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Everyone has a temperature. For most children that temperature hovers around 98.6 degrees when measured orally. Sometimes, a child's temperature gets higher than that. Is that dangerous? How high is too high? What's a fever for anyway? The following handout answers these questions and more.
 

 

Fever is an extremely common condition in early childhood, often causing great concern in parents. Misconceptions about the dangers of fever are commonplace. Unwarranted fears about harmful side effects from fever cause lost sleep and unnecessary stress for many parents. Let the following facts help you put fever into perspective.

Fever is often the result of a viral or bacterial infection.  Fevers are one of the body's protective mechanisms.  Most fevers are good for children and help the body fight infection. Use the following definitions to help put your child's level of fever into perspective:

 
  100°F to 102°F
(37.8°C to 39°C)

Low-grade fever: Beneficial. Try to keep the fever in this range.

 
  102°F to 104°F
(39°C to 40°C)
Moderate-grade fever: Beneficial.  
  Over 104°F
(40°C)
 High fever: Causes discomfort, but is harmless.  
  Over 105°F
(40.6°C)
 High fever: Higher risk of bacterial infections.  
  Over 108°F
(42°C)
 Serious fever: The fever itself can be harmful.  
   
 

Fever may be beneficial in enhancing the body's immune response and is rarely harmful.  Fevers with infections don't cause brain damage. Only body temperatures over 108°F (42°C) can cause brain damage. The body temperature goes this high only with high environmental temperatures (for example, if a child is confined in a closed car in hot weather).

A fever over 102° may cause discomfort, and anti-fever medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil/Motrin) will help this.  Fevers only need to be treated if your child appears uncomfortable.  With treatment, you can expect the fever to come down 2° or 3°F.  Anti-fever medicines are very safe when used in the recommended dosages and intervals.  Correct dosages should be based on weight, not age.  (See table).  PIP does not recommend alternating acetaminophen and ibuprofen.  There is no need to wake a child to give anti-fever medications.

The fever's elevation does not correlate with the severity of the infection, and the fact that anti-fever medications do not reduce a fever is not an ominous sign.  If a fever is not responding to medication, a lukewarm sponge bath with water (never alcohol) may help your child feel more comfortable.

The normal temperature changes throughout the day. It peaks in the late afternoon and evening.  A reading of 99.4°F (37.4°C) is the average rectal temperature. It can range from 98.4°F (36.9°C) to 100.3°F (37.9°C).  A reading of 98.6°F (37°C) is just the average oral temperature. It can range from 97.6°F (36.4°C) to 99.5°F (37.5°C).   However, how your child looks is what's important, not the exact temperature.

CALL YOUR CHILD'S HEALTH CARE PROVIDER IMMEDIATELY IF:

  • Your child is less than 3 months old and has a fever greater than 100.5°F (38°C).
  • The fever is over 105°F (40.6°C).
  • Your child looks or acts very sick.
CALL YOUR CHILD'S HEALTH CARE PROVIDER WITHIN 24 HRS IF:
  • Your child is 3 to 6 months old (unless the fever is due to an immunization).
  • The fever is between 104° and 105°F (40 to 40.6°C)
  • Your child has had a fever more than 24 hours without an obvious cause of infection.
  • Your child has had a fever for more than 3 days.
  • The fever went away for over 24 hours and then returned.
  • You have other questions or concerns.

Click here for a printable table of acetaminophen and ibuprofen doses by weight

 
Partners in Pediatrics ©2008