5 Things to Know About Fevers and How to Handle Them, From a Pediatrician Parent

If you’re about to freak out over a temp of 102°F, take a deep breath and remember this smart advice from Michael Steiner, M.D., a dad of two and associate professor of pediatrics at the University of North Carolina at Chapel Hill School of Medicine.

Child Sitting In Robe With Thermometer Stephanie Rausser

1. The fever isn’t the illness.

Parents often concentrate more on lowering the temp than figuring out what’s behind it. The most common misconception is that fever is dangerous, but that’s almost never the case. Fevers are simply the body’s response to an underlying infection (germs can’t thrive in high temperatures). For kids, the infection is usually viral like a common cold or stomach bug. But a child can have a fever without any other apparent symptoms. For example, if an older baby or a toddler has a high fever (103°F or more) for several days and then develops a full-body rash, she might have roseola. While contagious during the fever phase, this is a common virus in young kids that you can easily treat at home with acetaminophen or ibuprofen.

2. For an infant, 100.4°F is the number to know.

If your child is under 3 months, this is the rectal-temperature reading that means you should call the doc. Why not 99°F? Body temp is on a spectrum, and there’s a range in which most healthy people fall. But for babies, 100.4°F is the cutoff that signals something might be wrong. A baby’s immune system is still developing, so while it’s probably just a virus, a doctor needs to rule out a bacterial infection. 

3. For bigger kids, trust your gut.

If your child is 3 months or older, has a fever of 102°F or higher, and shows signs of cold or flu, give acetaminophen or ibuprofen for the fever and hang tight. A lukewarm bath may also bring down the fever and keep her comfortable. Liquid on the skin helps the body equilibrate, just like sweating when you exercise.

Most viruses go away in three or four days; if your child’s fever lasts longer, call the doctor. And always call if your child isn’t making wet diapers (which could be a sign of serious dehydration), won’t respond to your voice, or struggles to breathe (a possible sign of RSV or croup). Can’t ride out a low-grade fever without contacting your pediatrician? No doc will penalize you for getting in touch, even if you don’t go in to the office.

4. Febrile seizures are scary—but rare.

A rapid change in a child’s body temperature can trigger a seizure, which is why most febrile seizures happen within 24 hours of a fever’s onset. Between 2 and 5 percent of kids experience one before age 5, but the risk peaks during the second year of life.

How will you know it’s a seizure? Your child’s whole body will shake (usually for a few minutes) and he won’t be able to respond to voices. After the shaking stops, he’ll be confused for about half an hour. Thankfully, most kids who get seizures don’t have a dangerous infection and outgrow the tendency by age 6. But a kid’s first one definitely warrants a trip to the E.R.

5. All you need is a regular digital thermometer.

Doctors say basic is best. Proper use depends on a child’s age: In infants, a rectal temperature is the gold standard. (Have your pediatrician demonstrate at your next visit.) It’s the most accurate method for older babies, too, but if your child won’t stay still, sticking a thermometer under his arm works well. Try the oral method once he can hold one under his tongue with his mouth closed.