Definition and Overview

A child with fever may be alarming for parents, but in most cases, especially when the child is otherwise healthy, the raised temperature is only a sign that his immune system is fending off a common infection. Having a fever is actually a positive indication that the immune system is working as it should. However, a fever may sometimes point to something more serious, so it still helps to know what to watch out for.

The medical definition of a fever is having a rectal temperature that is higher than 100.4 F or 38 C. More often than not, parents rush to the emergency room with a slightly raised temperature that is not considered as a fever. A child’s temperature is not considered as the best indicator of his or her condition. It is still best to observe the child for symptoms and other obvious signs that something is seriously wrong. Parents who are in doubt are advised to take the safer path and call the pediatrician, who can tell if the child needs to be brought in for medical care.

Cause of Condition

A fever is triggered by the hypothalamus, the part of the brain that regulates the body’s temperature. This happens when the body detects an infection. The most common causes of a raised temperature in children include:

  • Bacterial infection, e.g. tonsillitis or rheumatic fever
  • Viral infection, e.g. the common cold or the flu
  • Upper respiratory tract infections (often accompanied by coughing and runny nose)
  • Medications for other conditions
  • Ear infections
  • Urinary tract infections
  • Heat exposure
  • Allergic reaction
  • Inflammatory disease
  • Recent immunization
  • Childhood illnesses, such as chickenpox

Some serious illnesses, such as meningitis, pneumonia, or septicaemia, may also cause fever.

Key Symptoms

Your child’s symptoms, as well as your child's general condition, are your best indicators of what to do. Fever is usually accompanied by some symptoms, such as vomiting or a general feeling of being unwell. Although your child may not be as active as normal, if she is still eating or drinking, smiling, generally looks well other than feeling hot, or still wants to play, the fever is most probably not serious.

Mild symptoms may include:

  • Irritability
  • Fussiness
  • Being unusually quiet
  • Crying
  • Changes in sleeping habits
  • Body aches

However, it is best to call the doctor if you notice the following symptoms:

  • The child is unresponsive
  • Breathing difficulties
  • Bluish skin or lips
  • Seizure
  • Stiff neck
  • Bulging fontanel (or soft spot, among infants)
  • Repeated and continuous vomiting
  • Severe diarrhea
  • Not peeing as normal, a sign of dehydration
  • Dry mouth
  • Rashes

Calling a doctor in case of a fever may also depend on the child’s age and temperature. The best way to take the temperature is through the rectum. You should call the doctor if:

  • Child is younger than three months old with a temperature of 100.4 F
  • Child is aged 3 to 6 months with a temperature of 101 F
  • Child between 6 months and one-year-old with a temperature of 103 F
  • Child has a temperature of 104 F or higher, regardless of age
  • Child has not received the recommended immunizations

The length of time the child has had fever should also be taken into consideration. Young children, especially those two years of age and younger, with a fever that lasts more than 24 hours should be brought for a checkup. On the other hand, older kids should be brought to the doctor if they have had a fever for three days or longer.

Lastly, children with existing immune disorders or blood problems should be brought to the doctor in case of a fever.

Who to See And Types of Treatments Available

A feverish child with high temperature should be brought to a pediatrician while a feverish child with severe symptoms should be brought straight to the emergency room.

If the fever does not seem to cause any serious trouble and the child is still active, some home remedies, such as giving a lukewarm sponge bath or giving him plenty of fluids to drink, especially water, may help. Drinking a lot of fluids during a fever is important as it helps the body flush out the infection. Also, while many parents are tempted to bundle their kids up in fear of making the fever worse, it is best to keep the child’s temperature properly regulated. This means that if the environment is warm, then the child should be kept cool; on the other hand, if the environment is already cold, the child should be kept warm. Wrapping him up in thick clothing or many blankets should be avoided as this may cause his body’s temperature to rise even higher.

For infants and young children, it is also best to hold off on medications unless advised by a pediatrician or if the child seems heavily affected by the fever. Older kids can also be given acetaminophen or paracetamol, especially if the fever seems to be causing distress, as long as proper dosage instructions are followed; aspirin, however, should be avoided.


  • Mick NW. Pediatric fever. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby Elsevier; 2013:chap 167.
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