A child with a fever sends a parent’s mind racing with questions.

A fever simply means your child’s body is fighting an illness or infection, usually a virus or bacteria, according Dr. Anthony Stone, a family medicine physician at the Essentia Health-International Falls Clinic. The brain responds to infection by elevating the body’s temperature. The good news, he said, is a fever shows your child has a healthy immune system that’s working the right way.

Fever is a symptom

While many parents worry about a fever, it’s just one symptom, Stone said. The accompanying symptoms are better clues to what’s going on and what a parent needs to do.

The physician tells parents to pay attention to what their child looks like and what he’s doing.

“If he’s playing and interacting with you, that’s a good sign,” Stone said. “If he’s not interested in activity, doesn’t have an appetite, isn’t drinking or sleeping – that’s more important than the reading on the thermometer.”

The first step is to get an accurate temperature. Stone recommends using a rectal thermometer for babies and an electronic oral thermometer for older children. He says only high quality infrared thermometers are accurate for taking temperatures in the ear and they can be expensive.

You need to see a doctor if a baby younger than 3 months old has a temperature of 100.4 degrees Fahrenheit or higher, even if the baby looks normal or seems fine. Young infants can quickly become seriously ill and also are susceptible to serious bacterial infections.

“Babies have a limited ability to fight infection and parents can’t see as many symptoms,” Stone explains. “Babies also can become dehydrated sooner than older children.”

In a child older than 3 months, a temperature of 102.2 degrees or higher that lasts longer than three days should be seen by a doctor, Stone said. They should be seen earlier if the fever is accompanied by concerning symptoms, such as difficulty breathing, lethargy, seizures or the inability to drink fluids.

Most fevers caused by a viral infection come at the beginning of an illness, so a fever that starts a couple days into an illness is worth checking out, Stone notes. That can mean a bacterial infection has set in.

A child of any age needs immediate medical attention if he appears lethargic or struggles to breathe, Stone warns.

Treating a fever

If your child has a fever, encourage her to drink fluids. To make a child more comfortable and bring down a fever, try a sponge bath or a bath using water at the usual bathing temperature.

If the fever doesn’t come down, try an over-the-counter medicine, such as acetaminophen or ibuprofen.

Proper dosing is important, Stone said. You need to know your child’s weight, not age, and follow the dosing guide from your physician or what’s outlined on the medicine’s bottle. Use the dosage tool that comes with the medicine, or buy a marked syringe at the pharmacy.

Don’t give more than four doses in 24 hours. Do not give children aspirin because of the risk of Reye’s syndrome, a rare but serious condition that causes swelling in the liver and brain.

Even though they are labeled differently, infant’s and children’s bottles of liquid acetaminophen are now the same concentration. Tylenol is a brand name of acetaminophen. Liquid ibuprofen, which is known by the brand names Advil and Motrin, still comes in two concentrations, one for infants and one for older children.

“Give the medicine based on how your child feels and his symptoms,” Stone said. “You don’t need to restore a normal temperature through the use of medicine.”

Stone recommends acetaminophen for most children but says parents can choose what fever reliever works best for their child. If the fever doesn’t come down in three hours with acetaminophen, you can change to a dose of ibuprofen and give it every six to eight hours, he said.

If you decide to use an over-the-counter medicine for other cold symptoms, check to see if it contains acetaminophen or ibuprofen. If it does, don’t give your child additional ibuprofen or acetaminophen at the same time. That could cause your child to get too much medicine.

Fever seizures

While parents worry that a high fever will cause a febrile seizure, such incidents are rare, Stone said. They occur in only 2 to 5 percent of children between the ages of 6 months and 5 years. Most febrile seizures occur during the first day of a fever and last a minute or two. They’re most common in children between the ages of 6-18 months.

“There are a lot of urban myths about fever, including fears of seizures and brain damage,” Stone said. “There’s no evidence of fever, even at 104 degrees, causing brain damage or neurological damage.”

The physician explains febrile seizures aren’t related to the height or duration of the fever, and it’s not known why they happen in some children.

If your child has a febrile seizure, call your doctor right away so your child can be examined. It’s more important to determine and treat the cause of the fever rather than the seizure, Stone explains.

In the end, Stone tells parents to treat fevers like other health issues. “Trust your judgment, and if you’re not sure, call your doctor,” he said.

When to call the doctor:

  • Child is younger than 3 months with a temperature of 100.4 degrees F or higher.
  • Child is older than 3 months with a temperature of 102.2 digress F or higher for three days or more.
  • Child is crying constantly, very fussy and cannot be comforted.
  • Child is listless, has little energy or is hard to wake up.
  • Child has a new rash.
  • Child has neck pain or stiffness.
  • Child has seizures.
  • Child refuses to drink.
  • Child has less urine than usual.
  • Child has chronic medical conditions that put him at increased risk for serious infections, such as kidney disease, splenii, immunosuppression or heart disease.
  • Call 911 if your child has trouble breathing.