There’s a lot of confusion when it comes to fevers in children. Parents often panic when their child has an elevated temperature, even if it’s not technically a fever. In her latest video, My Pocket Pediatrician Dr. Lili Moran talks about one of the hottest topics in pediatrics – fever – and gives some tips on how to know what a fever is, when to seek medical care, and how to treat a fever.

What is a fever?

A fever is a body temperature of 100.4º F and higher.

Body temperature is controlled by a small center in the brain called the hypothalamus.  It’s a little regulating center in the brain that can purposefully raise or lower body temperature in response to different stimuli. The most common reason the hypothalamus raises the body temperature is to help the body fight an infection, whether it’s caused by bacteria, viruses or something else.

In adults, the hypothalamus keeps the temperature tightly regulated, but children tend to swing up and down all over the place, so they can jump from low to high and back down again fairly quickly.

In most fevers, the temperature can go really high – kids can go up to 105-106º F very easily, and it doesn’t necessarily mean they are any sicker than if they were in the 102-103º F range.

How to treat a fever

There are two basic categories of medications you can give your child as a fever reducer: acetaminophen and ibuprofen. Both work slightly differently, and both work to stimulate the body to lower the temperature.

Your doctor, nurse, or pharmacist can help you figure out the correct dosing for your child. Both medications are available over the counter, meaning you don’t need a prescription for them.

When to seek medical care for a fever

If you have a baby that is three months or younger, you should take them to the doctor or emergency department as soon as they have a temperature of 100.4 º F or greater.  Fevers can indicate serious illness in young babies, and they definitely need a work up and evaluation by a physician immediately.

Babies in the 3-6 month range who received their two, and possibly four, month shots also need to be seen urgently for fever.

In older children who are fully vaccinated, fevers are very common. A fever can mean a simple cold or viral illness. It can also indicate ear infections, strep throat, influenza, pneumonia, urinary infections or vomiting and diarrheal infections like gastroenteritis. Some of those conditions require treatment, and some don’t.

You’ll also want to bring your child in if their fever isn’t responding to the appropriate doses of fever reducers, or if your child is showing any signs of difficulty breathing, decreased responsiveness or lethargy, changes in behavior, signs of dehydration or other concerns.

The truth is, kids get fevers. They just don’t regulate their temperatures the way adults do, and it’s perfectly normal for their temperatures to bounce up and down. Depending on your child’s age and the timing, you probably need a trip to the pediatrician to figure out the source, or if under 3 months, to your local hospital.


Lili Moran Lili Moran, MD, MPH, FAAP, is a board-certified pediatrician who produces a video advice series called My Pocket Pediatrician.

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Posts from Lili Moran, MD