A fever is a body temperature that is higher than normal, often shown by a thermometer reading of over 100.4°F/38°C. Body temperature can vary with age, activity/exertion level, clothing, and even the time of day. (Everyone’s temperature tends to be lower early in the morning and higher between late afternoon and early evening.)

A fever is generally harmless and will help a child to fight infection. It shows that the child’s immune system is working and the body is trying to rid itself of the infection. An increased body temperature is often a response to illness caused by a virus or bacteria, and except in the case of heat stroke fever itself is not the illness, only the symptom and a part of the body’s defence, and therefore does not necessarily signal a need for antibiotics.

A fever is often identified by the child appearing flushed, perspiring, and wanting more fluids than usual. When a child has a fever, the heart and breathing rates will naturally speed up, and the child will feel warmer to the touch. They will also often have symptoms of the illness that has caused the fever, such as an earache, sore throat, rash, or stomach ache. These signs will help to identify the cause of the fever, which could range from a common cold and/or ear infection, to poisoning, pneumonia, and heat stroke, and it is therefore essential that the cause is identified as soon as possible.

Most of the time fever in a child is harmless and there does not require the attention of a doctor. However, there are situations where a pediatrician should be consulted: If the child looks very ill and is unusually drowsy or very fussy; if there are additional symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, and repeated vomiting or diarrhoea; if the child has been in an extremely hot place, such as an overheated car; if the child has had a seizure; or if the child has a condition that suppresses immune responses, or is taking steroids.

Generally, children over 6 months old who have a fever of less than 101°F/38.3°C do not need to be treated for fever, unless the child is uncomfortable. To make the child more comfortable, try to keep the room cool, keep the child dressed in light clothing, encourage the consumption of fluids (water, diluted fruit juices, or commercially prepared oral electrolyte solutions), and ensure that there is no overexertion.

There are also medications which can reduce a fever: acetaminophen and ibuprofen are safe and effective in proper doses, although ibuprofen should only be used for children older than 6 months of age, and not given to children who are vomiting constantly or are dehydrated. Aspirin should not be given to children under the age of 16 as use in children has been known to cause side effects such as an upset stomach, intestinal bleeding and, most seriously, Reye syndrome.

If the child is vomiting and unable to take medication, then the pediatrician may recommend an acetaminophen suppository. A pediatrician should be consulted before giving any medication to a child under 2 years of age.

An alternative way of reducing fever in children is through sponging with lukewarm water, as the evaporating water on the skin can reduce the body temperature. A pediatrician may recommend this if the child’s temperature is above 104°F (40°C); if the child is vomiting and unable to take medication; or if the child has had a febrile seizure in the past.

The pediatrician would advise on the method of sponging, but it is important not to use cold water, as this could cause shivering, and in turn, increase the body temperature. Usually 5-10 minutes in a bath is enough time for a child’s temperature to start dropping. If the child is upset by the bath, or continues to shiver, it is better to end the sponging, even if there has not been enough time spent in the water to reduce the temperature. It is also important not to try and reduce the child’s temperature too quickly, as this could also cause the temperature to rebound higher.

When a child has a fever, remember that this is the body’s natural defense to fight off an infection, and this is healthy and normal, and should only cause concern if the child appears very sick, or if the fever persists for more than 24 hours (in children under than 2 years of age), at which point a pediatrician should be consulted.