When to Call the Pediatrician: Fever

When to call the doctor

The most important things you can do when your child has a fever are to improve your child’s comfort by making sure they drink enough fluids to stay hydrated and monitor for signs and symptoms of a serious illness. It is a good sign if your child plays and interacts with you after receiving medicine for discomfort.

Call your child’s doctor right away if your child has a fever and

  • Looks very ill, is unusually drowsy, or is very fussy
  • Has been in a very hot place, such as an overheated car
  • Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea
  • Has immune system problems, such as sickle cell disease or cancer, or is taking steroids
  • Has had a seizure
  • Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher
  • Fever rises above 104°F (40°C) repeatedly for a child of any age

Also call your child’s doctor if

  • Your child still “acts sick” once his fever is brought down.
  • Your child seems to be getting worse.
  • The fever persists for more than 24 hours in a child younger than 2 years.
  • The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.

Treating Your Child’s Fever

​If your infant or child is older than 6 months and has a fever, they probably do not need to be treated for the fever unless they are uncomfortable.

The key is to watch your child’s behavior. If they are drinking, eating, sleeping normally, and is able to play, you do not need to treat the fever. Instead, you should wait to see if the fever improves by itself.

What you can do

  • Keep their room comfortably cool.
  • Make sure that they are dressed in light clothing.
  • Encourage them to drink fluids such as water or a store-bought electrolyte solution.
  • Be sure that they do not overexert themselves.

What not to do

  • Do not use aspirin to treat your child’s fever or discomfort. Aspirin has been linked with side effects such as an upset stomach, intestinal bleeding, and Reye syndrome. Reye syndrome is a serious illness that affects the liver and brain.
  • Do not use sponging to reduce your child’s fever. Cool or cold water can cause shivering and increase your child’s temperature.
  • Never apply rubbing alcohol on your child to treat fever. Rubbing alcohol can be absorbed into the skin or inhaled, causing serious problems such as a coma.

Fever and pain medicine

Acetaminophen and ibuprofen can help your child feel better if your child has a headache or body aches or a fever.

  • Acetaminophen for children comes in liquid as well as pills that can be chewed. It also comes as a pill that is put in the rectum (suppository) if your child is vomiting and can’t keep down medicine taken by mouth.
  • Ibuprofen comes in liquid for infants and children and chewable tablets that may be given to older children. With ibuprofen, keep in mind that there are 2 different kinds of liquid medicines, one for infants and one for children (including toddlers and children up to age 11 years). Infant drops are stronger (more concentrated) than the medicine for children.

     Always look carefully at the label on the medicine and follow the directions. Each type of medicine has different directions based on the age and weight of a child. You should ask your child’s doctor about the right dose for your child. Also, if your child is taking other medicines check the ingredients. If they include acetaminophen or ibuprofen, let your child’s doctor know.

Signs and Symptoms of Fever

A fever is usually a sign that the body is fighting an illness or infection. Fevers are generally harmless. In fact, they can be considered a good sign that your child’s immune system is working and the body is trying to heal itself. While it is important to look for the cause of a fever, the main purpose for treating it is to help your child feel better if he is uncomfortable or has pain.

What is a Fever

Normal body temperature varies with age, general health, activity level, and time of day. Infants tend to have higher temperatures than older children. Everyone’s temperature is highest between late afternoon and early evening, and lowest between midnight and early morning. Even how much clothing a person wears can affect body temperature.

A fever is a body temperature that is higher than normal. While the average normal body temperature is 98.6°F (37°C), a normal temperature range is between 97.5°F (36.4°C) and 99.5°F (37.5°C). Most pediatricians consider a temperature above 100.4°F (38°C) as a sign of a fever.

Signs and Symptoms of a Fever

If your child has a fever, she may feel warm, appear flushed, or sweat more than usual. She may also be more thirsty than usual.

Some children feel fine when they have a fever. However, most will have symptoms of the illness that is causing the fever. Your child may have an earache, a sore throat, a rash, or a stomach ache. These signs can provide important clues as to the cause of the fever.


How to Take Your Child’s Temperature

​​​​​​​​​​​​​​During the COVID-19 pandemic, parents may need to check their children for symptoms, including fever, before they go to school, child care, or sports activities. Feeling your child’s forehead is quick but not very exact. Most modern digital thermometers work fast and are easy to use.

What type of thermometer is best for my child?

It is best to use a digital thermometer to check your child’s temperature. Do NOT use a mercury thermometer. These thin glass devices filled with the silvery metal can break and release toxic levels of mercury fumes. In fact, if you have a mercury thermometer at home, you should remove it.

​What is a normal temperature, and what is considered a fever?

A “normal” temperature varies with the child’s age, activity, and time of day. A fever usually is a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher. This is a sign that the body is fighting an illness. Your child’s temperature, age and other signs of illness will help your doctor recommend treatment that is best for your child.

Call your pediatrician right away if your child:is 2 months old or younger with a rectal temperature of 100.4 degrees Fahrenheit or higher, or if fever rises above 104°F (40°C) repeatedly at any age.looks very ill, is unusually drowsy, or is very fussy.
has been in a very hot place​, such as an overheated car.
has other symptoms, such as a stiff neck, severe headache, severe sore throat​, ​severe ear pain, an unexplained rash, or repeated vomiting or diarrhea.
has immune system problems, such as sickle cell disease or cancer, or is taking steroids.
has had a seizure.

​What are some different types of digital thermometers?

There are different types of digital thermometers that measure temperature at different areas of the body. Rectal (in the anus) temperatures are the most accurate. Forehead temperatures are the next most accurate. Oral and ear temperatures are accurate if done properly. Armpit temperatures are the least accurate, but you can use this method to screen a child of any age. 

Whatever approach is used, follow the cleaning instructions on the package before use.

Here are 3 types of digital thermom​​eters:

​Digital multi-use thermometer

  • Measures temperature in child’s bottom (rectal), mouth (oral) or armpit (axillary).
  • Oral use is not recommended until a child is age 4 or older.
  • ​Reads body temperature when the sensor located on the tip of the thermometer touches that part of the body.
  • It’s important to label the thermometer “oral” or “rectal” so it isn’t used in both places.

Temporal artery​

  • Measures infrared heat waves coming off the blood vessel that runs across the forehead just below the skin.
  • Can be used for all ages.
  • ​Temperature is  taken on the side and front of the forehead, depending on whether it is a non-contact​ or “no-touch” model. Check the instructions to find out how close to the forehead and other tips before using.
  • Non-contact models may help reduce the risk of passing germs.
  • Direct sunlight and cold temperatures after being outside may affect reading.


  • Measures temperature in a child’s ear by reading infrared heat waves from the eardrum.​
  • Can be used on children age 6 months and older. Not reliable for younger babies, whose ear canals are too narrow.​
  • It needs to be placed correctly in your child’s ear canal to be accurate (see “Ear temperature,” below).
  • ​Cold temperatures after being outside can affect reading.

How to Use a Digital Thermometer

To get the right thermometer reading, it is important to always follow the instructions that came with the device.

Rectal temperature​

Taking a rectal temperature gives the best reading, especially for infants under 3 months of age. Here is how to take a rectal temperature:

  • Put a small amount of lubricant, such as petroleum jelly, on the end of the thermometer and on your child’s bottom.
  • Place your child belly down across your lap or on a firm surface. Another way is on the back with the legs pulled up to the chest. Turn the thermometer on and slide it 1/2 inch (for babies less than 6 months old) to 1 inch into the anus. Be gentle. There should not be any resistance. If there is, stop. Hold your child still. Leave the thermometer in place until it beeps. Then remove and check the digital reading.
  • ​Thermometers should be disinfected before and after use with disinfecting soap and water or disinfecting alcohol swab.
  • ​Label the rectal thermometer so it is not accidentally used in the mouth.​

Oral temperature

Once your child is 4 years old, you can take a temperature by mouth. Here is how to take an oral temperature:

  • If your child has had a hot or cold drink, wait 30 minutes.
  • Turn the thermometer on and place the tip under one side of your child’s tongue toward the back of the mouth. Have your child hold the thermometer with their lips and fingers. Do not use the teeth to keep in place.
  • Keep the lips sealed over the thermometer until it beeps. Check the digital reading.

Forehead temperature

Temporal artery (forehead) thermometers can be used on children of any age. Here is how to take a forehead temperature:

  • Follow the instructions on the package to know how and where to slide or aim the sensor across the forehead to get the most accurate measurement.
  • The sensor measures the heat waves coming off the temporal artery. This blood vessel runs across the forehead just below the skin.
  • Read your child’s temperature on the display screen.

Ear temperature

Tympanic (ear) thermometers can be used on children 6 months of age and older, as young infants have narrow ear canals. Here is how to take an ear temperature:

  • Follow the instructions on the package.
  • A correct temperature depends on pulling the ear back. Pull the ear back and up if the child is over 1 year old. Then aim the tip of the ear probe between the opposite eye and ear.
  • Being outdoors on a cold day may cause a low reading. Wait 15 minutes after coming indoors to take the temperature.
​Some quick screening ways may not be bestSome products and quick methods are not as accurate at checking a child’s temperature. For example, taking the temperature under the armpit can help schools and child care centers quickly check, but is not very accurate.Other less accurate ways of checking for fever include using a pacifier thermometer (for children 1 year of age and younger) and fever strips on the forehead. ​​While parents can use them for quick screening, they do not work as well as measuring your child’s rectal, forehead, ear, or oral temperature with a digital thermometer.


Fever is just one sign of illness, but an important one. Talk with your child’s pediatrician if you have any questions about fever and taking your child’s temperature.​


Fever without Fear: Information for Parents

​Let’s face it, fevers can be scary for parents. When your child is burning up, it can be hard to think straight and make important decisions. Learning what causes fevers and how to treat them will ease your anxiety and help you take control of the situation.

What Causes a Fever?

Everyone has his or her own internal “thermostat” that regulates body temperature, and normal body temperature is around 98.6 degrees Fahrenheit plus or minus about one degree (37 degrees Celsius, plus or minus about 0.6 degrees). When the body detects an infection or other illness, the brain responds by raising the body temperature to help fight the condition.

A rectal temperature over 100.4 degrees Fahrenheit is considered a fever. It is not always necessary for a child with a fever to see their doctor.  It depends on the age of the child and the other symptoms they have.

Managing the Fever

A fever can’t always be detected by feeling your child’s forehead. It’s usually necessary to take his temperature as well. Although there are numerous thermometers on the market that measure temperature in different areas, parents should use rectal thermometers with their babies for the most accurate reading. 

Once you’ve identified a fever, the most important things you can do is to improve your child’s comfort and make sure they get enough fluid, so they do not get dehydrated.  While you may instinctively want to bring your child to the doctor’s office, it may not be necessary, especially if the child seems fine once their discomfort is treated.

Keeping Fever at Bay

Although not every fever needs to be treated, there are some things you can do to help make your child more comfortable.

  • Giving a child acetaminophen or ibuprofen will usually reduce a fever. It is important to make sure you give the right dose to your child. 
  • If your child is under two years of age, contact your pediatrician or pharmacist for the correct dose. For older children, follow the recommended dose on the label. 
  • Do not overdress your child. Other practices to reduce fevers such as an alcohol bath, ice packs, etc. are no longer recommended and can actually have adverse effects on your child.
  • A fever will also cause a child to lose fluids more quickly, so offer plenty of fluids to avoid dehydration. Signs of dehydration include crying without tears, a dry mouth, and fewer wet diapers.
  • Keep your digital thermometer ready and accessible so you don’t have to search for it once your child is ill.
  • Have children’s acetaminophen or ibuprofen on hand.
  • Make sure your pediatrician’s phone number is handy.

When to Call the Doctor

Call your child’s doctor right away if your child has a fever and:

  • Looks very ill, is unusually drowsy, or is very fussy
  • Has been in a very hot place, such as an overheated car
  • Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea
  • Has signs of dehydration, such as a dry mouth, sunken soft spot or significantly fewer wet diapers and is not able to take in fluids
  • Has immune system problems, such as sickle cell disease or cancer, or is taking steroids
  • Has had a seizure
  • Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher
  • Fever rises above 104°F (40°C) repeatedly for a child of any age

Also call your child’s doctor if:

  • Your child still “acts sick” once his fever is brought down.
  • Your child seems to be getting worse.
  • The fever persists for more than 24 hours in a child younger than 2 years.
  • The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.

Fever and Your Baby

​​​​​When your baby has a fever, especially if it’s their first one, it can be alarming. Keep in mind that fever, which is sign or symptom of illness, is usually a good sign that the body is fighting off an infection. But it’s important to figure out the cause of your baby’s fever so it can be treated, and to help keep your child hydrated and comfortable.

What’s considered a fever?

A child’s normal temperature can vary, depending on age and activity level. Time of day can also affect the reading. Body temperature is highest in the late afternoon and early evening, for example, and lowest at night and early morning. Plus, infants tend to have higher temperatures than older children. Generally, these are considered true fevers:

  • Rectal reading of above 100.4 degrees Fahrenheit (38 degrees Celsius)
  • Oral reading of above 99 degrees Fahrenheit (37.2 degrees Celsius)

How do I know if my baby has a fever?

Whenever you think your child has a fever, take their temperature with a thermometer. Feeling their forehead or other parts of the body is not accurate, especially if your baby is having chills. Using temperature sensitive tape or “fever strips” also is not reliable. Avoid using an ear thermometer for babies under 6 months old, since their ear canals are too small to allow an accurate reading.

Causes of fever in babies

Fever in babies can develop with illnesses such as:

  • Ear infections
  • Common colds
  • Urinary tract infections
  • Throat or sinus infections
  • Intestinal (bowel) infections
  • RSV
  • Croup
  • Influenza (flu)
  • Pneumonia

The most serious conditions that can cause fever are infections blood (sepsis) and the brain and spinal cord (meningitis​).

Fever in newborns

Infants younger than two months old​ who have a fever need immediate medical attention, even if they appear well and show no other signs of being ill. The challenge is to find the cause of the fever quickly while avoiding putting the baby through unnecessary tests or hospitalizations. 

About 10% of young infants with fever are found to have urinary tract infections. The rate is even higher in uncircumcised boys. That’s why having a urine sample checked is important. However, young infants can have more serious underlying infections that can rapidly progress. If your newborn develops a fever, contact your health care provider, without delay, and discuss steps needed to evaluate and treat your baby.

Febrile convulsions

In children between 6 months old and five years of age, fever can trigger seizures. These are called febrile convulsions. A child may get an odd look on their face for a few moments, then stiffen or twitch, roll their eyes, and become unresponsive for a short time. Febrile convulsions typically last less than a minute—or even just a few seconds–though it can seem forever to a frightened parent. Thankfully, febrile convulsions are not common and almost always are harmless, causing no lasting damage to the brain or nervous system. However, if your baby has a febrile convulsion, be sure to tell your pediatrician promptly.

Raised body temperature from heatstroke

Fever should not be confused with heat-related illness, or heatstrokeThis is not caused by infection. Instead, this dangerous condition is caused by surrounding heat in their environment and dehydration. With heatstroke, body temperature can rise to dangerous levels (above 105 degrees Fahrenheit [40.5 degrees Celsius]). Dozens of children die each year when left unattended in closed, overheated cars, for example. Never leave your baby alone in closed car, even for a few minutes. Babies can also develop heatstroke if overdressed in hot, humid weather.

If you think your child has heatstroke, call 911 or go to the emergency department right away.

Does teething cause fever?

Teething, which often starts at about 6 months of age, can cause a slight rise in your baby’s body temperature within the normal range. However, research shows teething does not cause a true fever. 


Febrile Seizures in Children

Febrile seizures are a type of seizure that can affect otherwise healthy children around the time they have a fever. Seizures can involve stiffening or shaking part of the body or the whole body.

When do febrile seizures occur?

Febrile seizures happen in in 3 or 4 out of every 100 children. They can occur between 6 months and 5 years of age, but most often around 12 to 18 months old.

A febrile seizure usually occurs during the first few hours of a fever. While they are most common with fevers of 102°F (38.9°C) or above, they can also happen with milder fevers.

What happens during a febrile seizure?

Your child may look strange for a few moments, then stiffen, twitch and roll their eyes. They may be unresponsive for a short time, or have changes in their breathing or skin color. After the seizure, the child usually returns to normal quickly.

Seizures usually last less than one or two minutes but, although uncommon, can last longer. A seizure longer than 5 minutes is usually a medical emergency and requires urgent treatment to stop the seizure.

Other kinds of seizures (ones that are not caused by fever) last longer, can affect only one part of the body, and may occur repeatedly.

If your child has a febrile seizure, act immediately to prevent injury.

  • Place them on the floor or bed away from any hard or sharp objects.
  • Turn their head to the side so that any saliva or vomit can drain from their mouth.
  • Do not put anything into their mouth; they will not swallow her tongue.
  • Call your child’s doctor.
  • If the seizure does not stop after 5 minutes, call 911 or your local emergency number.

Are febrile seizures dangerous?

While febrile seizures may be very scary, they usually are harmless to the child. Most febrile seizures are short and do not cause brain damage, nervous system problems, paralysis, intellectual disability or death. Long seizures need to be treated either with a rescue medication or by emergency medical services.

Will my child have more seizures?

Febrile seizures tend to run in families. The risk of having seizures with other episodes of fever depends on the age and development of your child. Children younger than 1 year of age at the time of their first seizure have about a 50% chance of having another febrile seizure. Otherwise healthy children older than 1 year of age at the time of their first seizure have only a 30% chance of having a second febrile seizure.

Most children out-grow febrile seizures by the time they get to school age. Only a very small number of children who have febrile seizures will go on to develop epilepsy.

Are there certain illnesses that cause febrile seizures?

Febrile seizures can happen with any condition that causes a fever, such as common colds, the flu, ear infection or roseola. They can also happen if your child experiences heat-related illness such as heat stroke when there is a rise in core body temperature. Febrile seizures usually happen only once during any given illness, often with the first fever spike. However, they can occur just before or just after your child gets a fever.

Can febrile seizures happen after getting a vaccine?

Vaccines can cause your child to have a fever, but febrile seizures are generally rare after vaccination. Recommended vaccines can actually help prevent some febrile seizures, since getting sick with measles, mumps, rubella, chickenpox, influenza (the flu), pneumococcal infections and other diseases can cause fevers and febrile seizures.

Febrile seizure treatments

If your child has a febrile seizure, call your child’s doctor right away. They will want to examine your child to identify the cause of their fever. It is more important to determine and treat the cause of the fever rather than the seizure. A spinal tap may be done to be sure your child does not have a serious infection like meningitis, especially if they are younger than 1 year of age.

In general, doctors do not recommend treatment of a simple febrile seizure with preventive medicines. However, this should be discussed with your child’s doctor. In cases of prolonged or repeated seizures, the recommendation may be different.

Medicines like acetaminophen and ibuprofen can help lower a fever, but they do not prevent febrile seizures. Your child’s doctor will talk with you about the best ways to take care of your child’s fever.


If your child has had a febrile seizure, do not fear the worst. These types of seizures are not dangerous to your child and do not cause long-term health problems. If you have concerns about this issue or anything related to your child’s health, talk with your child’s pediatrician.