Should You Treat a Child's Fever? Not Always

If you’re like most parents, your anxiety level rises along with your child’s temperature. Fever is a warning sign that your child may have an illness that needs attention. But the American Academy of Pediatrics (AAP) stresses that fever itself is usually not a problem. In fact, it can be beneficial.

“Fever is a sign that your child’s body is combating an infection. If your child is older than age 6 months, there’s generally no need to worry about bringing a fever down unless it’s causing your child discomfort,” says UH Rainbow pediatrician Douglas Fleck, MD, of Rainbow Ashtabula Pediatrics.   

To Treat or Not to Treat

A hand on your child’s forehead may be soothing, but it isn’t an accurate gauge of temperature. The AAP recommends you use a digital thermometer to be more certain. It’s also best to take the temperature rectally for children ages three and younger. A rectal temperature of more than 100.4 degrees is considered a fever. When taken orally, a temperature higher than 99 degrees is deemed a fever.

Once you’ve confirmed your child has a fever, Dr. Fleck offers this advice about when to seek treatment.

If your child is age 2 months old or younger and has a rectal temperature of 100.4 degrees or higher, call your baby’s pediatrician right away. “It’s important to find out what may be causing a fever in a newborn so it can be treated if necessary,” Dr. Fleck says.

While certain signs and symptoms may indicate the presence of a serious disease that needs specific treatment, if your infant seems healthy aside from their fever, Dr. Fleck says new AAP guidelines are in place to help providers avoid overtreating a fever.

These guidelines include recommendations for tests that may look at an infant’s urine, blood and sometimes fluid taken from their lower back. Depending the results of these tests, your infant’s exact age and your parental preferences, their provider will advise if your child should stay at the hospital or if they can be monitored at home.

“An older infant or child who is eating and sleeping well and having playful moments often doesn’t need any fever-lowering treatment,” Dr. Fleck says. However, he advises that you should call a pediatrician if your child is:

• Younger than age 2 with a fever that lasts more than 24 hours.
• Age 2 or older with a fever that lasts more than 72 hours.
• Any age with a fever that repeatedly goes higher than 104 degrees or is accompanied by other symptoms. These include seizures, severe sore throat, severe ear pain or headache, unexplained rash, repeated vomiting or diarrhea, unusual sleepiness, or very fussy behavior

Managing a Child's Fever

If a fever is making your child uncomfortable, Dr. Fleck offers additional advice that may help:

• Dress your child lightly to avoid overheating. Keep the room comfortably cool.
• Encourage your child to drink extra fluids to prevent dehydration. Water, diluted fruit juice, and store-bought electrolyte solutions are good choices.
• Discourage overexertion. However, it’s OK for your child to get out of bed and play calmly.

You may also want to consider using acetaminophen or ibuprofen to reduce a fever. For children younger than age 2, call the pediatrician or pharmacist to find out how much medicine to give your child. For older children, follow the label instructions.

Check with the pediatrician before giving any medicine to a child younger than age 2. Ibuprofen should only be given to a baby older than 6 months. Don’t give ibuprofen to a dehydrated or vomiting child.

Finally, avoid aspirin for children and teens. Its use in young people with viral illnesses has been linked to side effects ranging from stomach upset to Reye’s syndrome, a rare but serious disease that can harm the body, especially the liver and brain.

Related Links

Unsure of the proper dose for fever-reducing medication for your child? Learn about the proper drug dosage to give to a child depending on weight, indications for medicines and age limits for each drug.