Fevers

Our child is 14 months old. His temperature was up to 103 degrees. What are the best things to do before having to go to the doctor, and at what temperature does it become critical? What are the recommended fever reducing drugs for children?
Lianna Walden – Vancouver, British Columbia

Dr. Greene’s Answer:

Not very long ago — when my parents were children — a high fever in a child could easily mean the end for that child. High fevers resulting in death were common. Today, most of the devastating illnesses causing these high fevers are either treatable (thanks largely to antibiotics), or better yet preventable (thanks largely to vaccines). Nevertheless, for generation after generation on our planet, a high fever in a child was a chilling terror to the parents — their dream, their darling might slip from them despite everything they could do. Fever as enemy is deeply ingrained in our cultural memory.

I was surprised to learn in medical school that fever, far from being an enemy, is an important part of the body’s defense against infection. While a fever in a child signals to us that a battle might be going on in a child’s body, the fever is fighting for the child, not against.

Causes of Fevers

Most bacteria and viruses that cause infections in humans thrive best at 98.6 degrees F (37C). Raising the temperature a few degrees can give the body the winning edge. In addition, a fever activates the body’s immune system, accelerating the production of white blood cells, antibodies, and many other infection-fighting agents.

Cold-blooded animals adjust their temperatures by moving to a different spot. While a medical student, I sat fascinated as I learned that lizards, when infected, will move to a warmer place to give themselves a fever. If they are prevented from finding a warmer spot, they will likely die.


How many infections are too many?


Fevers and Brain Damage

Many parents fear that fevers will cause brain damage. Brain damage from a fever will not occur unless the fever is over 107.6 degrees F (42C) for an extended period of time. Many also fear that untreated fevers will keep going higher and higher, up to 107 degrees F or even more. Untreated fevers caused by infection will seldom go over 105 degrees unless the child is overdressed or trapped in a hot place. The brain’s thermostat will stop the fever from climbing above 106 degrees F. Some parents fear that fevers will cause seizures. For the great majority of children this is not the case. About 4% of children, though, will sometimes have seizures with fever. These febrile seizures are caused by rapid increase in temperature, not necessarily by the height of the temperature. Once a child already has a high fever, a febrile seizure is unlikely with the current illness. In any event, simple febrile seizures are over in moments without lasting consequences.

What temperature constitutes a fever?

While 98.6 degrees F is considered the normal core body temperature, this value varies between individuals and throughout the day. The daily variation is minimal in children less than six months of age, about 1 degree in children 6 months to 2 years old, and gradually increases to 2 degrees per day by age six. A person’s baseline temperature is usually highest in the evening.

Body temperature, especially in children, is normally raised by physical activity, strong emotion, eating, heavy clothing, elevated room temperature, and elevated humidity. A rectal temperature up to 100.4 degrees F (38C) may be entirely normal (no fever). A rectal temperature of 100.5 or above should be considered a fever. Lower values might be a fever, depending on the child.

When and How to Treat Fevers in Children

A fever does not necessarily need to be treated. If a child is playful and comfortable, drinking plenty of fluids, and able to sleep, fever treatment is not likely to be helpful. Steps should be taken to lower a fever if the child is uncomfortable, vomiting, dehydrated, or having difficulty sleeping. The goal is to bring the temperature between about 100 and 102 degrees F — not to eliminate the fever.

When trying to reduce a fever, first remove excess clothing or blankets. The environment should be comfortably cool (one layer of light weight clothing, and one lightweight blanket to sleep). Two medicines are useful for reducing fever in children: acetaminophen (Tylenol) and ibuprofen (Children’s Advil or Motrin). Acetaminophen is given every 4-6 hours, and works by turning down the brain’s thermostat. Don’t use under three months of age without first having the child examined by a physician. Ibuprofen is given every 6-8 hours, and helps fight the inflammation at the source of the fever. It is not approved for children under 6 months. Both medicines may be given for stubborn fevers, but be very careful about using the correct dose of each.

A lukewarm bath or sponge bath may help cool a febrile child (after medication is given — otherwise the temperature bounces right back up). Cold baths or alcohol rubs cool the skin, but often make the situation worse by causing shivering, which raises the core body temperature.

Fever is a signal that something is going on in your child. Usually this is a minor illness, but it can be a serious infection, such as meningitis. Any child less than 90 days old with a fever >100.4 degrees F should be examined by a physician right away, to rule out a serious infection (unless there was a DTaP shot in the previous 24 hours). Children of any age who have a fever >105 degrees F should also be seen, unless the fever comes down readily with treatment and the child is comfortable. Any child who has a fever and is very irritable, confused, has difficulty breathing, has a stiff neck, won’t move an arm or leg, or who has a seizure should also be seen right away. Also, if you have serious concerns about your child’s condition for any reason, do not hesitate to contact your pediatrician or to seek medical attention for your child.

Fevers in Infants

Even without obvious symptoms, children under 6 months of age with a fever should be examined by a physician within 24 hours (again unless they just had a DTaP), since they may have some infection that needs to be treated. Older children with a fever (6 to 24 months old) who are acting well and have no other symptoms should be seen if the fever lasts 48 hours (or 72 hours if they do have minor cold or flu symptoms).

While caring for your son with a fever, remember the shadows of the many generations before ours when a fever would break a mother’s heart. The fever was the body’s desperate attempt to save the child. Remember now that fever is a friend — alerting us to potential problems, activating the immune system, and fighting bacteria and viruses.

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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  1. wasim malik

    Hello dear doctor, my daughter is 6 year old she is suffering in fever from last week. We r doing treatment but her is not giong away. After every 8 hours she suffers in fever… i want your suggestions what should we do?

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  2. kirby

    my son is 5 years old since 7 months he spiked a fever of 103 they said he had a febrile seizure but he didn’t have any type of infection in his whole life hes had 15 seizures they turned out to be absent seizures well on Friday the 2nd he was sent home with a fever of 100.5 when he got home I gave him motrin then 4 hours later tylonel he went to sleep he was fine today at church they couldn’t wake him up so they called me he was so drained I just let him sleep he got up at 1 when we got home I checked his temp it was 101.2 I gave him tylonel then at 3:40 I gave him motrin because his temp was 102.6 its 4:56 now and his temp is still 102.6 what else could I do and do I need to take him in due to the fact he has a history of absent seizures

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  3. Christy

    Hi Dr. Greene, my 17 yr old son is a medically complex child with multiple rare disease diagnoses. Recently his fever spiked to 106.7/107 degrees from a Flu Virus & mild Pneumonia. When I found him in bed, he felt like he was on fire and going in and out of deliriousness. I quickly tried giving him Motrin to bring it down, but he wobbled into the bathroom and uncontrollably vomited it all up. We called 911 immediately. He started going into respiratory distress and was rushed to the ER. He had to be given 2 IVs to run fluids and start IV antibiotics, then was given a high dose steroid shot and put on continuous nebulizer treatments. He was admitted onto the pediatric respiratory ICU floor for 3 days. Is this common for children who are battling Autoimmune disease/rare disease to spike these high fevers with illness and why does it happen? The highest I’ve ever seen it go before was 105 degrees when he developed Aseptic Meningitis from IVIG infusions. The ER doctors told us it was so rare, they’d never seen it before, only read about it in literature. My son can no longer receive Immunotherapy infusions to treat his Autoimmune disease because he is at high risk for life-threatening reactions. He is now labeled “untreatable” and we were told to focus on quality of life instead. These high fevers are really scaring me and I am wondering if this is going to become more common as he gets older. We still have no treatment or cure for any of his rare diagnoses yet. I feel it’s not the diagnosis’ itself we need to fear taking his life anymore, it’s these high fevers! I feel we got very lucky we got to him in time before he laid there for a prolonged period without medical intervention to bring it down….I feel like he would have suffered brain damage or even lost his life! Would that have been the case? Why do you think his fevers are getting so high every time he comes down with a virus?? Is there any kind of testing I can get done for him to see the status of how strong his Immune system is??? I need to prepare for the next time. Thank you!

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  4. Tina Perkins

    My son is 17 years old and has been running a fever for 3 days. It’s been going up and down between 98.2 and 103.8. For the first 2 days he had no other symptoms, only a fever. Today nasal congestion has been added to it. We have been keeping fluids in him and he is still using the restroom regularly. Lukewarm baths, cold cloths on the forehead. The problem is we can get his temp down but we are having trouble keeping it down.

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  5. Evan Pressley grandma

    My grandson 5 years of age was taken to Children’s Hospital in Atlanta this morning and was told he had the flu. Which was determined by visual observation and a wiggle of his leg. NO TEST…I informed them of his high sensitivity to light. Fever was reduced to 100.3 and discharged to get Miralax, Tylenol, and Motrin to alternate. For the last 10 hours his fever is spiking to now 104.8. Now, having chills, watery eyes, vomiting, eyes more sensitive to light. Called emergency room and they said bring him back for observation…Charged $150 for a visual observation already. My grandson demeanor has changed drastically. He will go to his Pediatrician tomorrow. What should I watch for tonight?

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  6. sachi

    Hello doctor, My 11 and 1/2 month old is running high fever. First two day 102-103. Next three: 104-<106. Today is the sixth day and I have seen 101 so far. No other symptom. She is not eating or drinking much. Her blood work showed overall infection in the body. Doctors think its UTI and still waiting for the blood culture results to come back .. will take another two days. What's your suggestion? Could it be something else? also in the evening, she gets fever with chills and i have also seen her blue lips before her fever shoots up. In that last 5-6 days she had one diarrhoea incident (mild) and 2 throw ups. Thanks a lot!

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  7. liz Ducady

    When my child was 5 and half , I took him to the doctor and got told lungs were clear ,sinuses fine .. that night he blew a 105.8 oral temputure … they never told me to bring him to the hospital or anything….. we got the fever down in the 104’s … the next day took him to his doc again and again was put off … he got sicker and sicker , throwing up with just a tsp of water ,lethargic ect … wound up getting bloodwork to find out his wbc was in the high 36,000 ‘s … he was sent to hospital ..they couldnt figure out what was wrong and his cell count was raising by the hour … it got up to that i know of 43,000 … they though appendix ,ct scan was neg … we got sent to childrens hospital …at 3 am I figured it out…it was his sinuses … they ct scanned him and found a ” huge puss ball” as the nurse stated .. up in his sinus near his brain and they needed to drain it ( they didnt , the ent didnt want to take the risk ) he wound up on some really wicked antibiotic … He is now diagnosed with aspergers …. has moderate hearing loss (neuro sensory hearing loss of unknown origin ) has all kinds of learning disabilities , cognitive issues , and i could go on and on …. Could this have caused his hearing issues and his cognitive issues? What could a fever rectally of 107 due to your brain ? And they never told me he had ” sepsis” but the nurse just uttered those words the other day at the office when reciting his medical history …

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    • Marilyn

      Have you looked into PANDAS? Some of these symptoms post infection (strep in particular) could point to this autoimmune syndrome. Treatment can help if it is the proper diagnosis!

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      • liz Ducady

        Hi , yes we did look into PANDAS at his therapists advice , came out negative

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  8. Felicia

    my son who is 4 had a fever of 103.1 at night. He complained about his ear the day before the fever. took him to the doctor NOTHING… no flu, no ear infection! and no fever the next day GREAT!! His fever began to rise at night but no higher than 100.5 . I gave him Motrin before bed just in case. 1 hour after he was in bed he was screaming and had a fever of 104.9!! I put him in a cool bath for 20 mins checking his temp every 5 mins it was going down. and gave him Tylenol. he slept fine and now NO fever at all. If he gets a high fever again tonight what should i do? what does it mean and is it normal?

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  9. Naomi Shifferly

    My Grandson is 15 and has had a fever for 4 days. From 99.9 to 104.8 stomach hurting and can’t keep nothing down.

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    • Naomi,

      Poor guy. He sounds miserable. A fever of 104.8 seems high, even for a 15 year old. If you haven’t spoken to his doctor, I think it would be smart to call.

      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  10. Jason

    It’s a bad call to run 102/103 temp for 3 weeks before you see a doctor the reason I didn’t cause it was only a fever and wasn’t sick yet. Turns out I had Lyme disease, rocky mnt.spotted fever and 3 viral infections and since it took them a week just to find out I didn’t get on antibiotics quick enough and it went to every joint in my body ( Lyme arthritis) that was almost 5 yrs ago , currently taking three kinds of arthritis pills and one kind of pain pills daily, monthly shots and cortisone shots every 3 to 4 months under my knee caps and elbows, so do the right thing and go to doctor soon

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    • Great information. A word to the wise, right?

      @MsGreene
      Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner, but I am a not doctor. Please keep that in mind when reading my comments and replies.

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  11. Christina Mccoy

    My 19 month old has a 103 fever. He had one today around 2 also that was almost 104 . I have given him ibprofan. It broke the fever earlier but he is still hot this time. He’s never had a fever that I knew about. Should I take him to the hospital??

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    • Christina,

      In discussing a child (not a baby) Dr. Greene says, “Steps should be taken to lower a fever if the child is uncomfortable, vomiting, dehydrated, or having difficulty sleeping. The goal is to bring the temperature between about 100 and 102 degrees F — not to eliminate the fever.”

      You can read more at Fast Facts about Fevers.

      Best, @MsGreene
      Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner, but I am a not doctor. Please keep that in mind when reading my comments and replies.

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  12. Jessica

    I know this is an old post but I thought I would try. My son has had a fever of around 103-104 for almost a week. The last few days when he is sleeping his fever goes up to 106.5. He says his ears hurt but was diagnosed with strep yesterday. We have done two doses of antibiotics and give him Ibuprofen every eight hours, but when the medicine wears off he still spikes crazy temperatures. Today, when I checked him during his nap, he was 107.5!!! All I read is that your body wont let your temperature get that high but what if it does? We put him in a warm shower to cool him down (after making sure he has some fever reducers) and his temperature comes back down to 103 but I feel like his temperature shouldn’t be getting that high in the first place. The doctor didn’t seem too concerned with the 106’s and said that I need to stop taking his temperature so often, but we have a really good thermometer (the same ones our doctors use to take temps) and I calibrate it on myself regularly to make sure it is reading accurately as well as take several readings. I’m lost at what I should do and what can be done. Please help. Thanks!!

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    • All thermometers have a range in which they are accurate. Yours may not be accurate over 105, but any child with a fever of 107.5 should be taken to an Emergency Room.

      Hope that helps,
      @MsGreene
      Co-founder & Executive Producer, DrGreene.com
      Mother

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  13. Ewa

    Hi,

    My Son whi is 6 has a fever up to 38 Celcius degrees for 7 days now. He is very sleepy all the time, do not have energy at all, do not want to eat, he has headaches.
    It all started 7 days ago on Tuesday morning with vomitting and fever up to 39 Celsius degrees, he had vomitted several times till Friday, than stopped. We took him to hospital as he had signals of dehydration, he had blood test done (the doc said it suggested viral infection) and was given a drip to hydrate him.
    His state has slightly improven however he still is very weak, has a temperature up to 38 Celsius degree, has a lack of appettite :( :(
    How to cure him, what else can be checked, shoud I worry?
    Thank You,
    Ewa

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  14. Ntombi Ayanda

    Hi doctor my son is 14months old his temperature is very high and his vomiting I’m worried what can I do and another thing DAT worries me so much he likes to eat soil and small stones pls help…

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  15. Amanda

    Hi; my 14 months daughter has been having fever for 2 nights now. Though it dropped after giving her paracetamol last night but I saw some wax-like substance in one of her ears this morning. What do you suggest?

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  16. sangeetha

    my is son (5 month old) having fever in the early morning for the past 1 week.. doctor advised for fever medicine and cold medicine phenethyrane ..but it continued till date..he is active for the rest of the day.. the start by 5.30 in the morning once the medicine was given got controlled within 4 hours.. what kind of the fever this is?

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  17. jodie taylor

    Hi my name is Jodie, I’ve been getting really bad headaches and I checked my temp and it was 197.1. I get hot flashes all the time, I can’t eat as much as I used to. I’m not losing weight or gaining weight. I’m 16 years old and my weight is 153.8, sometimes I can go days with out eating. My doctors are just saying its because I’ve tried to lose weight is why it’s doing it and I have a lot of stress and yeah, I’ve tried to lose weight but, I never stopped eating for it, yeah I’m stressed out, but it’s just because my boyfriend’s leaving for college and I’m scared he’s never come back from it…. but I’m not always stressed out. I’m actually a happy person when it comes to it, so I really need help. I wanna know what’s wrong with me, since my doctors just say it’s just cause I’m stressed out…

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    • Sherlock Holmes

      I don’t think it’s possible for temperatures above 107 not to kill you. How are you still alive? Is your thermometer broken? Have you been to the doctor?

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      • Emdudditx

        Lol right. No such temp 197.

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  18. nabhira

    My child is 2 years old and suffering frequent fever — almost per month? What type of diseases may be causing this?

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  19. Alisha

    Hi! my 6yr old has the flu with a fever for 7 day. is that normal for the flu?

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  20. CaliforniaMom

    Googling questions related to my daughters current fever I stumbled across your website. The beginning terrified me! The mere mention of death almost made me stop reading. So glad I continued on. Some very informative information. Thank you for this post. I can now lay down knowing my little one will not need an ER trip this evening, What a weight you’ve lifted by sharing your knowledge! Thank you!

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  21. arpu thapa

    Since two days my brother has fever and we are tense about me brother taking medicine for brain.,.,.if fever injection cause infection to his brain.

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  22. Chloe

    My dad is about 37 and his temp is 101.5 it’s gone down from 102.9, he claimed he needs to go to the ER, but he won’t go without someone to watch my brother and I, what do I do?! Please help me!

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    • Chloe

      He has gotten in a cold bath to make his temp go down.

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  23. Tracy

    Maybe she needs recheck for ear infection might not be completely gone?

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  24. Tracy

    19Mth just got over ear infection last week, now she is running temps again of 100.4. WHAT do I do ? I already gave her Tyl. @9 pm temp 100.00, now 1am 100.4 gave her One dose amoxicillin 1t

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  25. Lexi Hamby

    My 13 year old friend has a temperature of 103.2, he is throwing up, and hasn’t eaten anything but soup all day. what do I do?

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  26. Travis MacLaren

    so what about prolonged fever of 102.5? my 4 y.o. daughter has had a fever of more than 102.5 and had spikes of 103.5 off and on for the last 3 1/2 days. I have been giving ibuprofen as needed to keep it down a bit but more so for the constant headache she is complaining of. She is taking fluids but not a lot and my other 2 kids had lower fevers and broke after 2 days… she also has had a small amount of vomiting and has not had a bowel movement the whole time…

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    • Lubomira

      My 4 y.o. daughter also had a fever up to 102.5 for 4 days. I also have been giving her motrin. She was checked by a pediatrician for ear infection and strep as we had to fly. Per the pediatrician, she just had a virus. She vomitted three times last night and the fevers continues….I keep giving her motrin as it last longer.

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