Fever in Children: 5 Things Caregivers Should Know

Fever is a common symptom in children when they are sick. It’s one of the main reasons that caregivers get medical care for kids. In fact, it’s the reason for up to one-third of medical visits.

Fever can be scary, even if it is only due to a mild illness. But it doesn’t have to be. Knowing what to expect and how to manage your child’s fever can help everyone stay calm.

What’s a normal body temperature for kids?

Average body temperature is considered to be 98.6°F. But a normal temperature can vary between 97.5°F to 99.5°F.

Normal body temperature can vary throughout the day. You can expect lower temperatures in the morning and higher temperatures later in the day. There are also other factors that can affect temperature. This includes:

• Clothing

• Activity level

• Meals

• Age (toddlers can have higher temperatures than older children)

What is considered a fever in kids?

A fever is a higher-than-normal body temperature. Most experts agree that a true fever is a temperature of 100.4°F or higher.

Sometimes, your child can have a higher temperature that’s lower than a standard fever. A temperature in the range of 99.6°F to 100.3°F is considered a low-grade fever.

If the temperature rises to 102°F or higher, it’s a high-grade fever. It’s important to know that a higher fever does not mean the illness is more severe.

What causes fever in children?

Fever is most commonly caused by viral or bacterial infections. These can include illnesses such as:

• Upper respiratory infection (URI)

• Ear infection

• Strep throat

• Flu

• Urinary tract infection (UTI)

• RSV

• Croup

• Gastroenteritis 

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Your child can also have fever after receiving vaccines. Up to 50% of infants can develop a fever within 1 to 2 days after receiving vaccines. 

While teething can raise body temperature slightly, it’s not believed to cause fever.

What are the symptoms of fever in kids?

Every child with fever is different and fever symptoms can vary. Some children show no symptoms at all and can look and feel fine. But others may complain of symptoms associated with the underlying cause of the fever. This can include symptoms such as sore throat, cough, or stomach upset. 

General symptoms that can come along with fever include:

• Less appetite

• Warm or flushed skin

• Crankiness or irritability

• Decrease in activity

• Less interest in play

• Fatigue

If you think that your child has a fever, there are five things you should know. 

1. The best way to take a temperature depends on the age of your child

Although you can check and feel if your child is warm, the best way to know if your child has a fever is to take their temperature with a digital thermometer. Mercury thermometers are no longer recommended because they can break and release fumes that are toxic.

You can measure your child’s body temperature in multiple places, but some places are more accurate than others. In general, rectal temperatures are the most accurate. Axillary (armpit) temperatures are the least precise.

The age of your child should determine the location you should use to measure their temperature. Common locations to check your child’s temperature include:

• Rectum (infants under 3 months)

• Forehead (any age)

• Oral (children 4 years or older)

• Ear (children 6 months and older)

• Armpit (any age)

2. Fevers can be helpful

If your child develops a fever, it’s important to know that a fever can be helpful. It’s your body’s natural response to infection. By itself, a fever is not dangerous — but rather a sign that your immune system is working. Fevers help to slow the growth of bacteria and viruses that can cause infection. And it can also improve the function of the immune system.

Most times, it’s more important to find the cause of the fever rather than focus on the fever itself.

3. Fevers can cause seizures

Your child could have a seizure with fever. Febrile seizures are most often seen with fevers greater than 101°F. But, it can happen at lower body temperatures, too. They are most common between 6 months and 5 years of age.

Treatment of the fever does not prevent febrile seizures from happening again. But fortunately, they are not harmful and tend to resolve within minutes. There is no evidence that untreated fevers or febrile seizures cause brain injury, long-term damage, or death. 

4. Not all fevers need to be treated

Unless your child is uncomfortable, it’s not necessary to treat their fever. As long as they are eating, drinking, and behaving normally, it’s OK to simply watch them. If your child is uncomfortable with fever, then it’s OK to treat. The goal is to limit any discomfort and not to return your child to a normal body temperature.

Keep in mind that if your child has an underlying medical condition or illness, you may want to treat their fever. This helps to lower the added stress that fever may place on the body.

5. You can treat a fever without medicine

There are several ways to make your child more comfortable when they have a fever. These include:

• Cool compresses

• Sponging

• Keeping the room cool

• Encouraging your child to drink fluids

• Wearing light clothing 

• Preventing overexertion

When trying to cool the body with a sponge bath or cool compress, make sure to use warm water. Cool or cold water can cause shivering which can actually raise body temperature.

Avoid bathing with rubbing alcohol. Absorbing it into the skin and inhaling the vapors can be harmful.

What’s the best medication to give my child for fever?

If you choose to treat your child’s fever, you can use over-the-counter (OTC) fever reducers. Both acetaminophen and ibuprofen would be good choices. While both are considered effective, it is important to note that there are differences between the two.

Acetaminophen is usually given every 4 to 6 hours, whereas ibuprofen is safe to give every 6 to 8 hours. And in many cases, they can be used together for staggered dosing. Although both medications are safe, there are risks to treatment especially if given the incorrect dose. So, it’s important to know your child’s current weight. This helps their medical provider confirm the correct dose your child needs.

Side effects for acetaminophen can include liver injury. And ibuprofen can cause kidney injury or bleeding in the digestive system. Check with your child’s provider to see which fever reducer is appropriate for your child based on their medical history.

Aspirin is no longer used as a fever reducer in children. That’s because of the risk of Reye’s syndrome. This is a rare, but serious condition that can cause severe brain swelling and liver damage most often after a viral infection. Aspirin should not be used by children under the age of 19 years unless directed by their healthcare provider.

When should my child be seen for a fever?

When your child has a fever, it is important to watch for any signs or symptoms of serious illness. You need to get medical help immediately if your child has any of the following:

• Less than 2 months old with a fever of 100.4°F or higher

• Fever higher than 104°F at any age

• Drowsy, confused, or difficult to wake

• Looks sick

• Stiff neck, headache, or rash

• A weakened immune system

• Seizures

• Signs of dehydration (like crying with no tears, less urine, and sunken eyes)

• Fever that is not improving

Why trust our experts?

Written by:

Tamara Johnson, MD

Tamara Johnson, MD is a board-certified pediatrician. She completed her undergraduate studies at Duke University and received her medical degree from the Medical University of South Carolina.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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