Parent’s Guide to Handling Your Child’s Fever

Your child comes to your bed in the middle of the night. They feel very warm. You take their temperature. The electronic screen turns red. The reading is 103.1. What’s the first thing you should do? Don’t panic! I recommend taking a deep breath.

While discovering your child has a fever is unsettling, it’s no cause for panic. You may actually find comfort in the fact that your child’s body is working to fight off whatever infection or illness it detects by raising your child’s body temperature. Believe it or not, most fevers between 100°F and 104°F are good for sick children as they help the body fight infection. The exception is babies less than 3 months of age who should be seen by a doctor.

But for children over 3 months, a trip to the doctor isn’t typically necessary. In fact, not all fevers even warrant medication. How a fever responds to fever medication depends upon what’s causing it. If your child’s temperature doesn’t drop after taking medication, it’s likely caused by viruses or bacteria. Again, not a reason to panic.

Rather than focusing on the number on the thermometer, I encourage parents to pay attention to making their child comfortable and observing their behavior.

Some steps you can take to help manage the fever include:

• Provide lots of fluids. Fever will cause children to lose fluids more quickly than when they are well, so offer plenty of fluids including water, diluted juices, or electrolyte solutions (Pedialyte) to avoid dehydration. 
• Don’t overdress your child. Dress them in a single layer of light, breathable clothing and provide one light blanket or a sheet if they experience chills.
• Keep them cool. If your child is warm, use a cool compress on their head and keep their room at a normal, comfortable temperature.
• Medicate for discomfort. Medication should only be given if your child is uncomfortable. Use child-specific acetaminophen or ibuprofen, taking care to dose correctly. If your child is under two years of age, contact your pediatrician or pharmacist for the correct dose if you do not have it available. Do not to give your child more than one medication containing acetaminophen, such as some cough and cold medicines, and avoid giving aspirin to children or teenagers.

As for when to call the doctor, do not hesitate to reach out if your child:

• appears unusually drowsy or fussy
• continues to "acts sick" once the fever is brought down
• child seems to be getting worse
• has a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash or repeated vomiting or diarrhea
• shows signs of dehydration, such as dry mouth, a sunken soft spot or significantly fewer
• is unable to take in fluids
• has a seizure
• is under 3 months and has a temperature of 100.4F or higher

You should also contact your child’s doctor if the fever:

• lasts for more than 24 hours in a child younger than 2 years.
• the fever lasts for more than 3 days (72 hours) in a child 2 years of age or older.
• rises above 104F repeatedly at any age.

Meghan Gunn, MD, FAAP, is board-certified in Pediatrics and Primary Care and the Medical Director of SVMC Pediatrics.