Fever is a symptom and not a disease.  It is most often associated with viral (flu or cold) or bacterial (ear or strep throat) infections.  The higher than normal body temperature which characterizes fever is one of the body’s natural defense mechanisms.  An elevated body temperature makes it difficult for many bacteria to survive.  How a person is acting and feeling, especially with children, is a better indicator of whether a fever should be treated or not.  Today, doctors are likely to suggest that the fever be allowed to do its work and not treat it unless the fever persist for several days or seems exceptionally high.

So how high is high?  Normal temperature varies with individuals, but is generally considered to be 98.6°F (37°C).  Most experts consider a fever to be a rectal temperature of 100.4°F (38°C).  If a child less than 12 months old has a fever, or an infant of less than 3 months has any temperature rise, a doctor should be consulted.  Brain damage does not occur until the body temperature exceeds 106°F (41°C). 

The most common form of measuring body temperature is with a glass mercury thermometer.  It is important to remember that when using this type of thermometer that it be “shaken down” so that the mercury column drops below the 98.6°F mark.  This type of thermometer can be used orally, rectally (requires a bulb end), or under the arm.  The thermometer should be left in place three minutes before being read.  Under the arm temperature will be a degree lower and rectal temperature a degree higher than oral temperature.  Rectal temperature is considered to be the most accurate for infants and children.  If a child’s temperature is high, it should be checked every 2-4 hours.  Temperatures are usually lower in the morning and higher in the evening, or when associated with activity.

A person with a fever should wear light clothing.  Infants and small children need only be dressed in a diaper or underpants with or without an undershirt.  A person should not be bundled up with heavy covers, blankets or quilts.  An increase in the intake of clear liquids…water, juices, Popsicles, soda pop, etc.…is important to offset dehydration.  If a person is feeling uncomfortable, a fever-reducing medicine such as acetaminophen (Tylenol, Tempra, etc.), aspirin, or ibuprofen (Advil, Motrin, etc.) can be used.  Teenagers and young children should not use aspirin to avoid the risk of developing Reyes syndrome, which can be fatal.  Also, if the temperature gets into the 103°F to 104°F range, sponging with or taking a bath in tepid (lukewarm) water can be helpful.  Alcohol sponge baths are no longer recommended.

On occasion, a young child with a fever might develop spasms or convulsions (called febrile seizures).  These do not cause brain damage; but if one should occur, the child’s doctor should be consulted.  A fever says that there is something not right, but it is not a cause for panic.

October 2000

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