Viral Infections: The Most Frequent Culprit

Viral infections are responsible for about 10 times more fevers than bacterial infections. Why are viruses so common in infants? Their immune systems are still developing, making them more susceptible to various viruses. Some examples include:

• Common cold viruses
• Influenza (flu)
• Roseola (a viral illness causing fever followed by a rash)

In many cases, fever may be the only symptom for the first 24 hours of a viral infection. Other symptoms like runny nose, cough, or diarrhea often appear later.

Bacterial Infections: Less Common but Potentially Serious

While less frequent than viral infections, bacterial infections can cause fever in infants and often require medical treatment. In girls, urinary tract infections (UTIs) are a common cause of unexplained fever. Other bacterial infections that can cause fever in infants include:

• Ear infections
• Pneumonia
• Strep throat (though rare in infants under 6 months)

Vaccine-Related Fever: A Normal Immune Response

Fever following vaccinations is a normal and typically harmless reaction. It usually begins within 12 hours of receiving the vaccine and lasts for 2 to 3 days. This fever is a sign that the vaccine is working and the baby’s immune system is responding appropriately.

When Fever in Infants Requires Immediate Medical Attention

While most fevers in infants are not serious, there are situations that require prompt medical evaluation. When should you seek immediate care for an infant with fever?

• Any fever in a baby under 12 weeks old
• Fever over 104°F (40°C)
• Signs of dehydration (no urine for over 8 hours, dark urine, very dry mouth, no tears)
• Difficulty breathing
• Seizures or convulsions
• Extreme lethargy or difficulty waking
• Severe headache or neck stiffness
• Persistent vomiting
• Unusual rash, especially purple spots or dots

In these cases, don’t wait – seek medical attention immediately. Early intervention can be crucial, especially for young infants whose condition can deteriorate rapidly.

Newborn Fever: A Special Concern

Fever in newborns, especially those under 3 months old, is considered a serious matter. Why is newborn fever treated so urgently? Their immature immune systems make them more vulnerable to severe infections, including sepsis (bloodstream infection) and meningitis.

Any fever in a baby under 12 weeks old warrants immediate medical evaluation. It’s important not to give fever-reducing medication before seeing a doctor, as it may mask symptoms and make diagnosis more difficult.

Signs of Serious Infection in Newborns

While fever is a key indicator, other signs of serious infection in newborns include:

• Poor feeding or refusing to eat
• Irritability or inconsolable crying
• Lethargy or difficulty waking
• Rapid breathing or grunting
• Pale, gray, or blue-tinged skin

If you notice any of these signs along with a fever, seek medical care immediately.

Distinguishing Between Serious and Non-Serious Fevers

For parents, it can be challenging to determine when a fever is cause for concern. How can you tell if your infant’s fever is serious? Here are some guidelines:

Factors Indicating a More Serious Condition

• Age: Any fever in infants under 3 months is considered serious
• Temperature: Fevers over 104°F (40°C) require immediate attention
• Duration: Fevers lasting more than 3 days should be evaluated
• Behavior: Extreme irritability, lethargy, or refusal to eat are concerning
• Other symptoms: Difficulty breathing, seizures, or unusual rashes accompany the fever

Signs of Less Serious Fevers

• The baby is still alert and responsive
• They’re still eating and drinking normally
• The fever responds to fever-reducing medication (for infants over 3 months)
• There are mild cold symptoms like a runny nose or cough

Remember, when in doubt, it’s always better to consult with a healthcare provider, especially for young infants.

Home Care for Infants with Fever

If your infant has a mild fever and is behaving normally, you may be able to care for them at home. What are some safe and effective ways to manage infant fever?

Keeping Your Baby Comfortable

• Dress your baby in light clothing to help them stay cool
• Keep the room temperature comfortable, not too hot or cold
• Offer plenty of fluids to prevent dehydration
• Give lukewarm sponge baths if the fever is high

Medication Guidelines

For infants over 3 months, acetaminophen can be given to reduce fever and discomfort. Always follow dosage instructions based on your baby’s weight. Ibuprofen can be used for infants over 6 months. Never give aspirin to infants or children due to the risk of Reye’s syndrome.

Remember, the goal is not to eliminate the fever entirely, but to keep your baby comfortable. Fever is part of the body’s natural defense against infection.

Myths and Misconceptions About Infant Fever

There are several common misconceptions about fever in infants. Let’s address some of these to help parents better understand and manage their baby’s fever:

Myth: Teething Causes Fever

Contrary to popular belief, teething does not cause significant fever. While teething may cause a slight increase in temperature, a true fever (over 100.4°F rectally) is not caused by teething alone. If your teething baby has a fever, it’s likely due to an unrelated illness.

Myth: Fever is Dangerous and Must Be Treated Aggressively

While fever can be uncomfortable, it’s generally not harmful in itself. Fever is the body’s natural response to fighting infection. The focus should be on the child’s overall condition rather than just the number on the thermometer.

Myth: Bundle Up a Feverish Baby

Bundling up a baby with fever can actually make them feel worse and potentially increase their temperature. Dress your feverish baby in light, breathable clothing to help them stay comfortable.

Myth: Cold Baths are Best for Reducing Fever

Cold baths can be uncomfortable and may cause shivering, which can actually raise body temperature. Lukewarm baths are more effective and comfortable for reducing fever.

Understanding these myths can help parents provide better care for their feverish infants and reduce unnecessary worry.

Prevention and Long-Term Health Considerations

While it’s impossible to prevent all fevers, there are steps parents can take to reduce the risk of infections in infants. How can you protect your baby’s health and potentially prevent some causes of fever?

Vaccination

Keeping your baby up-to-date on recommended vaccinations is crucial. Vaccines protect against many serious illnesses that can cause fever and other complications. While vaccines themselves may cause a brief, mild fever, this is far preferable to the diseases they prevent.

Hygiene Practices

• Wash your hands frequently, especially before handling your baby
• Keep your baby’s environment clean
• Limit exposure to sick individuals
• For breastfeeding mothers, continue breastfeeding as it provides antibodies that help protect against infections

Nutrition and General Health

A well-nourished baby with a strong immune system is better equipped to fight off infections. Ensure your baby is getting proper nutrition through breastmilk or formula, and later, a balanced diet of solid foods.

Long-Term Health Monitoring

While most infant fevers are not cause for long-term concern, recurrent or prolonged fevers may indicate an underlying health issue. Keep track of your baby’s fever patterns and discuss any concerns with your pediatrician.

By taking these preventive measures and staying vigilant about your baby’s health, you can help reduce the frequency and severity of fevers and promote overall well-being.

Fever (0-12 Months)

Is this your child’s symptom?

• An abnormal high body temperature
• Fever is the only symptom. Your child has a true fever if:
• Rectal (bottom), Ear or Forehead temperature: 100.4° F (38.0° C) or higher
• Under the arm (armpit) temperature: 99° F (37.2° C) or higher
• Caution: Ear temperatures are not accurate before 6 months of age
• Caution: Forehead temperatures must be digital. Forehead strips are not accurate.

Causes of Fever

• Overview. Almost all fevers are caused by a new infection. Viruses cause 10 times more infections than bacteria. The number of germs that cause an infection are in the hundreds. Only a few common ones will be listed.
• Viral Infections. Colds, flu and other viral infections are the most common cause. Fever may be the only symptom for the first 24 hours. The start of viral symptoms (runny nose, cough, loose stools) is often delayed. Roseola is the most extreme example. Fever may be the only symptom for 3 to 5 days. Then a rash appears.
• Bacterial Infections. A bladder infection is the most common cause of silent fever in girls.
• Vaccine Fever. Fever with most vaccines begins within 12 hours. It lasts 2 to 3 days. This is normal and harmless. It means the vaccine is working.
• Newborn Fever (Serious). Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment.
• Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can’t be consoled. If not treated early, can suffer brain damage.
• Overheated. The fever is usually low grade. Can occur during heat waves or from being overdressed. The temp becomes normal in a few hours after moving to a cooler place. Fever goes away quickly with rest and drinking extra fluids.
• Not Due to Teething. Research shows that “getting teeth” does not cause fevers.

Fever and Crying

• Fever on its own shouldn’t cause much crying.
• Frequent crying in a child with fever is caused by pain until proven otherwise.
• Hidden causes can be ear infections, kidney infections, sore throats and meningitis.

Normal Temperature Range

• Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range.

When to Call for Fever (0-12 Months)

Call 911 Now

• Not moving
• Can’t wake up
• Severe trouble breathing (struggling for each breath; can barely speak or cry)
• Purple or blood-colored spots or dots on skin
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Trouble breathing, but not severe
• Great trouble swallowing fluids or spit
• Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
• Fever over 104° F (40° C)
• Shaking chills (shivering) lasting more than 30 minutes
• Nonstop crying or cries when touched or moved
• Won’t move an arm or leg normally
• Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
• Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Age 3-6 months old with fever
• Age 6-12 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea).
• Fever lasts more than 3 days
• Fever returns after gone for more than 24 hours
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Fever with no other symptoms and your child acts mildly ill

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

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  Virtual Urgent Care
  
  
  

Care Advice for Fever

1. What You Should Know About Fever:
   • Having a fever means your child has a new infection.
   • It’s most likely caused by a virus.
   • You may not know the cause of the fever until other symptoms develop. This may take 24 hours.
   • For infants more than 3 months old, most fevers are good for sick children. They help the body fight infection.
   • Use the ranges below to help put your child’s level of fever into perspective:
   • 100° – 102° F (37.8° – 39° C) Low grade fever: helpful, good range. Don’t treat.
   • 102° – 104° F (39 – 40° C) Average fever: helpful. Treat if causes discomfort.
   • Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat.
   • Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high.
   • Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful.
2. Treatment for All Fevers – Extra Fluids:
   • Fluids alone can lower the fever. Reason: being well hydrated helps the body give off heat through the skin.
   • For shivering (or the chills), give your child a blanket. Make them comfortable.
   • Offer your child extra water or other fluids by mouth. Cold fluids are better. Until 6 months old, only give extra formula or breastmilk.
   • For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin.
   • For shivering (or the chills), give your child a blanket. Make them comfortable.
   • Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: Babies can get over-heated more easily than older children.
3. Fever Medicine:
   • Caution: Do not give a baby under 3 months any fever medicine. Most of these babies will need to be seen.
   • For fevers 100°-102° F (37.8° – 39°C), fever meds are not needed. Reason: fevers in this range help the body fight the infection. Fevers turn on the body’s imune system. Fevers don’t cause any discomfort.

   Fever meds are mainly needed for fevers higher than 102° F (39° C).

4. Give an acetaminophen product (such as Tylenol).
5. Another choice is an ibuprofen product (such as Advil) if over 6 months old.
6. Goal of treatment: keep the fever at a helpful level. Most often, the fever meds lower the fever by 2° to 3° F (1 – 1.5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect.
7. Do not use aspirin. Reason: Risk of Reye syndrome, a rare but serious brain disease.
8. Do not use both acetaminophen and ibuprofen together. Reason: Not needed and a risk of giving too much.
9. Pain: fever does not cause pain. If your child also has pain, it’s from the infection. It may be a sore throat or muscle pain. Treat the pain, if it’s more than mild.
10. Return to Child Care:
    • Your child can return to child care after the fever is gone. Your child should feel well enough to join in normal activities.
11. What to Expect:
    • Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C).
    • They may last for 2 or 3 days.
    • They are not harmful.
12. Call Your Doctor If:
    • Your child looks or acts very sick
    • Any serious symptoms occur such as trouble breathing
    • Fever goes above 104° F (40° C)
    • Any fever occurs if less than 12 weeks old
    • Fever without other symptoms lasts more than 24 hours
    • Fever lasts more than 3 days (72 hours)
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 07/16/2023

Last Revised: 12/30/2022

Copyright 2000-2023 Schmitt Pediatric Guidelines LLC.

Fever | Boston Children’s Hospital

Your child has a fever if her temperature is 100.4 degrees Fahrenheit or higher.

The body has several ways to maintain normal body temperature. The body responds to changes in temperature by:

• increasing or decreasing sweat production
• moving blood away from, or closer to, the surface of the skin
• getting rid of, or holding on to, water in the body
• naturally wanting to seek a cooler or warmer environment

What causes a fever?

When your child has a fever, her body works the same way to control the temperature but it resets its thermostat at a higher temperature. The temperature increases for a number of reasons:

• Chemicals called cytokines or mediators are produced in the body in response to an invasion from a microorganism, malignancy, or other intruder.
• The body is making more macrophages, which are cells that go to combat when intruders are present in the body. These cells actually “eat up” the invading organism.
• The body is busily trying to produce natural antibodies which fight infection. These antibodies will recognize the infection next time it tries to invade.
• Many bacteria are enclosed in an overcoat-like membrane. When this membrane is disrupted or broken, the contents that escape can be toxic to the body and stimulate the brain to raise the temperature.

What conditions can cause a fever?

The following conditions can cause a fever:

• infectious diseases
• certain medications
• heat stroke
• blood transfusion
• disorders of the brain

What are the benefits of a fever?

A fever actually helps the body destroy its microbial invader. It also stimulates an inflammatory response, which sends all kinds of substances to the area of infection to protect the area, prevent the spread of the invader, and start the healing process.

What are the symptoms that my child may have a fever?

Children with fevers may become more uncomfortable as the temperature rises. The following are the most common symptoms of a fever. However, each child may experience symptoms differently. In addition to a body temperature greater than 100.4 degrees Fahrenheit, symptoms may include:

• Your child may not be as active or talkative as usual.
• She may seem fussier, less hungry, or thirstier.
• Your child may feel warm or hot. Remember that even if your child feels like she is “burning up,” the actual rectal or oral temperature may not be that high.

The symptoms of a fever may resemble other medical conditions. According to the American Academy of Pediatrics, if your child is younger that 2 months of age and has a rectal temperature of 100.4 degrees Fahrenheit or higher, you should call your pediatrician. If you are unsure, always consult your child’s physician for a diagnosis.

When should a fever be treated?

If your child is very uncomfortable, treatment may be necessary. Treating your child’s fever will not help her body get rid of the infection any quicker, but it will relieve discomfort associated with it.

Rarely, children between the ages of 6 months and 5 years can develop seizures from high fever (called febrile seizures). If your child does have a febrile seizure, there is a chance that the seizure may occur again, but, usually, children outgrow the febrile seizures. A febrile seizure does not mean your child has epilepsy.

What can I do to decrease my child’s fever?

Give her an anti-fever medication, such as acetaminophen or ibuprofen. DO NOT give your child aspirin, as it has been linked to a serious, potentially fatal disease, called Reye syndrome.

Other ways to reduce a fever:

• Dress your child lightly. Excess clothing will trap body heat and cause her temperature to rise.
• Encourage your child to drink plenty of fluids.
• Give your child a lukewarm bath.
• Place cold washcloths over areas of the body where the blood vessels are close to the surface of the skin such as the forehead, wrists, and groin.

When should I call my child’s physician?

If your child’s temperature reaches 105 degrees Fahrenheit, this is considered a medical emergency and your child needs immediate medical attention, according to the American Academy of Pediatrics.

Call your child’s physician immediately if your child is younger than 3 months old and any of the following conditions are present:

• Your child’s rectal temperature is greater than 100.4 degrees Fahrenheit.
• Your child is crying inconsolably.
• Your child is difficult to awaken.
• Your child’s neck is stiff
• Purple spots are present on the skin.
• Breathing is difficult AND does not improve after you clear the nose.
• Your child is unable to swallow anything and is drooling saliva.
• Your child looks or acts very sick; if possible, check your child’s appearance one hour after your child has taken an appropriate dose of acetaminophen.

Call your child’s physician within 24 hours if your child, 3 months or older, has any of the following conditions present:

• The fever is 102 degrees Fahrenheit or higher (especially if your child is younger than 2 years old)
• Burning or pain occurs with urination
• Your child has had a fever for more than 24 hours without an obvious cause or location of infection.

Call your child’s physician during office hours if any of the following conditions are present:

• Your child has had a fever for more than 72 hours.
• The fever went away for more than 24 hours and then returned.
• Your child has a history of febrile seizures.
• You have other concerns or questions.

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Yellow fever – Udmurt AIDS Center

Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. “Yellow” it is called because of the jaundice that develops in some patients. Up to 50% of people who develop severe illness die from yellow fever. An estimated 200 000 cases of yellow fever occur worldwide every year, 30 000 of which are fatal, 90% of them are in Africa. This virus is endemic in tropical regions of Africa and Latin America with a total population of over 900 million. Over the past two decades, the number of cases of yellow fever has increased as a result of declining population immunity to infection, deforestation, urbanization, population migration and climate change.

There is no cure for yellow fever. Only symptomatic treatment is possible, aimed at alleviating symptoms for a more comfortable condition of patients. Vaccination is the most important measure to prevent yellow fever. The vaccine is safe, affordable and highly effective. It provides protection for 30-35 years or more. For 9In 5% of vaccinated people, the vaccine provides effective immunity one week after immunization. Yellow fever vaccination is highly recommended for those traveling outside urban areas in endemic countries (Africa and South America) that do not officially report cases and do not usually require a certificate to enter the country.

Vaccination against yellow fever is nearly 100% effective, while mortality from the disease reaches 60% in non-immune adults. The tolerability of modern vaccines is excellent. The only contraindication, in addition to a true allergy to the protein of chicken eggs, is the insufficiency of cellular immunity (congenital or acquired, the latter can only be temporary). A vaccination certificate can only be valid if it meets the requirements for its issuance and if the vaccine used is approved by WHO and the vaccination was given at a certified yellow fever vaccination center.

The validity of the vaccination certificate is 10 years, starting from the 10th day after the day of vaccination. If a person is revaccinated before the expiration of this period, the validity is extended for a further 10 years, starting from the date of immunization. If the revaccination is recorded on a new certificate form, it is recommended to keep the previous vaccination certificate for 10 days from the date of the revaccination, until the expiration date of the new certificate begins.

List of countries requiring an international yellow fever vaccination certificate97 No. 2510/4106-97-32 “On changing the requirements for vaccination against yellow fever when Russian citizens travel to foreign countries”)

• Benin
• Burkina Faso
• Gabon
• Ghana
• Zaire
• Cameroon
• Congo
• Ivory Coast
• Liberia
• Mauritania
• Mali
• Niger
• Rwanda
• Sao Tome and Principe
• Togo
• French Guiana
• Central African Republic

List of countries endemic for yellow fever or with areas endemic for this infection, when entering (or transiting with a stopover) it is recommended to carry an international yellow fever vaccination certificate:

Tourists are advised to get vaccinated against yellow fever

Russian epidemiologists urge citizens leaving for some countries of South America and Africa to get vaccinated against yellow fever. According to the World Health Organization, the number of people infected with this disease has increased significantly in recent years.

The Federal Service for Supervision of Consumer Rights Protection and Human Welfare told MK that deadly mosquito bites have become more frequent in Guinea, Brazil and the Gambia, and in Mali yellow fever was registered for the first time in the last 10 years. At the same time, only 16 countries require tourists to have an international certificate of vaccination. Another 27 countries where there are outbreaks of the epidemic are limited to recommendations to get vaccinated before entering the country. These are Angola, Burundi, Gambia, Guinea, Guinea-Bissau, Kenya, Mauritania, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Uganda, Tanzania, Chad, Equatorial Guinea, Bolivia, Brazil, Venezuela, Guyana, Guiana, Colombia, Panama, Peru, Suriname, Trinidad and Ecuador. In a word, tourists going there should take care of their own safety. And the only way of salvation that medicine can offer people today is a vaccine that is valid for 10 years.