When to be Concerned about Your Child’s Fever

It is always hard to know what it is you should do when a loved one is sick, particularly when that loved one is someone that you are responsible for taking care of, like your children. We asked Stephanie Kimmes—a mother of five who works as a Nurse Practitioner with HELPcare—what she thought parents should know about taking care of kids with fevers. By learning what causes a fever, what can help your child, and when to be concerned, you will feel more confident when the next fever comes around in your house.

What exactly is a fever anyway?

A fever is the body heating up as the body works on fighting off whatever is wrong with it. The exact threshold for what is considered a fever varies depending on the type of thermometer being used; generally, a fever is a temperature of 100.0+ degrees on an oral thermometer, 100.4+ on a rectal thermometer, or 99.0+ degrees on an axillary (under the arm) thermometer.

It's important to remember the fever itself is not a bad thing—it is a signal there is something wrong. It is a symptom, not the disease itself.

Fevers are mostly caused by viruses. It could be the common cold, RSV, Influenza, COVID-19, Mono, or any number of other viruses out there. Other common causes of fever include strep throat (which is due to bacteria) or an ear infection. There are other reasons your child might get a fever, but we will focus on the virus-caused variety today.

Taking your child's temperature

The first thing to do is take your child's temperature. Do this repeatedly through the course of the fever.

For babies, the most accurate way to measure temperature is rectally. There are a number of digital thermometers available that work well and fast. For comfort, use a little petroleum jelly on the rectal thermometer and insert it into your child's rectum, just enough for the thermometer to work. For toddlers, take a temperature with a digital thermometer under the arm. If they are not feeling well, you will probably be able to get them to hold still long enough. In older children, an oral thermometer can be placed under the tongue with their mouth closed. 

Helping your child feel better

There are a lot of things you can do to help your child feel better during their fever.

The most important thing you can do is make sure they get plenty of fluids to avoid dehydration.

For babies under one year of age, breastfeed often or provide pumped breastmilk or formula. For toddlers 12 months-2 years of age, offer whole milk, water, or juice. For vomiting issues, offer plain water or diluted juice. Check with your provider to see if an oral electrolyte solution is appropriate for your child. Older children may enjoy frozen popsicles, Jell-O, or juice in addition to plain water. You will know if your child is getting enough fluids if they are more alert and urinating more often. The color of the urine matters too. When well hydrated, urine should be light yellow. 

Try not to overdress your child. A single layer of clothing is just fine. Sponge bathing and bathing are also not recommended as they may cause shivering. Shivering actually increases the temperature. Do not sponge with rubbing alcohol—it may be absorbed through the skin, causing bad side effects. 

Remember that a fever itself is not a bad thing. It is a symptom. Not all fevers need to be treated with medicine. It depends on how your child is feeling while fighting a virus and how old your child is. Giving a three-month-old or older acetaminophen or ibuprofen will usually reduce a fever. It is important to make sure you give the right dose to your child. Carefully read the labels on pain relief products or contact your health care provider or pharmacist for the correct dose. For older children, follow the recommended weight-based dose on the label. 

Check your child's temperature before giving each dose of acetaminophen or ibuprofen to find out if the temperature is rising or falling. Another dose may not be needed. Never give aspirin or aspirin-containing products to children or teens as they can cause a nervous system illness called Reye's syndrome. 

Situations when a fever is something to worry about

Call your child's provider right away if your child has a fever and:

Caring for your child with a fever can be scary, but it doesn't have to be. A fever is the body's natural response to illness. There are things you can do to comfort your child and you can be comforted yourself in knowing when to call your healthcare provider. Please contact your health care provider any time you have questions or concerns about your child.

Note: These articles are presented for educational purposes only. Your use of this site does not create a doctor-patient relationship. Specific medical advice is only offered through membership in HELPcare Clinic.

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John Aase

John is part of HELPcare’s content development team and lives with his wife Bella in Plymouth, Minnesota. He is an MFA candidate at Hamline University.