Children And Fever
Scott Cohen (Pediatrician, Cedars-Sinai Medical Center) gives expert video advice on: How do I take my child's temperature?; What is the normal temperature of a child?; How do I control my child's fever? and more...
What is a "fever"?
The definition of a fever is any temperature of 100.4 or higher rectally. A rectal temperature is the best way to take a temperature, especially in the first couple months of life. There are many other ways to take temperatures; there's oral, there's under the arm, there's by the ear and there are new temple artery thermometers. The ear and the forehead thermometers tend to be very inaccurate at any age. They'll tell you fever or no fever, but the numbers tend to be all over the place. I usually recommend my parents do only rectal temperatures, especially in the first two to three months of life, and after that rectal temperature again is best, but if they want to do under the arm, it's OK. This is because we really don't care if it's 100.4 or 104 in older kids, we will do the same thing, which is treat the fever. In children under two months of age, any fever needs to be called to the doctor immediately, even before treatment.
What is the normal temperature of a child?
Any temperature under 100.4 is normal. We used 98.6 as a person's body temperature, but actually, what we found is our body temperature fluctuates throughout the day. It's probably lowest in the morning and then highest in the afternoon to evening, so our body's temperature fluctuates. I usually say anything under 100.4 is normal temperature and if your child is acting fine, don't worry about it. There is really no reason to routinely check you child's temperature, unless they're showing you signs that they may have a fever. Like if they're fussy, or they're not eating well, or they're felling hot. Remember that a fever is a good thing. A fever is your body's response to an infection. It's how you're fighting infection and it doesn't cause brain damage. The height of the fever doesn't cause seizures, it's your body's reaction to fighting. You don't even have to treat a fever. The only reason we do it is to make your child feel better, but it is not that the fever itself that will harm your child.
When do I need to call the doctor about my child's fever?
I would call the doctor if your child has a fever in the following instances. First of all, for any child under two months of age a parent should call their doctor for any temperature of 1.4 or higher. In those first couple of months it's really imperative that any child with fever is looked at. In older children, you should call the doctor if your child has a fever that is not responding to Tylenol or Motrin or that lasts more than 72 hours, or when your child has other symptoms that concern you; they are inconsolable, they are not eating or staying hydrated. Remember, when your child has a fever, I know they're going to look bad. So when your child has a fever, everything goes out the window. Their eyes are going to be rolled behind the back of their head, they're going to be really tired and lethargic, they're not going to eat well. You can't judge at that point in time. You need to treat the fever and then see what they look like when their fever goes away. If they look better when the fever goes away, that tells you you're on the right step and you're doing everything right. When the fever isn't responding, or it's prolonged, that's when it becomes a concern.