Fever | Chestnut Hill Pediatrics

Fever is a body temperature that is higher than 98.6-100°F. Temperatures below normal are usually not worrisome unless they occur in very young babies.
Fever itself is not an illness, but usually indicates that the body is fighting an infection. Fever is the body’s natural response to infection. In general, an elevated temperature is NOT dangerous. The infection that is causing the fever may or may not be concerning. Fever alone never causes brain damage unless the fever is very high (over 106-107°F).

How to take a temperature

  • Always check temperature with a thermometer. Feeling your child’s forehead is not reliable.
  • For infants, the most accurate way is to take a rectal temperature.
  • Oral (“mouth”) temperatures are also reliable when done in children who are least 4 years old.
  • Armpit, ear, and forehead temperatures are not as accurate as rectal or oral temperatures but are convenient for young children (over 3 months).

What to do if your child has a fever

  • In infants less than 3 months of age please call us immediately if your baby’s rectal temperature exceeds 100.4°F (38.0°C). Do not give any medication to lower fever in babies less than 3 months of age before talking to us.
  • From 3 months to 3 years of age, with temperature of
    • 100-102.1°F (37.8 – 39°C). This is often not serious. Most important is your child’s behavior. If your child seems well, that is reassuring. If your child seems ill, does s/he improve when the fever is reduced? Your child is less likely to have a serious illness if his/her overall condition improves when you bring down the temperature.
    • Greater than 102.2°F (39°C). Please call the office to determine whether your child needs to be evaluated. If your child is acting well, you can wait to call us during regular office hours.
    • Call us at any time if your child appears very ill or if you are unable to lower the temperature.
  • For children over 3 years of age
    • You may watch for 24 to 48 hours to determine if the fever decreases with treatment and behavior improves when temperature is reduced. If your preschooler or school-aged child with a high fever is eating, sleeping and acting well, s/he is less likely to have a serious illness.
    • Please call the office if the fever persists for 3 or more days or spikes after 3 or more days of illness.

Fever treatment
Many children do not need any treatment at all. Fever does not need to be lowered in a well-appearing, comfortable child. For instance, a child older than 3 months who has a temperature of less than 102°F (38.9°C), and who is otherwise healthy and acting normally, does not need a fever reducer.

  • Call us if you are not sure how best to handle your child’s fever.
  • NEVER give aspirin to a child younger than 18 years old. Aspirin can cause a dangerous condition called Reye syndrome.
  • Give a fever reducer to any child over 3 months of age with a fever who seems uncomfortable or won’t feed well.
  • Children often have poor appetites when they are sick. It is important to prevent dehydration. Offer your child plenty of fluids to drink. Call us if your child won’t or can’t drink fluids.
  • Encourage your child to rest as much as he or she wants but don’t force your child to sleep or rest.
  • Your child can return to school or regular activities when he/she is feeling better and has had no fever over 100°F for 24 hours.
Other fever facts
  • Children breathe more quickly as their temperature increases and slower as their temperature falls.
  • Most fevers fluctuate during the day, typically peaking in the afternoon/early evening.
  • 3% of children between 6 months old and five years of age may have a seizure (convulsions) from a fever. This is unavoidable, even with the best fever medications. Febrile seizures do look scary but are usually benign. If your child has a seizure, s/he needs evaluation. Call us immediately if your child has a seizure.
Occasionally a fever may be caused by a serious condition.
Please call us if
  • You are unsure about your child’s illness or have questions about this information.
  • Your child seems too sleepy
  • Your child is inconsolable/irritable
  • Your child is working hard to breathe
  • Your child has a stiff neck or seizure
  • Your child has a fever and new skin rash
  • Your child or has other extreme symptoms
  • Your child seems dehydrated. Signs of dehydration can include:
    • Decreased urination/dark yellow urine
    • Dry mouth
    • No tears from eyes when crying
    • Your child may feel thirsty, tired, dizzy, or confused.
  • Temperature is over 104°F
  • Your child has an underlying medical problem, such as heart disease, cancer, a seizure disorder, etc
  • Your child has not received all of the recommended childhood vaccines