A fever in children is any temperature at or above 100.4°F (38°C), and in most cases, it’s a sign the body is fighting off an infection rather than something dangerous on its own. The best ways to help your child feel better include lightweight clothing, plenty of fluids, age-appropriate fever reducers, and close monitoring for warning signs. How aggressively you need to act depends largely on your child’s age.
Why Age Matters: Infants Under 3 Months
Any rectal temperature of 100.4°F or higher in a baby 90 days old or younger needs prompt medical evaluation, no exceptions. At this age, a fever can signal a serious bacterial infection that’s difficult to identify by symptoms alone. Doctors will typically run blood work, a urine culture, and sometimes additional tests to rule out infections like meningitis. Don’t try to manage the fever at home first or wait to see if it resolves. Head straight to your pediatrician or emergency department.
Taking an Accurate Temperature
You’ll get slightly different readings depending on where you measure. Rectal thermometers are the most accurate, especially for babies and toddlers. Armpit, ear, and forehead thermometers are easier to use but less precise, and your pediatrician may ask you to confirm a reading rectally or orally if the number seems borderline.
For children under 3, a rectal thermometer is the standard. Once kids are old enough to hold a thermometer under their tongue without biting it (usually around age 4 or 5), oral readings work well.
Keeping Your Child Comfortable
Dress your child in light, breathable clothing. Bundling them in blankets or heavy layers traps body heat and can push the temperature higher. A single layer and a light blanket for sleep is enough. Keep the room at a comfortable temperature, not overly warm.
A lukewarm bath or shower can provide some relief, but skip cold water or ice baths. Cold actually causes shivering, which raises the body’s core temperature and makes the fever worse. Never apply rubbing alcohol to your child’s skin. It absorbs through the skin into the bloodstream and can cause alcohol poisoning, seizures, irregular heartbeat, and in severe cases, coma or death. Children’s smaller bodies make them especially vulnerable.
Fluids Are More Important Than Food
Fever increases fluid loss, so preventing dehydration is one of the most useful things you can do. What to offer depends on your child’s age:
- Under 6 months: Breast milk or formula only. Do not give water.
- 6 months to 1 year: Continue breast milk or formula. If your baby is vomiting, switch to a pediatric rehydration solution that contains salts and sugars, which help the gut absorb fluid faster.
- Over 1 year: Diluted apple juice or a sports drink mixed half-and-half with water works well. Water, popsicles, and broth are also good options.
If your child is having trouble keeping fluids down, offer small sips every five minutes for at least two hours, then continue giving small amounts regularly. You don’t need to force large cups. Frequent small sips add up and are easier on the stomach.
When to Use Fever-Reducing Medication
Fever itself isn’t harmful, so medication is primarily about comfort. If your child is eating, drinking, playing, and sleeping reasonably well, you don’t necessarily need to give anything. If they’re clearly miserable, achy, or unable to rest, a fever reducer can help.
Acetaminophen
Acetaminophen can be given to children of any age (with guidance from your pediatrician for very young infants). The dose is based on weight: 10 to 15 milligrams per kilogram of body weight per dose. You can repeat it every 4 to 6 hours, but don’t exceed five doses in 24 hours. Always use the measuring device that comes with the product, not a kitchen spoon.
Ibuprofen
Ibuprofen is only safe for children 6 months and older. It can be given every 6 to 8 hours. Like acetaminophen, the dose is based on weight. If you don’t know your child’s current weight, use the age guidelines on the package, but weight-based dosing is more accurate. Never give aspirin to children, as it’s linked to a rare but serious condition called Reye’s syndrome.
Warning Signs That Need Emergency Care
Most fevers resolve on their own within a few days. But certain symptoms alongside a fever signal something more serious. Call 911 or go to an emergency department if your child has a fever with any of these:
- Extreme drowsiness or difficulty waking up
- A stiff neck
- A rash, especially one that doesn’t fade when you press on it
- Trouble breathing
- Inconsolable crying
- Difficulty swallowing or excessive drooling
- Abdominal pain or tenderness
- Altered or slurred speech
- Trouble walking
- Blue lips, tongue, or nails
Also watch for signs of dehydration: no tears when crying, a dry mouth or tongue, sunken eyes, or very infrequent urination. These warrant a call to your pediatrician, even if your child otherwise seems okay.
What to Do if Your Child Has a Seizure
Febrile seizures happen in some children when their temperature rises rapidly. They look frightening, but they’re usually harmless and don’t cause long-term neurological damage. The simple type lasts anywhere from a few seconds to 15 minutes, with most ending well under five minutes.
If it happens, stay calm and note the time. Gently lay your child on the floor (not on a bed or table where they could fall) and turn them onto their side to prevent choking on saliva or vomit. Do not put anything in their mouth and do not try to hold them down. If the seizure lasts longer than five minutes, call 911 immediately.
After a first febrile seizure, your pediatrician will want to evaluate your child. Complex febrile seizures, those lasting longer than 15 minutes or occurring more than once in 24 hours, carry a slightly higher chance of a future seizure disorder, so follow-up is important. But the vast majority of children who experience a febrile seizure never develop epilepsy.
How Long a Fever Typically Lasts
Most viral fevers peak within the first two to three days and resolve within five. Your child may feel tired and cranky for a day or two after the temperature returns to normal, which is expected. A fever that persists beyond three days, goes away and comes back, or climbs above 104°F (40°C) is worth discussing with your pediatrician, even if no emergency symptoms are present. The goal isn’t to eliminate the fever entirely but to keep your child comfortable and hydrated while their immune system does its job.