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.

• 
  
  
  
  
  Bellevue
  
  
  
• 
  
  
  
  
  Everett
  
  
  
• 
  
  
  
  
  Federal Way
  
  
  
• 
  
  
  
  
  Seattle
  
  
  
• 
  
  
  
  
  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: 07/18/2023

Last Revised: 12/30/2022

Copyright 2000-2023 Schmitt Pediatric Guidelines LLC.

What Can I Do About a Fever (High Temperature)? (for Parents)

en español: Cómo tratar la fiebre

Medically reviewed by: Melanie L. Pitone, MD

Primary Care Pediatrics at Nemours Children’s Health

Parents might worry when a child’s temperature rises, but a fever itself causes no harm and can actually be a good thing — often, it’s the body’s way of fighting infections.

What Are the Signs & Symptoms of a Fever?

A child who has a fever might be:

• fussy
• uncomfortable
• warm to the touch
• flushed
• sweaty

What Can I Do About a Fever?

Call the doctor’s office if your baby is younger than 3 months old with a temperature of 100. 4°F (38°C) or higher. If you can’t reach the doctor, go to the ER.

It’s best to keep a child with a fever home from school or childcare until their temperature has been normal for at least 24 hours. If your child is uncomfortable, here are some ways to ease symptoms:

• Offer plenty of liquids to avoid dehydration.
• Give acetaminophen or ibuprofen based on the doctor’s recommendations. Do not give aspirin to your child or teen as it’s linked to a rare but serious illness called Reye syndrome.
• Never use rubbing alcohol or cold baths to bring the fever down.
• Dress your child in lightweight clothing and cover with a light sheet or blanket.
• Let your child eat what they want, but don’t force it if your child doesn’t feel like eating.
• If your child also is vomiting and/or has diarrhea, ask the doctor if you should give a children’s oral rehydration solution (also called oral electrolyte solution or oral electrolyte maintenance solution).
• Make sure your child gets plenty of rest.

Get Medical Care if:

• your baby is younger than 3 months old has a temperature of 100.4°F (38°C) or higher
• an older child has a fever and:
  • looks sick
  • develops a rash
  • has lasting diarrhea and/or repeated vomiting
  • has signs of dehydration (peeing less than usual, not having tears when crying, less alert and less active than usual)
  • has a fever for 5 days
  • has a
    chronicmedical problem like sickle cell disease or cancer

Can Fevers Be Prevented?

All kids get a fever from time to time, and in most cases they’re back to normal within a few days. The key is to make your child as comfortable as possible until the fever passes, and get medical care when needed.

Medically reviewed by: Melanie L. Pitone, MD

Date reviewed: December 2022

Share:

/content/kidshealth/misc/medicalcodes/parents/articles/fever-sheet

If a child has a fever, what should I do?

home

Articles

Health

05/14/2019

Before you start taking antipyretics, you need to answer a few questions:

• what is the age of the child?

• How does a child tolerate an increase in a particular temperature?

• Have there been any family or child history of febrile seizures?

• Are there any other symptoms of the disease besides fever?

An increase in temperature or fever is a protective and adaptive reaction of the body in response to the effects of pathogenic stimuli, which results in a restructuring of thermoregulation processes, leading to an increase in body temperature, which stimulates the body’s natural resistance.

An increase in temperature affects the child’s body both positively and negatively.

The positive effect of is that when the temperature rises in the child’s body, the immune system is activated, phagocytosis increases, the production of antibodies increases and the level of interferon increases, which helps to stop the reproduction of pathogenic microorganisms and overcome the infection.

Negative influence high temperature in a child is manifested in the occurrence of convulsions (febrile), increased stress on the baby’s cardiopulmonary system (heart rate and respiratory rate become more frequent). Therefore, fever is dangerous for children with malformations of the heart and bronchopulmonary system, heart rhythm disturbance. Also, when the temperature rises, the work of the brain, liver, stomach, kidneys and other internal organs suffers, which is dangerous for children with chronic pathologies of internal organs, symptoms of dehydration, developmental disorders and diseases of the nervous system.

Fever varies:

1. with the flow:

   • acute (fever up to 2 weeks),

   • subacute (up to 6 weeks),

   • chronic (over 6 weeks).

2. by the degree of increase of the indicator:

   • subfebrile (increase to +38.0 degrees)

   • febrile (from +38.0 to +39.0 degrees),

   • pyretic (from + 39.0 to + 41.0 degrees),

   • hyperpyretic (over +41.0 degrees).

3. according to the type of temperature curve:

   • constant (temperature fluctuations during the day are not higher than 1 degree).

   • laxative (daily fluctuations up to 2 degrees),

   • atypical (fluctuations are chaotic, different and irregular),

   • debilitating (a combination of laxative and atypical fever with fluctuations during the day more than 2-3 degrees),

   • intermittent (a combination of short periods of temperature increase and decrease to normal numbers),

   • return (alternation of periods of temperature increase with periods of temperature normalization from 2 to 7 days).

On the recommendation of the WHO (World Health Organization), antipyretics are prescribed for children according to age:

• from the moment of birth to 2 months at a temperature of +38.0 degrees,

• children from 3 months to 24 months at a temperature of +38.5 degrees,

• children from 1 to 5 years old at a temperature of +39.0 degrees,

• children over 5 years old with indicators of + 39.5- + 40.0 degrees.

On the other hand, the approach to each child should be individual.

If a child

• restless or feeling weak,
• cannot tolerate muscle pain, headache,
• have nausea,
• no appetite,

then you must first apply physical methods to improve the well-being of the child :

• put to bed – so the body will save strength to fight the infection, calm the child;

• drink fractionally with water or sweetened warm herbal tea with chamomile, linden, cranberry juice;

• provide access to fresh air;

• to feed in the presence of appetite in small portions of warm food (for example, soup, liquid porridge on the water, a light breakfast).

Also, according to the clinical variant of the course of fever, apply additional cooling measures.

With “red” or “pink” fever

• the child’s body feels hot to the touch,
• skin red or pink, moist,
• the child himself does not complain about his well-being, he is active, his appetite does not disappear.

In this case, child needs

• undress,
• wipe with a towel soaked in water at room temperature,
• apply a cool compress to the forehead,
• drink water at room temperature
• and be sure to call a doctor.

With “white or pale” fever

• the limbs and body of the child are cold to the touch,
• lips and nail beds become bluish,
• pale and dry skin,
• there is a violation of well-being: the child is lethargic, delirium is possible.

In this case child needs

• warm by rubbing the limbs with hands or using warm water (no other means!),
• put on socks,
• cover with a blanket
• and drink warm tea or water.

The use of antipyretics for such symptoms is ineffective – you need to urgently call a doctor!

An exception is children at risk, who have their temperature reduced above 37.1 degrees. These are children,

• with diseases of the nervous system,
• convulsions due to fever,
• suffering from chronic diseases of the circulatory system, respiratory organs or with hereditary metabolic diseases and other risks (overheating, symptoms of dehydration, etc.).

Febrile convulsions are diagnosed more often in children under 6 years of age with temperatures above +38 degrees, as well as in children with pathology of the nervous system at any temperature. For such children, it is recommended to lower the temperature to febrile levels (not higher than +38.0) or to those values ​​recommended by a neuropathologist.

Usually, against the background of an increase in temperature, the child’s heart rate and respiratory rate increase: the respiratory rate increases by 4 respiratory movements for every degree above +37. 0 degrees, and the pulse rate – by 20 beats per minute for every degree. However, against the background of diseases of the cardiovascular system and respiratory organs, such as malformations or cardiac arrhythmias, inadequate increases or slowdowns in heart rate and respiration are possible. Such children, on the recommendation of a cardiologist and pulmonologist, are prescribed antipyretic drugs to febrile numbers (ie, not higher than +38.0 degrees).

Children with hereditary metabolic diseases (diseases of the thyroid gland, kidneys, liver, disorders in the immune system, and others) and children with imperfect compensatory mechanisms of thermoregulation during fever (these are some children from birth to 2 months) are also prescribed antipyretic drugs on the recommendation of related specialists means to febrile digits.

Overheating – increase in body temperature due to additional exposure to heat

• prolonged sun exposure,
• use of excess clothing,
• excessive wrapping of children).

The danger of overheating is associated with the risk of heat stroke. It manifests itself

• not only in elevated temperature,
• but also in impaired consciousness, convulsions,
• disorders of the heart and breathing.

First aid is to call the ambulance “112”.

Until the doctor arrives

• undress the child,
• move to a cool place or shade,
• supply fresh air or fan (but not cool air!),
• apply a cold compress to the forehead,
• Wipe the body with cool water or cover with a sheet soaked in cool water.

Antipyretic therapy for children should be prescribed strictly individually, taking into account clinical and anamnestic data.

It is important to know that taking antipyretic drugs does not shorten the duration of the febrile period. At the end of the drug, the temperature rises again.

Antipyretics have a lot of side effects:

• allergic reactions,
• bleeding,
• stomach damage (vomiting, regurgitation),
• Reye’s syndrome (against the background of rash, vomiting, psychomotor agitation occurs).

In addition, the decrease in body temperature should not be critical, it is not necessary to achieve normal performance. It is enough to lower the temperature by 1.0 or 1.5 degrees, which will improve the child’s well-being and avoid collapse.

The collapse develops with a critical (rapid and sharp) decrease in temperature for a short time (from 40-41 degrees to 37-36.0 degrees) by 2.5 – 3.0 degrees or more.

The result is

• acute cardiovascular insufficiency, accompanied by vasospasm and circulatory disorders.

Child feels

• cold or chilly,
• severe weakness,
• headache,
• thirsty,
• he has pale skin up to a bluish tint,
• sticky sweat,
• cold extremities,
• insomnia,
• shortness of breath up to shallow breathing,
• palpitations,
• lowering blood pressure,
• convulsions,
• loss of consciousness.

First aid before the doctor arrives:

• put the child in such a way that the head is not raised, and the legs are on the pillow (30-40 cm above the head).
• Warm up by covering the child with heating pads,
• shelter,
• rub limbs with hands,
• drink warm sweetened herbal tea, water,
• change underwear and bed linen.

It is also important to know that antipyretics should not be used in courses, as this makes it difficult to diagnose a child’s disease. An increase in temperature is often the only manifestation of a violation of the child’s health. Therefore, a doctor’s examination and additional examinations are necessary.

Constipation in children. Prevention. Diet therapy

Medical examination before kindergarten and school

Return to the list

reasons, recommendations of doctors of CMD Central Medical Clinic Perovo, Novogireevskaya

An increase in body temperature in a child is the most common reason for seeking emergency medical care. And of course, it is right when the child’s parents, not self-medicating, seek medical help when their child has a fever.

However, it is useful for all parents to know some of the main causes of fever (fever) in a child and ways to normalize it.

Fever is divided into three main degrees of severity:

• A – fever from 37.0 to 37.9 degrees – mild or subfebrile fever, subfebrile condition;
• B – temperature increase from 38.0 to 39.0 degrees C – moderate fever;
• B – from 39.0 to 41.0 – high fever;
• D – increase in body temperature above 41 degrees – excessive (life-threatening) fever.

Fever in an infant

The body temperature of a newborn child during the first 5 – 7 days of life fluctuates around 37.0, and in some children, an increase in body temperature during this period up to 38.0 – 39.0 is possible. This phenomenon is called transient hyperthermia of the newborn. In addition to hyperthermia, newborns are even more likely to have hypothermia, that is, a decrease in body temperature below normal. Due to the immaturity of the brain structures, not only newborn children, but also children of the younger age group up to 3-5 years old have a tendency to overheat quickly and to quickly hypothermia. Especially such a “volatility” of body temperature is typical, of course, for children in the first year of life. Therefore, if you, having measured the body temperature of a baby, found an increase in body temperature to 37.0 – 37.4 degrees, do not rush to immediately call a pediatrician. It is enough to measure the body temperature, having previously unswaddled the child, or simply remove a warm blanket from him so that after 15-20 minutes the temperature returns to normal.

Another common cause of an increase in body temperature in the first 1.5 – 2 years of a child’s life is a reaction to teething. We wrote about this problem in a separate article on our website. In a nutshell, let me remind you that the reaction to teething in children is very individual. An increase in body temperature, most often, fits into the range from 37.1 to 37.6 degrees. Elevated temperature during teething usually lasts no more than 2-3 days, and in most children does not require the use of antipyretic drugs. However, in some cases, when teething, the child may have a fairly high fever of up to 38.0 and even up to 39.0 degrees. In this case, you can not do without the use of special anti-inflammatory gels for application to the gums and antipyretics in the form of suppositories (candles), such as Nurofen.

Prolonged, subfebrile fever in a child

If in infants the cause of sudden “temperature jumps”, most often, is the immaturity of the nervous system and the reaction to teething, then in older children, often prolonged subfebrile body temperature is kept against the background of psycho-emotional experiences, academic failure, conflict situations in the family.