Fever and Your Child
What is Fever?
Fever is defined as any increase in body temperature above normal limits. Therefore, it is important to know what these normal limits are. Body temperature naturally fluctuates throughout the day, with the lowest temperatures occurring in the early morning and the highest in the late afternoon. Generally, the normal temperature range for children under 12 years, depending on the measurement method, is as follows:
- Rectal: 36.5-37.9°C
- Oral: 35.5-37.5°C
- Axillary/Forehead: 35.5-37.1°C
- Ear: 36.1-37.8°C
- In infants, a temperature slightly higher than these ranges may still be normal.
Fever is not a disease but a symptom—an indication that the body is fighting an infection. It is a positive sign that the immune system is activated. Fever triggers the body’s defense mechanisms, such as activating white blood cells to attack the “invader.” Therefore, fever is useful, but it can make a child feel unwell. During fever, a child may experience rapid heartbeat, fast breathing, headaches, and increased thirst.
However, there are other causes of fever besides infection, such as medications, injuries, toxins, exposure to extreme temperatures, or excessive physical activity.
How to Measure Your Child’s Temperature
Mercury thermometers are no longer used. Only digital thermometers should be used. Choose one of the following methods and always use the appropriate thermometer:
- Rectal (for children under 3 years old):
- Clean the thermometer tip with soap and water or alcohol.
- Apply a little gel or oil to the tip.
- Place the baby on their stomach across your lap.
- Turn on the thermometer and insert 1 cm for infants under 6 months and 1.5-2 cm for older babies.
- Hold the thermometer firmly for at least 1 minute.
(Some pediatric organizations worldwide do not recommend this method at any age.)
-
Oral (for children 4 years and older):
- Clean the thermometer tip with soap and water or alcohol.
- Place the thermometer under the tongue and towards the back.
- Tell the child to close their lips without biting the thermometer.
- For accuracy, wait at least 15 minutes after drinking hot or cold liquids.
-
Ear (for children over 6 months old):
- Insert the thermometer tip into the ear canal and turn it on.
- The result usually appears within seconds.
-
Axillary (for all ages, mostly for children over 3 months old):
- Place an oral or rectal thermometer under a dry armpit.
- Press the arm against the chest and wait for at least 1 minute.
-
Forehead (for all ages):
- Follow the manufacturer’s instructions for accurate readings.
Call Your Pediatrician If Your Child:
- Appears very sick, lethargic, excessively sleepy, or irritable (especially infants).
- Was in an extremely hot environment (e.g., closed car).
- Has additional severe symptoms such as stiff neck, severe headache, persistent sore throat, intense ear pain, unusual rash, repeated vomiting, or diarrhea.
- Has a condition that lowers immunity (e.g., sickle cell anemia, steroid use).
- Has seizures.
- Is younger than 12 weeks old.
- Has a recurrent fever above 40°C.
- Shows signs of dehydration (no tears, dry mouth, reduced urination).
- Has a fever lasting more than 24 hours in children under 2 years old or more than 3 days in children over 2 years old.
- Is not interested in playing when the fever subsides.
Fever Management
Fever treatment aims to relieve discomfort rather than eliminate fever itself. If a child older than 6 months has a mild fever (up to 38.3°C) without significant symptoms, no treatment is necessary. In this case:
- Keep the room cool.
- Dress the child in light clothing.
- Ensure they drink plenty of fluids.
- Encourage rest.
The first-line medications recommended by most pediatric organizations are:
- Paracetamol (Acetaminophen): Apotel, Depon, Protalgon, Panadol
- Ibuprofen: Algofren, Nurofen
For the correct dosage, consult your pediatrician.
🚫 Never use aspirin as an antipyretic in children.
🚫 If the child cannot take oral medication due to vomiting, paracetamol can be given as a suppository.
A useful method to manage fever is applying cool compresses (not ice-cold) on the forehead and limbs. This is especially helpful when:
- The fever is above 40°C.
- The child cannot take medication due to vomiting.
- The child has a history of febrile seizures.
(These methods are not recommended if the child has chills.)
⚠️ Do not aggressively lower fever too quickly, as this can cause the body to raise the “thermostat,” leading to an even higher temperature later.
Febrile Seizures
In some children aged 6 months to 5 years, fever may trigger febrile seizures.
- They are harmless and not epilepsy.
- They do not cause brain damage, but they can be frightening for parents.
Symptoms:
- The child becomes unresponsive.
- Experiences tremors, jerking movements, or stiffness.
- Rolls their eyes upward.
- May be limp and floppy (rare).
- Seizures usually last up to 1 minute (rarely up to 15 minutes).
What to Do During a Febrile Seizure:
✅ Place the child on the floor or bed, away from hard/sharp objects.
✅ Turn the child onto their side to prevent choking.
🚫 Do NOT put anything in the child’s mouth.
📞 Call your pediatrician immediately.
Sources:
- American Academy of Pediatrics / HealthyChildren.org
- NICE Clinical Guidelines
- HealthLinkBC
- A Decrease in Temperature and Humidity Precedes Human Rhinovirus Infections in a Cold Climate, Viruses. 2016
- Immune Changes in Humans During Cold Exposure: Journal of Applied Physiology, 1999
This information aims to help parents understand fever and manage it effectively. Fever is usually a normal immune response, and most cases resolve without complications. However, always monitor symptoms carefully and consult a doctor when necessary.