Health Library Fever, Age 3 and YoungerFrom Healthwise

Fever is the body's normal and healthy reaction to infection and other illnesses, both minor and serious. Fevers help the body fight infection. Fever is a symptom, not a disease. In most cases, fever means your child has a minor illness. Often you must look at your child's other symptoms to determine how serious the illness is. Although it may be scary when your child's temperature goes up, fever is not harmful.

Normal body temperature

The average normal body temperature is about 98.6 °F (37 °C). It usually rises during the day from a low of 97.4 °F (36.3 °C) in the morning to a high of 99.6 °F (37.6 °C)in the late afternoon. Each child has a normal temperature range that may be different from another child's. Mild increases to 100.4 °F (38 °C) can be caused by exercising, wearing too many clothes, taking a hot bath, or being outside in hot weather.

Fever

A child has a fever when his or her temperature is 100.4 °F (38 °C) or higher, measured rectally (a thermometer is inserted into the rectum). Rectal temperatures are the most accurate for checking a fever in a young child. Oral temperatures read about 1° F (0.5° C) lower than rectal temperatures. All temperature guidelines listed in this topic are rectal. Other ways to measure temperature, such as ear probe thermometers, forehead temperature strips, or pacifier thermometers, may not be as reliable or accurate. For information about taking accurate temperatures, see the topic Body Temperature.

If you think your child has a fever but you are not able to measure his or her temperature, it is important to look for other symptoms of illness.

Children tend to run higher fevers than adults. The degree of fever may not indicate how serious your child's illness is. With a minor illness, such as a cold, a child may have a temperature of 104 °F (40 °C); a very serious infection may not cause a fever or may cause only a mild fever. It is important to look for other symptoms along with the fever.

A fever in a healthy child is usually not dangerous, especially if the child does not have other symptoms and the fever goes away in 3 to 4 days. Most children who have a fever will be fussy and play less and may not eat as much as usual.

High fevers may make your child uncomfortable, but they rarely cause serious problems. There is no medical evidence that fevers from infection cause brain damage. The body limits a fever caused by infection from rising above 106 °F (41.1 °C). However, outside heat—such as from being in a car that is parked in the sun—can cause body temperature to rise above 107 °F (41.7 °C), and brain damage can occur.

Childhood immunizations can reduce the risk for fever-related illnesses, such as Haemophilus influenzae type b (Hib) infection. Although no vaccine is 100% effective, most routine childhood immunizations are effective for 85% to 95% of the children who receive them. For more information, see the topic Immunizations.

Causes of fever

It is not unusual for a preschool-aged child to have 7 to 10 viral infections in a year. Each new viral infection may cause a fever. It may seem that a fever is ongoing, but if 48 hours pass between fevers, then the new fever is most likely from a new illness.

Common causes of fever include:

• Viral infections, such as colds, flu, and chickenpox.
• Bacterial infections, such as a urinary tract infection.
• Immunizations.

Teething does not cause a fever. If a baby is teething and has a fever, look for other symptoms that may need to be evaluated.

A fever that increases quickly may lead to a fever seizure in some children. If your child has a high fever and a seizure, see the topic Fever Seizures.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

Your child has:

• A fever seizure and:
  • Stops breathing. Before calling 911 or other emergency services, make sure your child is in a safe position on the floor.
  • Seizure activity lasts longer than 3 minutes, or a second seizure occurs during the same illness. Be sure to protect your child during a seizure.
• Moderate to severe difficulty breathing.
• Decreased level of consciousness.
• Signs of shock.
• Signs of severe dehydration.
• Signs of heatstroke.

Note:

After calling 911 or other emergency services, if your child is not breathing, begin rescue breathing. See Rescue Breathing in the topic Dealing With Emergencies. You may transport your child for emergency care if you can do it safely and quickly.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your child's symptoms.

	Yes	Does your child have a fever and any signs of a serious infection?
When to See a Doctor See significance of signs of a serious infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Does your child have a severe headache, neck pain or stiffness, and fussiness? Yes Is your child very sleepy or hard to wake up? Yes Is your child acting confused or struggling with you for no reason? Yes Does your child have a bulging soft spot on the head when he or she is not crying? Yes Does your child have new swelling in or around a joint? Yes Does your child have severe pain in or around a joint? Yes Does your child have sudden redness or warmth in or around a joint? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child have a fever and breathing problems?
When to See a Doctor See significance of breathing problems if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Is your child grunting, wheezing, or having mild difficulty breathing? Yes Is your child drooling and not able to swallow? Yes Does your child have a barking cough? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child have a fever and pain? See evaluating pain in a child.
When to See a Doctor See significance of pain if you need information to help you answer the question below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to the following question. Yes Does your child have moderate to severe pain? See evaluating pain in a child. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child have a fever and a new skin problem?
When to See a Doctor See significance of new skin problem if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Does your child have a fever and new, tiny purple or red spots (petechiae)? Yes Does your child have new bruises (purpura) but he or she has not had an injury? Yes Does your child have a fever and a skin infection (cellulitis)? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think or know your child has an extremely high fever [105 °F (40.6 °C) or higher]?
When to See a Doctor See significance of high temperature if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Does your child have a temperature of 105 °F (40.6 °C) or higher? Yes Do you think that your child has an extremely high fever, but you are not able to measure his or her temperature? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your baby younger than 3 months have a fever?
When to See a Doctor See significance of fever in a baby younger than 3 months if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Note: A 2-month-old baby who has received the first DTaP or DPT shot may have a fever up to 104 °F (40 °C) but may not need medical evaluation for this fever. If your health professional has given you instructions on how to treat your baby's fever after immunizations, follow those instructions. Watch your baby closely for other symptoms with the fever that you need to report to your health professional. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Does your baby younger than 3 months have a temperature of 100.4 °F (38 °C) or higher? Yes Do you think your baby younger than 3 months has a fever, but you are not able to measure his or her temperature? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child older than 3 months have a fever?
When to See a Doctor See significance of fever in a child if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Note: Be sure to try home treatment when your child has a fever. Sometimes home treatment is all that is needed to help lower your child's fever and help your child feel better. If you are not able to measure your child's temperature, look for other symptoms of illness. Remember, fever is only a symptom, and often the importance of a fever can only be determined when other symptoms are evaluated. It is not unusual for a young child to have 7 to 10 viral infections in a year. Each new viral infection may cause a fever. It may seem that a fever is ongoing, but if 48 hours have passed between fevers, then the new fever is most likely from a new illness. Call your child's health professional immediately if you answer "Yes" to any of the following questions. Yes Has your child had an operation or other medical procedure within the past 2 weeks? Yes Does your child have a medical condition or take a medicine that affects the immune system? Call your child's health professional today if you answer "Yes" to any of the following questions. Yes Does your child have a temperature of 104 °F (40 °C) or higher? Yes Has your child had a temperature of 102 °F (38.9 °C) to 104 °F (40 °C) that has not come down after 12 hours of home treatment and medicine? Yes Do you think your child has a high fever after 12 hours of home treatment and medicine? You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Has your child had a temperature of 100.4 °F (38 °C) to 102 °F (38.9 °C) after 24 hours of home treatment and medicine? Yes Do you think your child has a mild fever after 24 hours of home treatment and medicine? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child have a fever and signs of mild to moderate dehydration?
When to See a Doctor See significance of mild to moderate dehydration if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional immediately if you answer "Yes" to the following question. Yes Does your child have symptoms of moderate dehydration, and he or she is not able to drink any fluids? Call your child's health professional today if you answer "Yes" to the following question. Yes Does your child have symptoms of moderate dehydration, but he or she is able to drink enough fluids? You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Has your child had symptoms of mild dehydration for 24 hours or longer, and he or she is not able to drink enough fluids? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think your child's fever may be caused by a medicine?
When to See a Doctor See significance of medicine if you need information to help you answer the question below. Review health risks that may increase the seriousness of your child's symptoms. Call your child's health professional today if you answer "Yes" to the following question. Yes Do you think your child's fever may be caused by a medicine? Note: Call the health professional who prescribed the medicine before giving your child another dose to determine whether your child should stop taking the medicine, take a different one, or have the dose adjusted. An appointment may not be necessary. If the fever is caused by a medicine, it usually goes away within 48 hours of stopping the medicine. If you gave your child a nonprescription medicine, stop giving the medicine. If you feel your child needs to continue taking the medicine, call your child's health professional to discuss it. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your child age 3 months to 3 years have ongoing or frequent fevers?
When to See a Doctor See significance of ongoing or frequent fevers if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your child's symptoms. Note: If you are not able to measure your child's temperature, look for other symptoms of illness. Remember, fever is only a symptom, and often the importance of a fever can only be determined when other symptoms are evaluated. It is not unusual for a young child to have 7 to 10 viral infections in a year. Each new viral infection may cause a fever. It may seem that a fever is ongoing, but if 48 hours have passed between fevers, then the new fever is most likely from a new illness. You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Has your child had a temperature of 100.4 °F (38 °C) for 24 to 48 hours that came down for a short time after medicine was given but returned after the medicine effect was gone? Yes Do you think your child has had a mild fever for 24 to 48 hours that came down for a short time after medicine is given but returned after the medicine effect was gone? Your child needs an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Does your child have frequent fevers that do not seem to be caused by a viral illness, such as a cold? Yes Does your child have frequent fevers and no other symptoms of illness? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Does your child have any of the following symptoms?

• Vomiting, diarrhea, or stomach pain: Go to the topic Diarrhea, Age 11 and Younger, Vomiting, Age 3 and Younger, or Abdominal Pain, Age 11 and Younger.
• Upper respiratory system or lung problems: Go to the topic Respiratory Problems, Age 11 and Younger.
• Ear pain (babies may pull at painful ears): Go to the topic Ear Problems and Injuries, Age 11 and Younger.
• Painful urination or signs of a urinary tract infection: Go to the topic Urinary Problems and Injuries, Age 11 and Younger.
• Unexplained skin rash: Go to the topic Rash, Age 11 and Younger.
• Joint pain: Go to the topic Arm Problems, Noninjury or Leg Problems, Noninjury.
• Injury to the skin and signs of a skin infection: Go to the topic Cuts.
• Swollen glands and sore throat: Go to the topic Sore Throat.
• Tooth pain: Go to the topic Teething or Toothache and Gum Problems.
• Suspected poisoning: Go to the topic Poisoning.
• Recent immunizations: Go to the topic Immunizations for information about reactions.
• Recent heat exposure: Go to the topic Heat-Related Illnesses.
• Symptoms of possible exposure to a contagious disease: Go to the topic Chickenpox, Measles, or Mumps.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

It can be hard to know whether you should call your health professional when your child has a fever, especially during the cold and flu season. The degree of the fever may not be related to the seriousness of the illness. The way your child looks and acts is a better guide than the thermometer. Most children will be less active when they have a fever.

If your child is comfortable and alert, eating well, drinking enough fluids, urinating normal amounts, and seems to be improving, home treatment without medicine is all that is needed for a fever of 100 °F (38 °C) to 102 °F (39 °C). If you are not able to measure your child's temperature, look for other symptoms of illness and follow these home treatment measures.

• Encourage your child to drink extra fluids or suck on Popsicles. Your child should be urinating at least every 6 to 8 hours.
• Dress your child lightly, and do not wrap him or her in blankets. Dressing lightly will help your child's body cool down.

Keep your child comfortable

Lowering your child's temperature is important when the fever is causing discomfort. If the fever is higher than 102 °F (39 °C) and your child is uncomfortable:

• Try giving your child a sponge bath with lukewarm water. Do not use cold water, ice, or rubbing alcohol.
• Encourage quiet activities.
• Watch for signs of dehydration.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment:

• Your child's temperature gets higher and he or she appears sicker than before.
• You suspect your child has an extremely high fever.
• Home treatment is not making your child feel better.
• There is a significant decrease in your child's activity level or level of consciousness, or your child acts confused or struggles with you for no reason.
• Signs of dehydration develop.
• Pain develops or the pain becomes more severe.
• Fever lasts longer than 72 hours.
• Symptoms become more severe or frequent.

The best way to prevent fevers is to reduce your child's exposure to infectious diseases. Hand-washing is the single most important prevention measure for people of all ages.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your child's health professional diagnose and treat your child's condition by providing the following information:

• The history of the fever, including:
  • When did the fever start? Did it come on suddenly or increase over several hours?
  • Are you able to measure your child's temperature? How high is the fever?
  • Does the child have any other symptoms?
• Does your child have frequent fevers?
  • How often does your child get a fever?
  • How long does the fever usually last?
• Has your child had any other health problems during the past 3 months?
• Has your child been eating, drinking, and playing normally?
• Has anyone else in your family been ill?
• Is your child in day care? If so, have any other children at the facility been ill?
• Has your child recently traveled outside the country?
• Has your child recently had close contact with immigrants or nonnative people?
• Has your child had any animal or insect bites (including ticks) in the past 6 weeks?
• Does your child have any health risks?

• Abdominal Pain, Age 11 and Younger
• Acute Bronchitis
• Chickenpox (Varicella)
• Crying, Age 3 and Younger
• Cuts
• Dehydration
• Diaper Rash
• Diarrhea, Age 11 and Younger
• Ear Problems and Injuries, Age 11 and Younger
• Fever Seizures
• Fever, Age 4 and Older
• Heat-Related Illnesses
• Immunizations
• Influenza
• Measles (Rubeola)
• Meningitis
• Mouth Problems, Noninjury
• Mumps
• Pneumonia
• Rash, Age 11 and Younger
• Respiratory Problems, Age 11 and Younger
• Respiratory Syncytial Virus (RSV) Infection
• Shock
• Sore Throat
• Teething
• Urinary Problems and Injuries, Age 11 and Younger
• Vomiting, Age 3 and Younger

Author:	Jan Nissl, RN, BS	Last Updated: April 24, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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