What to Do When Your Child Has a Fever: A Parent’s Guide

‍In this guide, we will break down what a fever is, discuss how to measure your child’s temperature, share tips for how to manage your child’s fever, and provide resources for when to seek medical care. It can be stressful any time your child is sick, so read on to better understand what to do when your child has a fever.

Understanding Your Child’s Temperature & Fever

What to Do When Your Child Has a Fever

Fever is a common symptom of many illnesses. Fevers can be caused by viruses like the common cold or the flu, or by bacteria like strep throat or some ear infections. Sometimes, teething and vaccines can also cause fever. 

For parents, it can be scary when your child has a fever. But, most of the time a fever is harmless and there are steps you can take at home to reduce your child’s temperature and their discomfort. If your child is still alert and smiling, eating and drinking normally, and wants to play, these are all signs that they likely do not have a serious illness. In addition to treating your child’s fever at home you may need to treat the underlying illness. Talk to your doctor early if you suspect it may be more than a common cold.

When to Be Concerned About Your Child’s Temperature

To assess the severity of your child’s fever at home think about time, temperature, and other symptoms.

Time

In general, if your child’s fever does not go away after 3-4 days, you should call your doctor. For younger children and infants, keep a close watch of their fever if it lasts for 2 days or more. When your child has a fever that usually means their body is working hard to fight off an infection, but when a fever doesn’t go away that can be a sign that the body needs medical help to fight the infection.

Temperature

A high temperature may require immediate medical attention. Even a slight fever can be serious for newborns and infants. You can measure your child’s fever by taking their temperature with a thermometer.

Other Symptoms

When your child’s fever is accompanied by other symptoms like constant vomiting or diarrhea, difficulty breathing, unconsciousness, stomach pain, new skin rash, or seizures you should seek emergency medical attention immediately.₁ 

How to Measure Children’s Temperature Accurately

Using a Thermometer to Measure Your Child's Temperature

Many of us grew up checking the temperatures of ourselves or others by touching the face of the warm person with our arm or a hand to see if they feel hot. While this may be a quick way to notice if a person might have a fever, we cannot accurately measure a fever with our own bodies. We need to use a thermometer for an accurate temperature.

A digital thermometer is the best tool that we have to measure children’s temperatures.

Where to get a thermometer:

If you do not have a digital thermometer at home, ask your pediatrician for low or no-cost resources. You can find digital thermometers at your local grocery store or pharmacy.

How to choose a thermometer:

Choose a digital thermometer that can measure oral or rectal temperature. Try to avoid thermometers designed to measure ear and underarm temperatures since ear and underarm temperatures are less accurate. The American Academy of Pediatrics recommends avoiding mercury thermometers since mercury is poisonous.₂  

Preparing to use your thermometer:

Make sure the thermometer is clean by washing with lukewarm soapy water or rubbing alcohol before each use. Even after washing, do NOT use the same thermometer for both rectal and oral temperature measurements. When you are about to place the thermometer you will turn the thermometer on, this is usually signaled by the device when you hear a beep or see numbers appear on the screen.

Steps for measuring Rectal and Oral Temperature

Rectal (bottom) Temperature

A rectal temperature is the most accurate way to measure a child’s temperature when they are under 5 years old. To measure temperature rectally:

1. Have your child lie down on his or her stomach on your lap.
2. Apply a small amount of lubricant (such as petroleum jelly) to the tip of the thermometer.
3. Gently insert the thermometer about ½ an inch to 1 inch (1.25cm to 2.5cm) into the rectum, while bracing your finger against their buttock.
4. When the thermometer has completed its reading you may hear a beep or see a flash (this may take about 1 minute). Then you can remove the thermometer and read your child’s temperature.

Oral (mouth) Temperature

Once a child is four years old and older, an oral temperature can be measured. To measure temperature orally: 

1. Wait at least 30 minutes after your child has had anything cold or hot to eat or drink.
2. Place the thermometer under your child’s tongue and toward the back of their mouth.
3. Have your child close their mouth and hold the thermometer in place using their lips and fingers. If your child struggles to keep their mouth closed, encourage them to breathe through their nose.
4. When the thermometer has completed its reading you may hear a beep or see a flash (this may take about 1 minute). Then you can remove the thermometer and read your child’s temperature.

Does Your Child’s Temperature Indicate a Fever?

Once you have measured your child’s temperature using a digital thermometer, you can use that number to determine if your child has a fever.

How to Care for Your Child’s Fever at Home

Managing Your Child's Fever With Over-the-Counter Medication

There are many types of over-the-counter medications and they are usually sold at your local grocery store or pharmacy. Over-the-Counter Medications are medications sold directly to a consumer without a prescription from a healthcare professional. Many are not suitable for children or cannot be used the same way for children as they are used for adults.

When considering over-the-counter medications for your child, avoid any cough and cold medication for children under 6 years old.₃ Also, unless otherwise directed by a healthcare provider, avoid Aspirin for any child under 18 years old due to the risk of Reyes syndrome which is a very serious illness.₃ It is important to discuss all medications with your child’s doctor before administering them for the first time. Talking to a healthcare provider can help you consider:

• The correct dose for your child considering their age, size, and weight.
• How often this medication should be given to best manage your child’s symptoms.
• If there are any potential side effects of this medication.
• If this medication might interact negatively with any other medications, herbs, or supplements that your child is already taking.
• If your child might have any allergies to this medication.

Medicines like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) can help lower your child’s temperature and also ease their discomfort. If you have concerns about finding affordable acetaminophen or ibuprofen for your child, ask your pediatrician for low or no-cost medication resources.

When administering acetaminophen or ibuprofen:

• Always read the package label.
• Always give the correct dose based on your child’s weight.
• Always measure medicine with a dropper, dosage cup, or an accurate measuring device.

Other Ways to Manage Your Child’s Fever at Home

A fever is usually a sign that your child’s body is working hard to fight off an infection. One of the best ways to care for a child with a fever is to let them get plenty of rest and hydration.

Sleep is as important to your health as healthy food and exercise. Extra sleep and rest are essential for recovery from any illness. Fevers make most children tired and achy, their body is doing a lot of work! Encourage children who want to rest, to rest and sleep as much as they want. A child who is alert and wants to play does not need to be forced to rest.₄ 

Fluids prevent dehydration and help the body cool itself. Give your child plenty of water, milk, formula, or clear soup. If your child has diarrhea or is vomiting, use Pedialyte or another oral rehydration solution. These contain water and salts to replenish the water and nutrients lost when sick. Oral rehydration products are usually sold at your local grocery store or pharmacy. If you have any concerns about purchasing an oral rehydration product, ask your child’s healthcare provider about low or no-cost options.

Kids may also feel cold or have chills when they have a fever, this is usually normal. While it might seem like extra layers will help, heavy layers can lead to overheating. Heavy blankets or too many layers can raise your child’s temperature which can be dangerous, especially for infants and young children. You may choose a light blanket to help keep them comfortable without overheating.

When to Call a Doctor or Visit the Emergency Department

Assess Temperature to Determine If Your Infant Needs Immediate Medical Attention for a Fever

When children are below 6 months in age even a slight fever can be a sign of a serious infection. Call your doctor or go to the emergency department if:

Symptoms That Require Immediate Medical Attention

If your child’s fever is accompanied by other symptoms like difficulty breathing, new skin rash, unconsciousness, or seizures you should call your local emergency number or go to the emergency department immediately.₁

How to Access Emergency Care

We offer urgent care services and accept calls after-hours for "urgent medical advice." If you do not have a healthcare provider, you are unable to reach your child’s doctor, or your infant is displaying any symptoms that require emergency medical attention, you can call your local emergency department or visit the emergency department directly. Emergency departments are open 24/7 and they are required by law to provide emergency care to all patients. To find an Emergency Department in a hospital in NYC that treats children visit NYC Health.

Accessing Pediatric Care for Your Child in NYC

Scheduling a Pediatric Appointment at Charles B. Wang Community Health Center

Charles B. Wang Community Health Center pediatricians provide care to patients up to 21 years of age, including regular checkups, sick visits, and immunizations. Our approach to pediatric care is rooted in understanding your child's unique needs and addressing your questions and concerns. Our pediatricians understand that by working together with young patients and their families, everyone can make healthy decisions together. Charles B. Wang Community Health Center offers pediatric care at three of our locations in Manhattan’s Chinatown and Flushing, Queens. Learn more about each of our pediatric providers here to find a provider that meets your family’s needs. If you are considering making Charles B. Wang Community Health Center your child’s medical home, give our office a call.

• To learn more about our pediatric providers at 125 Walker Street, 2nd Floor, Manhattan, or to schedule an appointment, call (212) 226-3888.
• To learn more about our providers at 136-26 37th Avenue, Flushing, or to schedule an appointment, call (718) 886-1222.
• To learn more about our pediatric providers at 137-43 45th Avenue, Flushing, or to schedule an appointment call (929) 362-3006.

Charles B. Wang Community Health Center accepts most major insurance plans and offers fee discounts based on family size and income. Services are provided regardless of a patient's ability to pay or immigration history. 

FAQs:

1. How do I take my child’s temperature?

A digital thermometer is the best tool to measure children’s temperatures. If you do not have a digital thermometer at home, ask your pediatrician or your child’s school for low or no-cost resources. You may also be able to find digital thermometers at your local grocery store or pharmacy. A rectal temperature is the most accurate way to measure a child’s temperature when they are under 5 years old. Once a child is four years old and older, an oral temperature can be measured. An oral temperature is also very accurate. Ear and underarm temperatures are less accurate and should therefore be considered with caution.

2. When should I be concerned about my child’s temperature?

Call your doctor or go to the emergency department if:

• Your infant is younger than 3 months old with a temperature of 100.4°F (38°C) or higher.
• Your child is between 3 and 36 months with a temperature of 102°  (38.9°C) or higher.
• Your child is between 3 and 36 months with a temperature of 100.4°F (38°C) or higher for more than 3 days.

3. Can I use a sponge bath to reduce my child’s fever?

Sponge baths may be given if a child has a high fever. Place your child in a bathtub and use a damp washcloth to apply lukewarm water to the entire body. Never sponge with alcohol. It can be absorbed through your child’s skin or inhaled.

4. How can I prevent fevers in my child?

Fevers are commonly caused by viruses like the common cold or the flu, or by bacteria like strep throat or some ear infections. You can take steps at home and outside to prevent the spread of illness. Washing hands well with soap and water before eating, after playing, and after using the bathroom is one way to protect children from viral and bacterial infections throughout their lives. Following your child’s recommended vaccine schedule is a safe and effective way to prevent the serious health impacts of viruses. And keeping up with your child’s annual doctor’s visits can help identify, prevent, and manage any health concerns for your child before they cause serious harm.

Sources:

1. https://www.emergencyphysicians.org/article/pediatrics/childhood-seizures
2. https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/How-to-Take-a-Childs-Temperature.aspx
3. https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Using-Over-the-Counter-Medicines-With-Your-Child.aspx
4. https://www.uptodate.com/contents/fever-in-children-beyond-the-basics/print
5. https://www.uptodate.com/contents/fever-in-children-beyond-the-basics/print
6. https://www.cdc.gov/clean-hands/about/
7. https://publications.aap.org/DocumentLibrary/Solutions/Toolkits/Well_Child_Visit_Why_What_en.pdf