Fever is the single most common reason parents call a pediatrician, and the most common source of unnecessary worry. A fever is not an illness — it is the immune system doing its job. What matters is not the number on the thermometer but your child’s age and how they look and behave.
What counts as a fever?
A temperature of 100.4°F (38°C) or higher, taken rectally, is a fever. Below that is not.
Under 3 months old: any fever needs to be seen the same day
This is the one rule we would ask every parent to remember. In a baby under three months, a rectal temperature of 100.4°F (38°C) or higher needs urgent medical attention, even if the baby seems otherwise well. Very young infants have immature immune systems and can become seriously unwell quickly, with few outward signs.
Do not give fever medicine before your baby has been seen. Lowering the temperature can mask the picture a clinician needs in order to judge how unwell your baby is. Call us, or go to the emergency room outside our hours.
How to take your child’s temperature accurately
- Under 3 years: a rectal reading is the most accurate, and it is the one we will ask you for in an infant.
- Forehead and in-ear thermometers are convenient but less reliable in small babies — useful for tracking a trend, not for deciding whether a newborn has a fever.
- Older children: an oral reading is fine once they can hold the thermometer under the tongue.
- Note the time and the reading. A pattern over a day is far more useful to us than a single number.
Go to the emergency room or call 911 if
- Your child is having difficulty breathing, or their lips or face look blue or grey
- They are unresponsive, limp, or very hard to wake
- They have a seizure
- They have a stiff neck with fever, or a rash of small purple spots that does not fade when you press a glass against it
- They show signs of serious dehydration — no wet nappy or urine for 8 hours, no tears, sunken eyes
Call the office if
- Your baby is under 3 months with any fever
- A child aged 3 to 24 months has a fever of 100.4°F or higher lasting more than 24 hours
- A child 2 years or older has a fever lasting more than about 3 days
- The fever goes away and then comes back
- Your child is refusing fluids, has no wet nappies, or is unusually sleepy or irritable
- You are worried. You know your child better than any guideline does, and “something is not right” is a reason to call.
Treating a fever at home
The aim is comfort, not a normal thermometer reading. A child who is drinking, resting and reasonably content at 102°F needs less intervention than a listless child at 100.5°F.
- Fluids matter more than medicine. Offer small amounts often — breast milk or formula for infants, water or an oral rehydration solution for older children.
- Acetaminophen may be used in infants and children, but ask us first for any baby under 3 months.
- Ibuprofen should not be given under 6 months of age — it carries a risk of kidney injury in young infants, particularly if they are even mildly dehydrated.
- Dosing is by weight, not age. Check the packaging and call us if you are unsure — this is one of the most common places parents get caught out, especially when switching between infant and children’s formulations.
- Never give aspirin to a child or teenager for a fever. It is associated with Reye’s syndrome, a rare but serious condition affecting the liver and brain.
- Dress your child lightly. Do not use cold baths or alcohol rubs — they cause shivering, which raises body temperature, and alcohol can be absorbed through the skin.
Febrile seizures
A small number of young children have a seizure when their temperature rises quickly. It is genuinely frightening to witness, but simple febrile seizures are usually brief and do not cause lasting harm or epilepsy. Lay your child on their side, do not put anything in their mouth, and time it. Call 911 if the seizure lasts more than five minutes, and let us know about any febrile seizure so we can review it.
Speak to a pediatrician in MetroWest, Orlando
Dr. Revati Narahari and our team see children with fever at 1507 S Hiawassee Rd, Suite 105, Orlando, FL 32835, Monday to Friday, 9:00 AM – 5:00 PM. Call (407) 445-9224 — and if you are unsure whether your child needs to be seen, call and describe what you are seeing. See also same-day sick visits and ear infections in children.
