Kids’ fevers: When to be concerned

A child with a fever can be scary in normal times. These days, it’s especially so. Here are some steps to take when it happens, and how to know when a fever is too high for a child.

Is it really a fever?

First, make sure it’s really a fever. As with adults, a child’s normal temperature isn’t as steady as the usual guidance of 98.6 degrees Fahrenheit (37.8 Celsius) suggests. A range of 97 to 99 degrees is more typical of normal temperatures. What constitutes a fever in a child depends on how the temperature was taken.

  • Orally: 100 F (37.8 C)
  • Rectally: 100.4 F (38 C)
  • Under the arm: 99 F (37.2 C)

More important than the number, though: How is your child acting? If they are otherwise fine, and the fever is moderate, you may not need to treat it. If your child is fussy, has chills or aches, treat the fever with acetaminophen or ibuprofen.

When to get medical help

If the fever isn’t responding to treatment, contact your pediatrician immediately. Any fever in an infant 2 months or younger needs to be treated as an emergency.

Get medical help promptly if your child is at high risk of serious complications from a virus, has difficulty breathing or you feel like they need emergency care.

Never attempt to use rubbing alcohol (isopropyl alcohol) to bring down a fever. It is absorbed through the skin quickly and could be inhaled, possibly causing alcohol poisoning. Ice baths can backfire as the body reacts to the rapid cold by increasing the internal temperature.

A lukewarm bath or compress can provide temporary relief from a fever.

Age Temperature Other symptoms What to do
2 months or younger 100.4 F or higher rectally Seek emergency care.
3 to 6 months Above 102.2 F (39 C) rectally Contact your pediatrician.
3 to 6 months Lower than 102.2 F rectally None Rest and plenty of fluids. Consider fever reducers and cooling off by removing layers and a lukewarm bath.
3 to 6 months Above 102.2 F rectally Particularly cranky, weak and tired or uncomfortable Contact your pediatrician.
6 to 24 months Above 102.2 F taken rectally Younger children can have acetaminophen. If 6 months or older, ibuprofen is also an option. Don’t give aspirin to an infant or toddler.
6 to 24 months Above 102.2 F taken rectally Fever doesn’t respond to medication or lasts longer than 24 hours. Contact your pediatrician.
Age 2 to 17 years Lower than 102.2 F Rest and plenty of fluids. Consider fever reducers and cooling off by removing layers and a lukewarm bath.
Age 2 to 17 years Lower than 102.2 F No energy, significant discomfort Call your pediatrician.
Age 2 to 17 years Above 102.2 F Uncomfortable Treat with acetaminophen or ibuprofen. Avoid aspirin.
Age 2 to 17 years Above 102.2 F Fever doesn’t respond to medication or lasts more than three days Call your pediatrician.

Care when you need it, close to home

Norton Healthcare has convenient options for flu symptom treatment in kids and adults through our primary care and pediatrician offices, Norton Immediate Care Centers, Norton Prompt Care at Walgreens clinics, Norton eCare and pediatric emergency care.

Get better

Also, ask your pediatrician about any specific guidelines.

Fever guidance is different for adults.

Based on your child’s medical history, your pediatrician will recommend a plan. Norton Children’s pediatrician offices are available anytime, even after hours — just call the office and a provider will call you back to discuss your child’s illness and next steps for care.

For less urgent concerns, you can message your provider’s office if you have signed up for a free MyNortonChart account and set up proxy access for your child. If you haven’t signed up for MyNortonChart, it doesn’t take long at MyChart.NortonHealthcare.org. You may be able to schedule a Norton Telehealth visit with your provider.

If you do not have a primary care provider and your child is age 2 or older, you can schedule a video visit with Norton eCare, 24/7, to speak with a Norton Healthcare provider from home. They will be able to help guide you and write a prescription if necessary.

Isolate from others

Even in your home, you and your child should stay away from others if possible.

Viruses spread mainly through droplets that get in the air when people with an illness cough, sneeze or talk. It is also possible to pass infection by human contact or touching a surface with the virus on it and then touching your own mouth, nose or eyes.

If you live in close quarters and can’t realistically isolate with your child, all family members should act as if they are at high risk. That means wearing a mask at home, washing your hands often, keeping 6 feet apart as much as possible, covering coughs and sneezes, and disinfecting frequently touched surfaces such as doorknobs, light switches, toilets and sinks, daily.

Continue to stay home until your child is symptom-free and their fever has been gone for 24 hours.

Should your child get tested?

If you are concerned, get tested for flu through your primary care provider, a Norton Immediate Care Center or Norton Prompt Care at Walgreens clinic. COVID-19 screening is available at these locations as well as at a Norton Respiratory Illness Testing Center, by appointment.

With the flu, antiviral medications may be helpful, depending on how long your child has had symptoms and any chronic health conditions that they have. If your child’s symptoms are mild, they may be able to ride it out with over-the-counter remedies.

A positive test for the coronavirus/COVID-19 allows contact tracing. With health officials able to warn others with whom your child has been in contact — you or your child’s identity won’t be disclosed — spread of the virus can be reduced.

Reviewed by Becky S. Carothers, M.D., pediatrician with Norton Children’s Medical Group – Broadway.


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