Children's

Fever FAQs & Advice from a Pediatrician

All kids get a fever from time to time. A fever itself usually causes no harm and can actually be a good thing — it’s often a sign that the body is fighting an infection.

But when your child wakes in the middle of the night flushed, hot, and sweaty, it’s easy to be unsure of what to do next. Should you get out the thermometer? Call the doctor?

Here’s more about fevers, including advice from Children’s of Alabama pediatrician, Dr. Peily Soong.

What Is a Fever?

Fever happens when the body’s internal “thermostat” raises the body temperature above its normal level. This thermostat is found in a part of the brain called the hypothalamus. The hypothalamus knows what temperature your body should be (usually around 98.6°F/37°C) and will send messages to your body to keep it that way.

Most people’s body temperatures change a little bit during the course of the day: It’s usually a little lower in the morning and a little higher in the evening and can vary as kids run around, play, and exercise.

Sometimes, though, the hypothalamus will “reset” the body to a higher temperature in response to an infection, illness, or some other cause. Why? Researchers believe that turning up the heat is a way for the body to fight the germs that cause infections, making it a less comfortable place for them.

What Causes Fevers?

It’s important to remember that fever by itself is not an illness — it’s usually a sign or symptom of another problem.

Fevers can be caused by a few things, including:

Infection: Most fevers are caused by infection or other illness. A fever helps the body fight infections by stimulating natural defense mechanisms.

Overdressing: Infants, especially newborns, may get fevers if they’re over bundled or in a hot environment because they don’t regulate their body temperature as well as older kids. But because fevers in newborns can indicate a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations: Babies and kids sometimes get a low-grade fever after getting vaccinated.

Although teething may cause a slight rise in body temperature, it’s probably not the cause if a child’s temperature is higher than 100°F (37.8°C).

Is it a Fever?

A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature (called tactile temperature) won’t give an accurate measurement.

Use a reliable digital thermometer to confirm a fever. It’s a fever when a child’s temperature is at or above one of these levels:

  • measured orally (in the mouth): 100°F (37.8°C)
  • measured rectally (in the bottom): 100.4°F (38°C)
  • measured in an axillary position (under the arm): 99°F (37.2°C)

But how high a fever is doesn’t tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102°–104°F/38.9°–40°C range), but this doesn’t usually mean there’s a serious problem. In fact, a serious infection, especially in infants, might cause no fever or even a low body temperature (below 97°F or 36.1°C).

Because fevers can rise and fall, a child might have chills as the body’s temperature begins to rise. The child may sweat to release extra heat as the temperature starts to drop.

Sometimes kids with a fever breathe faster than usual and may have a faster heart rate. Call the doctor if your child has trouble breathing, is breathing faster than normal, or is still breathing fast after the fever comes down.

Q&A with Dr. Soong, Pediatrician at Children’s of Alabama

Q: What advice do you have for parents when their child is dealing with a fever?

A: “Fevers are a natural way your body reacts when fighting off infections. For the most part, parents should not panic about a fever and can treat their child’s fever with over-the-counter fever reducers if their child is feeling bad from the fever. With normal cold infections such as the common cold or flu, fevers can commonly reach temperatures of 105F. Parents should not stress on how high a fever is, but stress on how their child is feeling or acting.”

Q: When should a parent call the doctor?

A: “Parents should contact their doctor immediately if their child is less than 2 months of age and has a temperature greater than or equal to 100.4F. Parents with older children with fever should seek immediate care if their child is lethargic, having trouble breathing, or not drinking. If at all concerned about your child having fever, go ahead and have your child seen by a doctor. Children with fevers persisting for several days should be evaluated by their doctor.”

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