What’s Normal, What’s Not: The Facts About Fever

Your daughter woke up with a fever and a sore throat this morning. Do you need to give her pediatrician a call?

Maybe, but maybe not. In many cases, you can care for a fever at home — if it’s a fever in the first place. A “high” temperature isn’t always a fever. How can you know whether an elevated temperature is cause for concern in yourself or your child?

A Fever Can Actually Be a Good Thing

Any parent knows that a fever can be scary. When you wrap your child in a hug and feel hot skin, it’s natural to worry.

Fevers aren’t a bad thing, though. They’re the body’s mechanism for fighting off bacterial and viral infections. When the immune system recognizes an invader like a virus, it signals the brain to turn up your child’s body temperature to help fend off the infection.

Infections thrive at the body’s normal temperature, so a slight elevation in temperature can be just what the doctor ordered to fight against infection.

When Is a High Temperature a Fever?

Normal body temperature is around 98.6 degrees, though everyone’s body temperature is a little different. You may have heard the term “low-grade fever.” That’s defined as when a person’s body temperature is higher than normal but doesn’t meet the criteria for being an actual fever.

The Centers for Disease Control and Prevention defines a fever as a body temperature of 100.4 or higher. The American Academy of Pediatrics (AAP) enhances the definition a bit, noting that a fever is a rectal temperature of 100.4 or higher. The AAP recommends a rectal thermometer as the most accurate way of checking the temperature of children, particularly for infants.

There are several other types of thermometers, and the definition of a fever can vary depending on the type. According to the National Library of Medicine, a child’s oral temperature is a fever at 99.5 degrees or higher, while a temperature measured under the arm is a fever at 99 degrees.

Forehead thermometers, which read the temperature at the temporal artery, are common these days. If you’re using a forehead thermometer, use the 100.4-degree marker to indicate when your child has a fever.

When to Seek Medical Care for a Fever

Even if your child has a fever, you may not need to see your pediatrician. In most cases, you can safely care for a fever and other symptoms of an infection at home. The AAP recommends using basic at-home care to keep your child comfortable.

First and foremost, have your little one drink plenty of fluids, such as water or an electrolyte-replenishing drink. You can make staying hydrated a little more fun by giving your child sugar-free popsicles, which can also ease a sore throat.

You can give your child a lukewarm bath or use over-the-counter medications, such as fever reducers or nonsteroidal anti-inflammatory drugs, to lower his or her temperature. Plenty of rest is also helpful for fighting off infection.

While you can usually care for a fever at home, there are some cases where medical attention is needed. Call your child’s pediatrician promptly if your little one:

• Experiences a febrile seizure, which is a seizure caused by a fever
• Has a fever along with symptoms such as a stiff neck, an unexplained rash, or a severe headache, ear pain, or sore throat
• Has a fever that repeatedly spikes to 104 degrees or higher
• Has been exposed to intense heat
• Has symptoms of dehydration, including a dry mouth
• Seems very ill, drowsy, fussy, or “off”

You should also call your pediatrician’s office if your child has an immune system disorder or is younger than 3 months and has a temperature of 100.4 or higher. Your pediatrician or an on-call provider can advise you about next steps, including whether you should come into the office, head to a walk-in clinic, visit the emergency room, or call 911.

The list above can help you determine whether to check in with your pediatrician when your child first develops a fever, but there are also some indicators that you should check in later. Call your pediatrician’s office if your child is younger than 2 and has a fever that lingers for longer than 24 hours or if your child is 2 or older and has a fever that lasts for more than 72 hours.

You should also check in with the office if your child’s fever goes away but your child still seems sick or if your child’s illness seems to be getting worse.

When should you call a provider about a fever of your own? Many of the same red flags listed above apply to adults as well as children. You should also seek medical attention for a fever accompanied by severe pain, trouble breathing or swelling. Trust your gut — if something seems off, it’s worth checking out.

Are you looking for a pediatrician for your child or a new primary care provider for yourself? Find one here.