Fever: How to Care for Your Child, Age 3 Years and Older

Fever can seem frightening, but it isn't dangerous or bad for children. It can help the immune system fight infection. During the hospital stay, the health care team examined your child carefully. They may have done some tests to look for specific viral or bacterial infections. If your child was dehydrated, he or she may have gotten fluids through a vein (IV fluids). Your child may also have been given antibiotics while waiting for test results. The health care team did not find a serious cause for the fever, and your child is feeling better and can be cared for at home. But symptoms can change, so keep watching your child carefully.

• If your child feels warm, measure the temperature. The best way is to take an oral temperature (in your child's mouth) with a regular digital thermometer if your child can hold the thermometer in his or her mouth (most 4- or 5-year-olds can do this).

• Other methods to measure temperature are less accurate, but can give you a general sense of whether your child might have a fever:

  • You can use a regular digital thermometer to take an axillary (armpit) temperature.

  • You can use a temporal artery thermometer by swiping across the forehead. 

  • Ear (tympanic) thermometers are OK to use, but earwax can affect the reading.

  • Do not use a glass thermometer with mercury because these are not safe.

• If your child has a fever and is uncomfortable, a medicine may help your child feel better:

  • If your child has an ongoing medical problem (for example, a kidney, liver, or blood problem): Check with your health care provider before giving any pain or fever medicine.

  • Otherwise you may give acetaminophen (such as Tylenol® or a store brand) OR ibuprofen (such as Advil®, Motrin®, or a store brand).

  • Do not give aspirin to your child as it has been linked to a rare but serious illness called Reye syndrome.

• Offer your child plenty of fluids to drink. It's OK if your child does not want to eat much while having a fever.

• Let your child rest as needed.

• Your child may return to child care or school after the fever is gone for 24 hours without the use of fever-reducing medicine.

Your child:

• refuses to drink

• still has a fever after 2 or 3 days

• develops a new symptom or specific problem, such as vomiting or diarrhea, cough or congestion, rash, pain when peeing (urinating), belly pain, ear pain, or sore throat

• seems to be getting sicker

Your child:

• is very upset and can't be calmed down, or is hard to wake up

• appears dehydrated; signs include drowsiness, a dry or sticky mouth, sunken eyes, crying with few or no tears, or peeing less often

• develops bruising or tiny red dots on the skin that look like broken blood vessels

• has a stiff neck or severe headache

• has trouble breathing or swallowing

• has a seizure (body movements that look uncontrolled)

What causes fever? In most cases, fever in a child is due to a viral infection (such as a cold or a stomach bug). But fever can also be caused by a bacterial infection, which needs antibiotics. 

If my child feels warm, is it always fever? Not all kids who feel warm have a fever, so it's best to use a thermometer to measure their temperature if you have any concerns. Kids can feel warm when they are very active, play outdoors in hot weather, sleep in warm pajamas under blankets, or are upset and crying. These things make the skin feel hot because the skin is doing its job of getting rid of heat in the body.

What temperature is considered a fever? Temperatures taken in different ways can give different readings. You should know the number that is a fever for the type of measurement you are taking:

Can a high fever damage my child? No. Only high body temperatures caused by heat coming from outside the body can cause damage (such as when a child is left in a hot car). A few children have seizures during a fever (febrile seizures). These are scary to see, but they do not cause brain damage or mean a child has a seizure disorder. Most kids who have febrile seizures grow out of them. High fevers don't necessarily mean an illness is serious or that antibiotics will be needed. How your child is feeling is more important than how high the fever is. 

Does a fever always have to be treated? Not always. If your child seems well, is alert, is drinking, and is acting normally, there's no need to give medicine for fever. If your child seems cranky, tired, and uncomfortable, reducing the fever can help make your child feel better.