Signs of fever in children and what to do

When your child is sick with an infection (caused by either bacteria or a virus), it is common to have a fever. As a parent or caregiver, this can be a source of worry and concern. It is important to keep in mind that fever itself is not an illness. Fever is a sign or symptom of infection and in fact, helps to fight infection.

Fevers are also often short-lived and in most cases your child will be completely back to normal within a few days. However, it is important for parents and caregivers to learn the signs of fever and what you can do to help manage the fever.

The average normal body temperature is 37°C (98.6°F). Temperature readings can vary between individuals, and may vary a bit throughout the day, can differ by age or activity level, and can depend on where the temperature is measured. Fever is usually, and more precisely, defined as a temperature that is abnormally high, 38°C or higher (100.4°F).

How to tell if a child has a fever

Behaviour – Children with fevers often do not act like their normal selves and the way your child acts and looks is often more important than how high the fever is. Children may:

Talk less
Be less active or play less
Eat or drink less
Be more fussy (or lethargic)

How to take a child’s temperature when they have a fever

There are several ways to take your child’s temperature when they have a fever. The most accurate way to measure body temperature is with a thermometer. The method you choose will depend on your child’s age and your own personal preferences.

The methods for measuring fever temperature may include using a thermometer:

In the rectum (rectal temperature)** Do not use a glass thermometer which contains mercury
In the mouth (oral temperature)
Under the armpit (axillary temperature)
In the ear (tympanic temperature)

Rectal temperature is generally recommended and thought to be the most accurate for measuring fever temperature in babies, in children under three years of age, or for older children who are continually coughing, congested and cannot have their temperature taken by mouth.

Oral temperature, taking your child’s temperature by mouth, is usually preferred in children four or five years of age and older who can hold the thermometer under the tongue while in their mouth.

The other methods of measuring fever temperature (via the ear or armpit) are generally considered to be less accurate but may still be useful sometimes.

What can I do if my child has a fever?

The aim or focus is to ensure the comfort of your child, being aware or paying attention to signs of serious illness, and avoiding dehydration.

Offer plenty of fluids such as cool water or other drinks that may be helpful, but it does not really matter whether the drinks are warm or cool. Fever will make your child’s body lose slightly more fluid, so encourage your child to drink more.
Remove extra blankets and clothing so heat can leave your child’s body and help lower the body temperature. Children with fever should be lightly dressed but if they do experience chills or shivers, it’s okay to offer them a light blanket.
Make sure your child gets plenty of rest.
Sponging is NOT recommended. Many children find sponging uncomfortable as it can cause them to shiver since it only cools the body externally and does not help to decrease internal body temperature.

Should you use medications to bring down fever temperature?

Medication is not always needed to reduce a child’s fever temperature.

If your baby is less than three months old, do not give any fever medication unless your doctor says so. All children under three months of age with fever should be seen by a doctor.

Medicines are used to help with the management of fever and to make your child more comfortable, but they do not treat the underlying cause of the fever.

Although medications may sometimes help to temporarily reduce fever temperatures by as much as 1°C or 2°C (2°F to 3°F), they generally do not bring the fever temperatures back to normal.

It is not always easy to tell whether a fever is reduced because of medicine or because of the natural fever pattern. Fevers may cycle up and down on their own. If your child is sleeping comfortably, it is not necessary to wake him/her up to give these medicines.

There are two types of medicines usually recommended for the management of fever. They are:

Acetaminophen (Tylenol, Tempra)
Ibuprofen (Advil, Motrin)

If you use medications be sure to adhere to the correct recommended dose, based on the child’s body weight. The dose and length between doses will be different depending on what medication you use. It is important to keep track of when any medication is given. Your doctor and / or pharmacist can help you decide what is safest for your child.

Important points to remember about fever medications

Acetaminophen and ibuprofen should not be given at the same time.
Aspirin should not be used to treat your child’s fever, unless directed by your doctor.

When to take your child to a doctor for fever

Contact your health care provider or go to the emergency room immediately if your child has a fever and:

Is an infant less than three months old
Has been feverish for more than 72 hours
Is unusually cranky, fussy or irritable
Seems overly drowsy, lethargic or won’t respond
Has a persistent wheeze or cough, or has problems breathing
Shows other signs of illness or rash that worries you
Has a fit (seizure, convulsion)
Cannot be settled down and cries constantly
Appears to be in constant pain
Has skin that looks pale (or grey), or is cool or mottled
Or you are concerned and uncomfortable with your child’s temperature, illness, or appearance