Fever is the body’s natural response
to infection and may be quite helpful in fighting the infection.
Fever is defined as a rectal temperature over 100.5°F,
an oral temperature over 100°F, or an
axillary (under arm) temperature over 100°F.
The body’s average temperature of 98.6°
may normally fluctuate from 97° in the
morning to a high of 100° F in the
evening. Exercise, excessive clothing, hot weather, and warm drink
may cause mild elevations of temperature. For this reason, low-grade
temperatures should be retaken one hour later to verify their
For children under three years, the most accurate method of
temperature measurement is rectally. Axillary measurements can give
general estimates of body temperature. Oral measurements are
practical beginning at three years of age. Ear thermometers are
useful with older children, but are inaccurate with children under 6
months and difficult to properly use under 2 years of age.
Most childhood fevers are caused by viral infections that require no
treatment and last from one to three days. Other causes of fever
include infections of the ears, sinuses, throat, urinary tract,
lungs and skin. In general, the height of the fever and the
effectiveness of fever medication in lowering the temperature are
not related to the seriousness of the infection. What is more
important is the child’s appearance and general disposition during
the illness. Many children with viral infections tolerate
temperatures as high as 103° F without any
significant change in activity – this is a favorable sign that the
condition is not serious. Other children with temperature elevations
may be particularly irritable, excessively sleepy, or may complain
of pain in a certain part of their body. These children will require
a medical evaluation to determine the cause of their fever.
Since fever is not harmful to the body, it need only to be treated
if a child is experiencing some discomfort as a result. Low-grade
fever is usually well tolerated, but fever of 102°F
or higher may cause a child to feel poorly. The following measures
will help reduce the fever.
1. Lightly clothe the child to allow the body to lose its excess
2. Encourage the
drinking of cool liquids and eating of Popsicles as tolerated.
3. If the child is
uncomfortable, give a fever medication: acetaminophen (Tempra,
Tylenol) or ibuprofen (Advil, Motrin). If the fever is greater than
101°, use acetaminophen, and if greater
that 102.5° use ibuprofen. For fever
persistently above 103°, doses of
acetaminophen and ibuprofen may be given together. Antibiotics and over-the-counter medications may be
given along with fever medications.
4. Sponge baths to
reduce fever are usually not necessary. Exceptions would be
emergencies such as heat stroke, delirium from fever, a seizure from
fever or fever over 106°. Do not sponge
with alcohol or ice water. Place the child in about two inches of
lukewarm bath water and sponge the water slowly over the head,
shoulders, chest, and back. The child’s body temperature will slowly
fall, but don’t expect the fever to drop below 101°.
Although fever aids the body’s defenses in fighting infection and is
not harmful to the body, an occasional child may have a seizure with
high fever. These seizures are generally of short duration (less
than five minutes) and result in no brain damage. They are generally
caused by a rapid rise in body temperature, and therefore are not
easily prevented. If your child does experience a seizure, lay him
on the floor on his side away from any objects that he might strike
with his arms or legs during the seizure. Don't try to force
anything into your child's mouth since tongue swallowing is not
possible. An immediate examination by a physician is recommended.
Each of the following conditions will require consultation with a
pediatrician or the office staff:
1. Fever above 101°
rectally in a child less than four months of age.
2. Fever lasting
longer than three days. Fever caused by most viral infections
usually resolves within three days.
3. Fever associated
with a stiff neck, severe headaches, or excessive drowsiness.
4. Fever with pain
in a specific part of the body such as an earache, sore throat, neck
pain, or painful urination.
5. Fever with the
sudden appearance of a skin rash.
See the Dosing
Tables for Fever Reducing Medications