Pediatric Fever
A raised body temperature in infants and children, usually fighting infection
Quick Facts
- Type: Common childhood symptom
- Usual cause: Viral or bacterial infection
- Fever defined: 100.4 F (38 C) or higher
- Urgent in infants: Any fever under 3 months needs prompt care
Overview
A fever is a body temperature that is higher than normal, usually defined as 100.4 F (38 C) or above. In children, fever is one of the most common reasons families seek medical advice. It is not an illness in itself but a sign that the body is responding to something, most often a viral or bacterial infection.
In most cases a fever helps the body fight infection and resolves on its own. How a child looks and behaves often matters more than the exact number on the thermometer. However, fever in very young infants, or fever with certain warning signs, can be serious and needs prompt medical attention.
Symptoms
Fever itself is a sign, and it often comes with other symptoms depending on the cause:
- Warm or flushed skin and feeling hot
- Sweating or shivering and chills
- Tiredness, fussiness, or reduced activity
- Reduced appetite
- Headache or body aches
- Symptoms of the underlying infection, such as cough, runny nose, sore throat, ear pain, vomiting, or diarrhea
A child who is feverish but still drinking, alert, and playing between fever peaks is usually less worrying than one who is very drowsy, limp, or hard to rouse.
Causes
Most fevers in children are caused by common infections:
- Viral infections: colds, flu, and many childhood viruses, which are the most frequent cause
- Bacterial infections: such as ear infections, strep throat, urinary tract infections, or pneumonia
- Recent vaccinations: a mild, short-lived fever can follow some immunizations
- Overheating: being overdressed or in a hot environment, especially in infants
- Less commonly, other inflammatory conditions
Risk Factors
- Young age, especially infants under 3 months
- Close contact with sick children, such as at daycare or school
- Incomplete vaccinations
- Weakened immune system or certain chronic illnesses
- Recent travel to areas with specific infections
Diagnosis
A doctor focuses on finding the cause of the fever and judging how unwell the child is.
- Temperature measurement: using a reliable thermometer appropriate for the child's age
- History and exam: asking about other symptoms and examining the ears, throat, chest, and abdomen
- Tests when needed: urine tests, blood tests, throat swabs, or chest X-rays depending on the suspected cause
- Closer evaluation in infants: very young babies with fever often need more thorough testing
Treatment
The goal is to keep the child comfortable and to treat the underlying cause when needed.
- Comfort and fluids: encourage rest and offer plenty of fluids to prevent dehydration
- Fever-reducing medicine: acetaminophen or, in children over 6 months, ibuprofen can ease discomfort; follow age- and weight-based dosing carefully
- Light clothing: dress the child lightly and keep the room comfortably cool
- Treating the cause: antibiotics are used only for bacterial infections, not for viral ones
Important: do not give aspirin to children, and check with a doctor or pharmacist before giving medicine to a baby. Lowering a fever helps comfort but is not always necessary if the child is otherwise doing well. Avoid cold baths, rubbing alcohol, or bundling a feverish child in heavy blankets, as these can cause shivering or discomfort. Always measure liquid medicines with the dosing tool provided rather than a kitchen spoon, and never give two products containing the same ingredient at once.
Prevention
- Keep vaccinations up to date
- Encourage regular handwashing
- Keep sick children home when possible to limit spread
- Avoid close contact with people who are ill when possible
- Make sure your child drinks enough fluids during illness
- Dress infants appropriately to avoid overheating
When to See a Doctor
Seek medical care promptly for any fever in a baby under 3 months old. For older children, contact a doctor or seek emergency care if your child:
- Is very drowsy, limp, hard to wake, or extremely irritable
- Has trouble breathing, a stiff neck, or a rash that does not fade when pressed
- Has a seizure, looks very unwell, or has a fever that lasts more than a few days
- Shows signs of dehydration, such as no wet diapers, no tears, or a dry mouth
- Has a high fever that does not improve with medicine, or you are simply worried
Frequently Asked Questions
What temperature counts as a fever in a child?
A fever is generally a temperature of 100.4 F (38 C) or higher. How your child looks and acts matters as much as the number, but any fever in a baby under 3 months should be checked by a doctor promptly.
When should I worry about my child's fever?
Seek care if your child is very drowsy, limp, or hard to wake, has trouble breathing, a stiff neck, a non-fading rash, a seizure, or signs of dehydration. Always get prompt care for fever in an infant under 3 months.
Should I always treat a fever with medicine?
Not necessarily. Fever-reducing medicine like acetaminophen or ibuprofen is mainly to make a child more comfortable. If your child is drinking, alert, and playing, you may not need to treat the fever, but follow dosing carefully and never give aspirin to children.
Do antibiotics help a child's fever?
Only if the fever is caused by a bacterial infection. Most childhood fevers come from viruses, which antibiotics do not treat. A doctor can determine whether antibiotics are needed.
How can I keep my feverish child comfortable?
Offer plenty of fluids, encourage rest, dress them lightly, and keep the room comfortably cool. Fever-reducing medicine can help if they are uncomfortable. Watch for warning signs and contact a doctor if you are concerned.
References
- American Academy of Pediatrics (AAP). Fever in children.
- Mayo Clinic. Fever in children.
- MedlinePlus, U.S. National Library of Medicine. Fever.
- Centers for Disease Control and Prevention (CDC).