Fever is a commonly misunderstood condition that all children experience. Amra Nasir, MD, medical director for Adventist HealthCare Urgent Care, answers common questions about fevers and when to seek medical help.
Q – My Child’s Forehead Feels Warm. What Should I Do?
Dr. Nasir – Your child comes to you hot, sweaty, flushed. He’s obviously not feeling well, not wanting to play. You put a hand to his forehead —it’s warm. You’re not sure what the situation is.
With my own kids, I dealt with plenty of fevers and always started by seeing what the exact temperature is and what could be causing it. That will help determine your action plan to help them start to feel better. Remember, a fever is a sign your child’s body is fighting infection. The fever presents itself as an increase in the body’s temperature above normal level (typically 98.6 degrees F). However, a physician will not consider a slightly elevated temperature (99 degrees F or so) to be a fever. Body temperature can vary a little during the day for various reasons, so don’t be concerned by this slight elevation.
My advice: always have a rectal thermometer available for the most accurate reading. A temperature of 100.4 degrees F or higher is considered a fever.
Q – What Causes a Fever?
Dr. Nasir – Several situations can trigger a fever. Most commonly, a fever is caused by a viral infection (common cold or upper respiratory infection) or another illness: The fever stimulates the body’s natural defense mechanisms, which helps fight the infection.
A few more fever triggers could be:
- Overdressing – With too many clothes on, any child can develop a high temperature. That’s especially true of a newborn. Remove those extra layers and take the child’s temperature. If your child is a newborn, call your doctor with any fever — even if the newborn was overdressed.
- Immunizations – A child may develop a low-grade fever after a vaccination.
- Teething – The child may have a slight temperature, but not likely over 100 degrees F.
Q – When Should I See a Doctor?
Dr. Nasir – I always tell moms to set their speed dial for either their pediatrician — or their insurance company nurse advice line. You need a medical professional who can quickly give you answers about fevers.
The child’s age, temperature, and other variables will determine whether it’s essential to see a doctor, go to urgent care or the emergency room.
Guidelines for Very Young Children
- Infant 3 months or younger with 100.4 degrees F or higher – Call your doctor and 911. Go to the emergency department immediately. In a very young baby, even a slight fever can be a sign of a serious infection.
- Under 6 months old with a fever over 102 degrees F – Call your doctor and 911. You should go to the emergency department. Watch for these signs: extremely irritable, lethargic, blue lips and blue fingertips.
- Over 6 months old and fever over 100.4 degrees F – Call your doctor. Go to an urgent care center or your pediatrician. Watch for signs of sore throat, ear pain, cough, burning and mild abdominal pain.
- Child between 3 months and 3 years old with a fever of 102.2 degrees F or higher – Call your doctor. You can give the child ibuprofen or acetaminophen to keep them comfortable. Go to the urgent care center.
- For older children – You should call your doctor if the they are lethargic, not eating or drinking, not peeing or pooping. By watching how your child behaves, you will have a pretty good idea whether this is a minor illness or if your child should be seen by a doctor. If they’re playing, eating and drinking, alert, smiling and has normal skin color, it’s probably nothing serious. Even if the child has a fever and isn’t interested in food, it’s nothing to worry about. As long as they are still drinking and urinating, it’s OK if they’re not hungry.
Q – What Do You Advise for Home Care?
Dr. Nasir – To help your child feel better, you can take a few steps to ease symptoms. Acetaminophen or ibuprofen are safe for children; read the labels closely for recommendations based on age and weight.
For infants less than 2 months old, talk with your doctor before you give them anything.
Other ways to help your child feel better includes:
- Dress the child in lightweight clothing. Cover them with a light sheet. Any extra bedding or clothing can trap the heat and cause their temperature to rise.
- Keep the bedroom at a comfortable temperature that’s not overly cold or hot.
- Give your child a sponge bath with semi-cold water, NOT ice water. This might help lower the temperature.
- Provide plenty of fluids to prevent dehydration, as fever can make kids lose fluids more quickly. Water, soup, ice pops, and gelatin are good choices. Avoid anything with caffeine, including colas and tea as they will cause dehydration.
- Keep the child at home; don’t send them to school if they look sick to you.
- Rest is best, but not outdoors where they might overheat.