Should I Be Worried? A Fever Primer

One of the more challenging aspects of parenting can be evaluating your child for a fever. It sounds simple, right? A temperature of 98.6 degrees F is an average normal temperature.1 Does that mean anything higher is cause for concern? Not necessarily. Normal temperatures can fluctuate throughout the day. Fever, which starts at 100.4 degrees F, is one aspect of illness, but we can give you a few more guidelines to help. Forewarned is forearmed and knowing what you need to know before that middle-of-the-night panic can make you breathe a little easier.

We’ve all seen movies where the mother presses a concerned palm to her child’s forehead and pronounces fever without any need for any other tool but her hand. For the rest of us, it’s not that easy, nor cut and dried. As a mom and a pediatrician, I’m a huge advocate of a combined approach: tools, knowledge and experience. And I want you to be as well.

Fever Isn’t a Bad Thing

Bear with me for a moment. An increase in temperature is your body’s way of doing a little self-repair. A fever causes the body to rev up the immune system and puts a damper on viruses and bacteria. Yes, they should be monitored, but a fever is rarely cause for alarm. Again, temperature is just one aspect of your child’s well-being.

Every Child Has a Fever at Some Point

Fully 85-90 percent of fevers are due to viral illnesses that resolve themselves with 48 hours and leave behind no lasting damage. These go away of their own accord without any intervention.

What’s in Your Toolkit?

Get a digital thermometer. It’s accurate and easy to use. For babies under six months old, the most accurate temperature is from a rectal reading. The same holds true for toddlers, although you can get a pretty accurate reading from their armpit. Over the age of five, use an oral reading.

Keep children’s acetaminophen on hand, along with the proper dosing tools. If using liquid medication, make certain you use the dispensing tool that came with the medication. Double check dosing and times, remembering to keep a record. If your child’s temperature exceeds 102 degrees F and he is uncomfortable, use medication. If it’s under 102 degrees F and they feel fine, hold off. Once again, you know your child best. If he is uncomfortable at 100 degrees F, give him the acetaminophen.

Keep the fluids going. Encourage drinking or sipping as much as possible. Always keep water nearby and offer frequently.

How High is Too High?

Normally we evaluate temperature along with your child’s other symptoms. Is he lethargic (not just tired, but not interactive)? Does she have any appetite? Will they interact with you? Are they alert? Here’s the mom (or dad) part coming into play. You know your own child best.

Call Immediately When:

  • Your child’s temperature exceeds 105 degrees F
  • Your child has a seizure
  • You see purple spots that look like blood blisters on the skin
  • Your baby is less than 2 months old, with a temperature over 100.4 degrees F
  • You notice joint swelling, and a refusal to move an arm or leg
  • Your child is crying and cannot be comforted one hour after a dose of acetaminophen or ibuprofen
  • You cannot awaken your child

Call During Office Hours When:

  • The fever symptoms have lasted three days or more
  • Your child is between 2-6 months old, and has a temperature of 100.4 degrees F
  • Your child is 6 - 24 months old, with a fever of 102 degrees F, and no obvious illness
  • Your child has been sleeping poorly for two nights in a row
  • Your child has burning sensation or pain with urination

I Just Can’t Tell…

It’s okay. If you have questions, or are unsure about what to do, call us. We’re here to help and sometimes you just need confirmation that what you’re doing is indeed the right thing. We’re all parents here, and we know how difficult it is when your child is sick. If you need help, call. It’s why we’re here, and we’ll help you in any way we can. Parenting is a learning process as well!


1 Fever Without Fear
2Acetaminophen Medicine Dosages

About the Author:
Dr. Michelle Chapin is a mother and pediatrician with Greenwood Pediatrics in Colorado. A native New Yorker, she graduated from Harvard with a degree in English Literature before heading to California to complete her medical training at the University of California, San Francisco. Following a residency at The Children’s Hospital In Denver, she joined the Greenwood team and currently gets families off to a good start doing what she loves best.

Posted: 1/15/2018 9:29:43 AM by Deb Braun | with 0 comments
Filed under: acetaminophen, child, fever, fluids, ibuprofen, in, lethargic


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