: Fever in Children
What causes fever?
Fever is a symptom and not a diagnosis or a medical condition.
The most common cause of a fever in children is an infection,
mostly viral but in some cases a bacterial. One of the challenges
in evaluating children with fever is trying to determine the cause,
or at least to make sure it is not due a bacterial infection.
This distinction is important, as viral infections do not need
antibiotic treatment, but bacterial infections usually do. More
rarely there are other, so called "non infectious" causes of fever,
but in this circumstance, the fever persists for prolonged periods
of time(weeks or even months) rather than just for a short period
coincident with a current infection.
Fever is part of the overall picture
In general, the younger the child, the sicker looking the child
and/or the longer the fever persists, the higher the chance of
a bacterial infection. Also as important as the degree of fever
is how a febrile child generally looks. A sick looking child with
a low fever may be more ill than a very well, active child with
a higher fever.
Taking a child's temperature
There are 3 ways to take a child's temperature:
Rectal: this is the most exact reading and is
recommended for children less than 5 years of age
Oral(by mouth): recommended for children older
than 5 years of age
Axillary(armpit): this is the least precise
way to measure the temperature
What is the normal body temperature?
The average (normal) body temperature is usually 98.6º F (37ºC),
rectally. However there are ranges of normal temperatures depending
on how the temperature is measured:
The normal temperature range when measured rectally
is: 36.6º - 38º (C), or 97.9º - 100.4º (F)
The normal temperature range when taken by mouth is:
35.5º to 37.5º (C), or 95.9º - 99.5º (F)
The normal temperature range when taken from the armpit is:
34.7º to 37.3º (C), or 94.5º - 99.1º (F)
What body temperature is considered to be fever?
A child is considered to have a fever if:
The rectal temperature is
greater than 38º (C) or 100.4º (F),or
The oral( by mouth) temperature is
greater than 37.8º (C ) or 100º (F),or
The armpit temperature is
greater than 37.2º (C) or 99º (F)
About fever medications:
Today, there are 2 commonly used anti-pyretic or anti-fever medications:
Here are some general guidelines for using fever medications
- Acetaminophen(Tylenol, Tempra or Panadol) is a medication
that has a long and favorable track record and is considered
to be appropriate for use in children for fever and/or pain
control.Available in liquid, drop or pill form, acetaminophen
is given every four to six hours, as needed. Acetaminophen
is also available in suppository form which can be helpful
when a child needs to take fever medication but is throwing
up, with a "gastro" or stomach flu, for example. Although
acetaminophen is considered safe when used as recommended,
taking it regularly, for more that a week at a time can be
dangerous. Over dosage of acetaminophen can result in liver
damage. So it is important to follow the dosage based on a
child's age or weight and not to give it regularly for more
than 4 or 5 days
- Ibuprofen(Advil, Motrin) is a newer fever medication which
has not been around as long as acetaminophen. Most experts
agree that ibuprofen is a relatively safe and very effective
medication, but still recommend acetaminophen as a first line
fever medication given its longer track record.
Aspirin(acetylsalicylic acid) should never be used in children
Overdosing by accidental ingestion of these fever medications
can be very serious. These medications, as all others, should
be stored well out of the reach of children.
Acetaminophen and ibuprofen are available in combined preparations
with decongestants or cough medicines. These combination forms
should be avoided.
If a child is on antibiotics for a bacterial infection( an ear
infection) and has fever, then fever medication can be given as
well for temperature control during the first 48 hours which is
the time usually needed for to antibiotics to start working.
Other measures to help lower the fever:
Lowering the temperature with Acetaminophen or Ibuprofen can help
your child feel better and be less irritable. It usually takes
up to 60-90 minutes for the fever to go down. If fever medication
does not bring the temperature down, the child could be given
a luke-warm sponge bath. Do not use cool or cold compresses or
baths and never use alcohol sponging. Also children with fever
should not be overdressed.
When to call your doctor about your child's fever
Worrisome or alarm signs needing immediate medical attention include:
the fever is higher than 39.5º C(103ºF)rectal or
the child appears unwell or unusually ill(this applies even when
there is no fever) or
persistent fever(more than 3-4 days) or
the child is less than 6 months of age
Other Childhood Illnesses
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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