Key takeaways (30-second read)

1. Fever definition: Rectal/ear/temporal ≥100.4°F (38.0°C); oral ≥100.0°F (37.8°C); axillary ≥99.0°F (37.2°C). Mayo Clinic
2. Look at comfort & hydration more than the number. Many fevers can be managed at home with fluids, rest, and comfort care.
3. <3 months old: any fever ≥100.4°F (38.0°C) → contact your pediatrician promptly. AAP
4. Medicines: Acetaminophen (all ages if advised), Ibuprofen (≥6 months). Dose by weight. No aspirin for kids/teens. AAP
5. Skip alcohol baths & ice water. If using a bath, keep it lukewarm and stop if your child shivers. AAP

What counts as a fever?

Fever is a normal immune response. For practical home decisions, use these thresholds:

• Rectal / Ear / Temporal: ≥100.4°F (38.0°C)
• Oral: ≥100.0°F (37.8°C)
• Axillary (underarm): ≥99.0°F (37.2°C)

When calling your pediatrician, report the number + method (e.g., “temporal 101.2°F”).

How to take your child’s temperature (by age & device)

• <3 months: Prefer rectal for accuracy.
• ≥6 months: Ear can be used if aimed correctly; earwax and cold exposure can skew readings. AAP
• Temporal (forehead): Works across ages; let your child warm up after coming indoors; avoid sweat/glare interference. AAP
• Axillary: convenient but least accurate; confirm with a more accurate site if results and appearance don’t match. Mayo

Home care: comfort first

• Fluids: small, frequent sips of breast milk/formula/water or oral rehydration solutions. Watch dehydration signs (dry mouth, fewer tears, fewer wet diapers, sunken soft spot). AAP
• Clothing & room temp: light breathable layers; add a thin blanket only if shivering. AAP
• Lukewarm baths only (optional): avoid cold water and never use alcohol sponges. AAP

Fever medicines & weight-based dosing

Goal: help your child feel better (rest, drink), not to “zero out” the number.

• Acetaminophen (paracetamol): 10–15 mg/kg per dose, every 4–6 hours; max 4 doses in 24h. Use mL syringes, not kitchen spoons. AAP dosing table
• Ibuprofen: 5–10 mg/kg per dose, every 6–8 hours; use only if ≥6 months. AAP dosing table
• No aspirin in children/teens (Reye syndrome risk). AAP
• Avoid routine alternating of acetaminophen & ibuprofen unless your clinician gives a written schedule. AAP clinical report

When to seek care (by age & red flags)

Go to the ER now (any age) if one or more is present

• Breathing trouble: fast/labored breathing, chest retractions, noisy breathing/stridor/wheezing, blue/gray lips/face. AAP symptom checker
• Very poor responsiveness: unusually sleepy/hard to wake or “looks very ill.” AAP
• Age <3 months with temp ≥100.4°F (38.0°C). AAP
• Repeated ≥104°F (40.0°C) or a seizure. AAP
• Severe dehydration: very few/no wet diapers, dry mouth, no tears, sunken fontanelle, marked lethargy. AAP

Contact your pediatrician the same day

• Fever duration: <2 years >24 hours; ≥2 years >72 hours. AAP
• Cough with risk signs: clearly faster breathing, chest pain, wheeze, or cough >3 weeks. AAP symptom checker
• Poor intake + less urine: refusing to drink/nurse plus fewer wet diapers → dehydration concern. AAP
• Your gut says your child is getting worse or still “not right” even after fever comes down. AAP

Combo symptoms: fever + cough + poor appetite + restless sleep

This cluster is common with viral respiratory illnesses. What matters most is breathing, hydration/urine output, alertness, and the duration of fever/cough:

1. ER now if any breathing distress or very poor responsiveness occurs (see list above).
2. Same-day visit if fever exceeds the duration thresholds above, if your child won’t drink + pees less, or if cough is persistent/worsening with chest pain/wheeze. Details above.
3. Home care is fine if appetite is down but your child is still drinking, urinating normally, and interacting reasonably well. Re-check trends over 24–48 hours.

When fever comes with a cough: simple comfort care

• Humidified air and warm clear fluids (if age-appropriate); avoid second-hand smoke.
• Honey can soothe nighttime cough for children >1 year (2.5–5 mL as needed). Do not give honey to infants <1 year. AAP
• OTC cough/cold medicines: not recommended <2 years; manufacturers label most products “do not use under 4 years.” Use caution for older kids and avoid multi-ingredient combos. FDA

Febrile seizures: what parents should know

• Occur in about 2–5% of children (typically 6 months–5 years). Most are brief, with excellent recovery and no long-term harm. CDC
• If a seizure happens: place your child on their side, clear nearby hazards, do not put anything in the mouth, and time the event. Call emergency care if it lasts >5 minutes or if you’re worried. CDC

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