Most childhood fevers are harmless and resolve on their own within a few days. A fever is your child’s immune system fighting off an infection, and the goal isn’t to eliminate it completely but to keep your child comfortable and watch for warning signs. Here’s a practical guide to managing a fever at home and knowing when it’s time to call for help.
Check the Temperature and Know the Thresholds
A normal body temperature hovers around 98.6°F (37°C), with slight variation throughout the day. A reading of 100.4°F (38°C) or higher counts as a fever. The number on the thermometer matters less than how your child looks and behaves. A child with a 102°F fever who is playing and drinking fluids is in a very different situation than a child with a 101°F fever who is limp, unresponsive, or refusing to drink.
Rectal thermometers are the most accurate option for babies under three months. For older toddlers and children, an ear or forehead thermometer works well. Avoid relying on touch alone, since it’s easy to over- or underestimate a fever that way.
Keep Your Child Comfortable
Reduce your child’s clothing to a single light layer and keep the room at a comfortable temperature. Bundling a feverish child in blankets traps heat and can push their temperature higher. If your child is shivering, a light blanket is fine until the shivering passes.
A lukewarm sponge bath can help bring the temperature down. Use water that feels slightly warm to the touch, not cold. Sponge from head to toe for about 15 to 30 minutes. Cold water or ice baths are counterproductive because they cause shivering, which actually raises the body’s core temperature. Never use rubbing alcohol on a child’s skin to reduce fever, as it can be absorbed and cause harm.
When and How to Use Fever Reducers
Children’s acetaminophen (Tylenol) and children’s ibuprofen (Advil, Motrin) are the two safe options for reducing fever and relieving discomfort. Ibuprofen is approved for children six months and older, while acetaminophen can be used from birth. Follow the dosing instructions on the package based on your child’s weight, not their age, since weight-based dosing is more accurate.
The purpose of these medications is to relieve discomfort, not to normalize the temperature. If your child has a mild fever but seems comfortable and is eating and drinking, you don’t necessarily need to give anything. Fever reducers won’t make an illness go away faster, but they can help a miserable child rest and stay hydrated.
Never give aspirin to a child or teenager. Aspirin has been linked to Reye’s syndrome, a rare but serious condition that causes swelling in the liver and brain. The risk is highest when aspirin is taken during a viral illness like the flu or chickenpox. Check labels carefully, because aspirin hides in some over-the-counter products under names like acetylsalicylic acid or salicylate. Products like Alka-Seltzer, for example, contain aspirin.
Push Fluids to Prevent Dehydration
Fever increases fluid loss through sweating and faster breathing, so dehydration is the most common complication to watch for. Offer small, frequent sips rather than large amounts at once. Water, diluted juice, broth, and ice pops all count. For babies who are breastfeeding or formula feeding, offer the breast or bottle more frequently than usual.
If your child is also vomiting or having diarrhea, an oral rehydration solution like Pedialyte is a better choice than plain water or juice. These solutions replace the electrolytes and sugars lost during illness. The general guideline is roughly 2 mL per kilogram of body weight after each vomiting episode and 10 mL per kilogram after each episode of diarrhea. For a 22-pound (10 kg) toddler, that works out to about two tablespoons after vomiting and a third of a cup after diarrhea.
Signs of dehydration include fewer wet diapers than usual (or dark urine in older children), a dry mouth, no tears when crying, sunken eyes, and unusual irritability or sleepiness. Mild dehydration responds well to oral fluids at home. If your child refuses to drink or can’t keep anything down for several hours, that’s a reason to call your pediatrician.
When to Call Your Pediatrician
Age is the single biggest factor in how urgently a fever needs medical attention. Any baby under three months old with a temperature of 100.4°F or higher needs to be seen in the emergency department right away, even if they appear well. Young infants don’t always show obvious signs of serious infection, so the fever itself is the trigger for evaluation.
For babies between 6 and 24 months, call your pediatrician if a fever of 100.4°F or higher lasts more than one day. For children of any age, a fever lasting more than three days warrants a call even if your child doesn’t seem severely ill. A persistent fever sometimes signals a bacterial infection that needs treatment beyond what the immune system can handle alone.
You should also call if your child’s fever goes above 104°F (40°C), if the fever keeps returning after a period of seeming well, or if your child has an underlying health condition that makes infections riskier.
Emergency Warning Signs
Some symptoms alongside a fever require an immediate trip to the emergency room. Don’t wait for a callback from your pediatrician’s office if your child:
- Has difficulty breathing or is breathing unusually fast
- Develops pale, blotchy, or bluish skin, especially around the lips
- Has a rash that doesn’t fade when you press on it (roll a clear glass over it to check)
- Is extremely drowsy or difficult to wake
- Has a stiff neck, severe headache, or is bothered by bright light, which can suggest meningitis
- Becomes very unwell very quickly
A rash that doesn’t blanch (turn white) under pressure can indicate a serious blood infection or meningitis. This is one of the most important signs to know. Test it by pressing a clear drinking glass firmly against the rash. If the spots remain visible through the glass, seek emergency care immediately.
What to Do if Your Child Has a Seizure
Febrile seizures affect 2% to 5% of young children, with a peak around 18 months of age. They’re triggered by a rapid rise in temperature, not by how high the fever gets. Watching your child have a seizure is frightening, but the vast majority of febrile seizures are harmless and don’t cause brain damage or epilepsy.
If it happens, place your child on their side on a flat surface so they can’t fall. Don’t put anything in their mouth or try to restrain their movements. Time the seizure with your phone. Most febrile seizures last less than five minutes and stop on their own. If a seizure lasts longer than five minutes, or if it’s your child’s first seizure, call emergency services.
Giving fever reducers does not prevent febrile seizures. The seizure is caused by the rapid temperature change, which typically happens before you even realize your child has a fever. Some children who experience frequent or prolonged febrile seizures may be prescribed a rescue medication to keep at home, but this is the exception rather than the norm.
How Long a Typical Fever Lasts
Most fevers caused by common viral infections last two to three days, though some can stretch to five days. The fever often spikes in the late afternoon and evening, then improves by morning, creating a pattern that can make you think your child is getting better before it returns. This is normal and doesn’t mean the illness is worsening.
Your child may be clingy, less interested in food, and more tired than usual for a day or two after the fever breaks. Appetite typically returns last. Let your child eat what appeals to them during and after the illness. Staying well hydrated matters more than eating full meals while the fever is active.