Understanding Kids’ Fevers: From Common Illness to Febrile Seizures

Fever in children can be a scary thing for parents, often causing them to wonder if a trip to the emergency room is necessary. Le Bonheur Pediatrician Blake Bergeron MD, of Le Bonheur Pediatrics, shares the advice he often gives parents when their child feels feverish.

"A fever isn’t something to be afraid of,” says Dr. Bergeron. “it’s your child’s natural reaction to an infection, and having an elevated temperature can help your child fight off an infection faster in some cases.”

Dr. Bergeron offers three important questions to ask yourself when your child has a high temperature:

1. Is your child drinking less or experiencing decreased urine output?
2. Is your child crying inconsolably?
3. Is your child’s breathing labored?

If you answer yes to any of these questions, it's best to call your pediatrician's office, no matter your child's degree of fever.

Dr. Bergeron stresses that if you have an infant younger than 2 months with a rectal temperature of 100.4 degrees Fahrenheit or higher, you need to call your pediatrician immediately.  Fever in newborns does require an exam, as newborns have immature immune systems and are more susceptible to serious illness.

Even if your child does not show signs of serious illness, a fever can make him or her uncomfortable. To make your child as comfortable as possible, you can provide temporary relief by administering a dosage of acetaminophen (at age 2 months or older) or ibuprofen (if 6 months or older). Most children with a temperature lower than 101 degrees Fahrenheit may not need medication, but if you notice that your child is uncomfortable, it won't hurt to give them an over-the-counter medicine. You should also keep your child dressed in light clothing, keep the house at a comfortable temperature, offer plenty of fluids and make sure they rest.

Febrile Seizures

Febrile seizures are an uncommon response to fever that can occur in infants and children from 6 months old to 5 years of age.  These seizures can appear very scary, as the child will lose consciousness and have convulsions all over for less than 15 minutes.  The child will have a high fever (above 102 degrees Fahrenheit) within a few minutes of the seizures.  In most cases, the seizures will not happen again within 24 hours.   Experts think that the degree of the fever is the precipitating factor for most of these events. 

If your child experiences one of these, don’t panic, but we do recommend calling 911 or taking your child to the nearest emergency room, as this would be considered a medical emergency.  Most of these seizures will be over in under 15 minutes, but it’s best to have medical personnel assess your child just in case the seizures happens to last longer.  Most of these seizures do not require any lab tests or imaging to be done, but it will be important to figure out why your child is having the fever. 

Frequently Asked Questions (FAQ)

What temperature is a fever?

100.4 degrees Fahrenheit measured rectally, orally, temporally (forehead) or tympanically (ear).

What ‘is’ a fever?

Fever is the body's natural defense against infection.

When should I call the doctor?

Call your pediatrician if you have an infant younger than 2 months with a rectal temperature of 100.4F or if your child is experiencing any of the following:

• Labored breathing
• Inconsolable crying
• Decreased drinking or urine output

You should also call your doctor if you have a child with a temperature higher than 104 degrees Fahrenheit or temperature does not respond to medication.

What should I do if my child has a temperature of 104 degrees Fahrenheit but is acting normally?

If your child is not exhibiting any of the behavioral red flags, give your child a dosage of acetaminophen or ibuprofen if he or she is at least 6 months old. Continue to monitor your child's behavior and call the doctor if the fever has not gone down after 24 hours with medication.

What type of thermometer and method gives the most accurate temperature reading?

A digital thermometer administered rectally will give you the most accurate temperature.