When & How to Treat A Child’s Fever – Fever With A Purpose

As many of the families in my practice know, I do not recommend treating a child’s mild or moderate fever with medications such as Tylenol and Ibuprofen.

While it can sometimes be scary, it is important to remember that the fever can be quite purposeful and very important in allowing your child to recover easier and faster from their illness.  In fact, their fever is a wonderful sign that their immune system is working hard to combat the infection and speed recovery.


What is considered a fever and how high is too high?

A fever is considered to be a temperature over 100.5 if measured on the forehead, in the mouth, in the ear or rectally.  If measured under the arm, you would add a degree to the thermometer’s reading.

If you have a young baby under the age of 2 months, the temperature should always be taken rectally as it is the most accurate.  With that being said, I do not typically recommend monitoring a child’s fever regularly.

The degree of fever does not necessarily tell us anything about how sick your child is.  It will also not change how we end up treating the fever.

A fever is not truly dangerous to your child’s health unless it rises above 105-106 degrees.  Some children will mount a very high fever (up to 104 or above) even with a mild viral infection. Most untreated fevers do not rise above 105.      


What causes a fever?

A fever is typically a response to a common viral or bacterial infection such as a cold, flu, UTI, ear infection, croup, gastroenteritis (stomach flu), etc.   The presence of fever OR the degree of the fever does not always have a bearing on how sick your child is or whether the illness is viral or bacterial.


The purpose of a fever

A rise in body temperature helps the immune system respond more efficiently.  A fever helps the body produce more infection-fighting white blood cells and can stop some viruses or bacteria from reproducing.

The feeling of being cold, having the chills or shakes and feeling very tired can come with a fever.  A high temperature will also result in a fast heart rate and rapid breathing, which is a normal part of the fever process.


How to care for your feverish child

A child’s fever will usually resolve on its own after 1-3 days.  It will often go up and down and will usually be higher at night.  Most parents instinctively know how to support their child with a fever through fluids, rest, cool compresses, etc.

Here are some specific tips, some of which you may already know.

  • Increase their hydration as much as possible with frequent sips of water, coconut water, herbal teas, soups, etc.
  • Use a fan, cool compress or washcloth to the forehead for comfort.
  • Sponge bath with tepid water
  • Herbal medicine and vitamins to treat the underlying infection (i.e. Vit C, Vit D, probiotics, zinc, elderberry, echinacea and herbal medicine specific to their other symptoms).  Specific herbal/vitamin recommendations can be recommended by your holistic provider and will depend on your child’s age and symptoms.


When to treat with pharmaceuticals?

Fever reducing medications can be used for high fevers (above 103-104) or for children who are in significant discomfort or whom the fever is interfering with their ability to stay hydrated, rested, etc.

I typically recommend using Ibuprofen (Motrin, Advil, etc) as opposed to acetaminophen (Tylenol) as it is more effective and since there have been recent reports with some concerning short and long term side effects with Tylenol.

If you are concerned about your child’s fever and need help deciding how best to support them or whether to use medication, we encourage you to contact your provider.

If your child is too young or too small for the dosing listed on the bottle of medication,  please contact your healthcare provider for the appropriate dose.


When to seek medical attention

Here are some times when it would be important to schedule a visit with your physician:

  • If you have an infant under 3 months of age with a rectal temperature over 100.5
  • If your child has a fever over 102 for more than 2-3 days
  • If the fever is accompanied by a headache and stiff neck
  • If your child is not drinking well and urinating well
  • If your child is lethargic and is not able to act normally when the fever comes down (a child will normally be very tired and often lethargic when the fever is high …this is normal)
  • Any time you are significantly concerned about your child’s health



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