Fevers are one of the most common reasons parents worry about their child’s health. Seeing a high number on the thermometer can feel alarming. But in most cases, fever is a normal response and not something to fear.
The fever itself is not an illness– it’s your child’s immune system doing its job. First, it’s important to remember that a fever is any temperature above 100.4°F (38°C). For babies under 8 weeks old, though, any fever is a big deal– you need to seek medical attention. For older children, I’m more concerned about fevers lasting longer than five days.
For more information on fevers in general, check out this PedsDocTalk YouTube video.
Understanding when to check a temperature, how to keep your child comfortable, and when to seek medical care can help ease uncertainty. As a pediatrician and a parent, I’m sharing my step-by-step approach to handling a fever–what to monitor, when to use fever-reducing medication, and when to call a doctor.
Step 1: When to Check for a Fever
Not every warm forehead means your child has a fever. I check their temperature if they are:
- Cranky or more irritable than usual
- Feeling noticeably warm
I also check if they’re sick, especially when I’ve been monitoring fevers or right before nap or bedtime. Even if they seem comfortable, tracking fever patterns– how often they’re spiking and whether it’s affecting their sleep or hydration–helps guide my approach. If needed, I may give medication before sleep to help them rest more comfortably.
What if they feel warm but are acting fine? If they’re playing, drinking, and acting like their usual self, I don’t rush to grab the thermometer. Kids can feel warm for all sorts of reasons– running around, being bundled up, or even just waking from a nap. A warm child without other symptoms doesn’t always need a fever check.
One exception for me is before nap or bedtime– this is when I’ll check and consider medication if it helps them sleep better.
When to be extra cautious:
- For babies under 3 months: I check their temperature if they seem fussy, cranky, or just “off.” If they have a fever, call their pediatrician immediately.
- For children prone to febrile seizures: caregivers may check temperatures more frequently to monitor for sudden spikes. For more information, watch the PedsDocTalk YouTube video about febrile seizures.
- For older kids: I track fever patterns– if it’s persistent, interfering with sleep and hydration, or lasting more than five days, I check more regularly.
Remember: It’s important to treat symptoms, not just the number on the thermometer. Avoid over-checking temperatures– focus on how your child is feeling instead.
Step 2: How to Take a Temperature the Right Way
Once I decide it’s time to check a fever, the next step is making sure I get an accurate reading. The method I use depends on my child’s age:
- Under 2 years old: Rectal thermometer (most accurate for infants and young toddlers). I apply a small amount of petroleum jelly to the tip, insert the thermometer just past the silver tip, and wait for a beep. Rectal temperatures provide the most reliable measurement for babies.
- 2+ years old: Ear thermometer (quick and reliable). I gently pull their ear back, insert the thermometer snugly into the ear canal, and wait for the reading. This method is easy and less invasive for toddlers and young children.
- Older kids: Oral thermometer (best when they can hold it properly under the tongue). I place the thermometer under their tongue and remind them to keep their mouth closed until the beep. This method is effective once they can cooperate for an accurate reading.
What about forehead or underarm thermometers? These can be useful for a quick check, but they’re less precise than rectal, ear, or oral readings. If I need more reliable measurements, I use the method that matches their age for the best accuracy.
What if my child won’t stay still? For wiggly babies and toddlers, distraction helps– singing, handing them a toy, or making silly faces. For older kids, I let them choose between an ear or oral thermometer to give them a sense of control. The real key is to stay calm– if you’re chill, they’re more likely to roll with it.
Why do different thermometers show different readings? Slight variations are normal between thermometer types. The key is is to stick with one method consistently rather than comparing different types. The most important thing is how your child is acting, not just the number. If something feels off, trust your gut and give your child’s pediatrician a call.
Step 3: When to Give Fever-Reducing Medication
While a fever itself isn’t always the issue, it can make kids uncomfortable. I don’t treat the fever just to bring the number down– I focus on how my child’s feeling. I give medication if my child is:
- Cranky, irritable, or clearly uncomfortable
- Struggling to sleep due to the fever
- Not drinking well, which can lead to dehydration
For kids over 6 months, I usually prefer Ibuprofen (Motrin) because it lasts longer and reduces both fever and inflammation (great for ear infections, teething, and sore throats). For more about medications and calculating accurate doses, watch this PedsDocTalk YouTube video. It’s always important to follow the dosing instructions based on weight or age– no guessing– if you’re unsure, double-check with your child’s pediatrician.
Can I alternate between Ibuprofen and Acetaminophen? Yes, but only if needed. If my child is still uncomfortable before the next dose of Ibuprofen is due, I might use Acetaminophen in between. I always track what I’ve given and when to avoid overdosing.
The key takeaway: Medication should be used for comfort, not just to bring down the number on the thermometer. Always assess whether it’s really needed and follow the recommended dosing intervals to avoid overmedicating.
Step 4: Other Ways to Keep Your Child Comfortable
Medication isn’t always necessary– there are other ways to help a child feel better when they have a fever. Even if I give medication, I also focus on comfort measures to support their recovery.
Hydration is key: Staying hydrated is one of the most important things when a child has a fever. I encourage small, frequent sips of fluids like water for older kids, breast milk or formula for infants. Check out this PedsDocTalk YouTube video on dehydration. Don’t stress about food. When kids aren’t feeling well, they lose their appetite–it’s normal. I offer hydrating snacks like watermelon or cucumbers.
Let them rest: Sleep is essential for healing, so I let my child sleep as much as they need, whether that means extra naps or going to bed earlier. I don’t wake them up just to check a temperature unless I have a specific concern. If they wake up uncomfortable or irritable, I assess whether hydration, cuddles, or fever-reducing medication will help them settle back to sleep.
Keep them comfortable: Fever can make kids feel achy and restless, so I focus on keeping them comfortable. Sometimes, extra cuddles and one-on-one time are the best remedies– feeling comfortable and reassured makes a big difference when they’re not feeling well.
Step 5: When to Call the Doctor
Most fevers resolve on their own, but there are times when medical attention is necessary. Rather than focusing only on the number, I pay close attention to how my child is acting and whether other concerning symptoms are present.
For babies under 8 weeks old, any fever is a reason to seek medical attention immediately. Their immune system is still developing, and even minor infections can become serious quickly.
For older babies and children, I call the doctor if a fever lasts more than five days, if my child is extremely irritable or lethargic despite fever medication, or if they aren’t drinking enough fluids and showing signs of dehydration. If they’re working harder to breathe or sound hoarse (like with croup) and steam or cold air doesn’t help, I seek medical evaluation. A fever with persistent ear pain that isn’t relieved by medication could indicate an ear infection. Febrile seizures, while often harmless, can be alarming–if one occurs, it always warrants a call to the doctor.
If something just feels off, I trust my gut. As a parent, you know your child best, and it’s always okay to check in with a pediatrician for peace of mind.
Final thoughts
Fevers can feel overwhelming, but in most cases, they are simply a sign that your child’s immune system is doing its job. Rather than focusing on the number, I pay attention to how my child is acting, keeping them comfortable, hydrated, and well-rested.
If you’re ever unsure, trust your instincts– checking in with your child’s pediatrician is always okay. And if something doesn’t feel right, don’t overthink it. Your peace of mind matters, and it’s always better to reach out for reassurance.
Watch the PedsDocTalk YouTube Video HERE!
