08/30/2025
Fevers can be scary! This has some helpful information
Do you suffer from fever phobia? I’m here to offer a cure as we venture into the new school year.
A true fever is 100.4°F and above. Any temperature below that is normal. Fevers are the body’s HEALTHY, natural way of ramping up the immune system to fight off infections. By far, most fevers are due to pesky viral illnesses (common colds) presenting as cough, congestion, runny nose, poor appetite, and fever.
Viruses usually go away within a week or two WITHOUT any prescription medicine. Antibiotics will not make the common cold go away any faster because antibiotics only work on bacterial infections. Unnecessary antibiotic use is extremely common. It leads to antibiotic resistance, undesirable side effects, and alterations in the gut microbiome. Find a provider who will take the time to the explain this to you rather than just write your child a script and send you on your way in the face of a viral infection.
There is no set temperature at which you need to give Tylenol or Motrin to your little one. 💊 There is no need to wake a sleeping child to give these medications. If your child’s fever is making them UNCOMFORTABLE, then go ahead and offer Tylenol (for all ages) or Motrin (6 months and up). Notice how the decision to treat is based on the way that they FEEL and ACT – no numbers involved.
Fever-reducing medications only knock the temp down by 1-3°F at the most. The fever WILL likely come back after several hours. That's okay. Again, the body is doing this to fight off the infection. Be careful if you choose to alternate between Tylenol and Motrin, as this can lead to dosing errors. Do NOT give aspirin to children - it is potentially toxic to little livers.
Some children tolerate fevers to 104°F without problem while others become cranky right at 100.4°F. Some kids get so fussy that they refuse to eat, sleep, or drink enough fluids. 💦 It’s actually fine if your child won’t eat solid food for a few days, but they need to stay HYDRATED enough to urinate roughly every 8 hours. Encourage breast milk, formula, Pedialyte, or any other age-appropriate fluids that you can. Having less than 3 wet diapers a day is a sign of dehydration, and dehydration is a reason to bring your child in.
Any sign of respiratory distress (sucking in between the ribs or flaring nostrils to breathe, rapid breathing, head bobbing, turning blue or pale) is another reason to bring your child in ASAP.
Febrile seizures are a common concern. They occur among roughly 2-5% of all children. A seizure is terribly frightening for parents to watch, but here's the good news: the vast majority of febrile seizures self-resolve with zero long-term effects. There is no evidence that routine Tylenol or Motrin use will prevent febrile seizures, so I do not typically recommend using them for that specific purpose. Unfortunately, the seizure itself often happens very early in the course of illness before anyone is aware that a fever even exists.
The fear of “brain damage” is another common fear, but I have more good news: No study suggests that fever itself poses a threat to an otherwise healthy brain except in the rare event that body temp exceeds 107°F, which typically only occurs in the setting of hyperthermia due to dehydration and/or excessive heat exposure (eg, getting locked in a hot vehicle). 🧠
A doctor’s visit is not necessary under most fever circumstances, but there are some VERY important exceptions that I need to mention. Seek urgent medical care for a fever if your child is less than 2 months old, has chronic medical conditions such as sickle cell or heart disease, or has any of the following 🚩 RED FLAG SIGNS: Bulging soft spot, inconsolable crying, bright green vomit, confusion, disorientation, difficult to arouse, poor urine output, stiff neck, new seizures, difficult or rapid breathing, refusal to move an arm or leg as normal, widespread peeling/blistering/bruising of skin, or simply appearing very ill.
The common cold can lead to secondary infections, so schedule an office visit for persistent ear pain or fever lasting greater than 4 days. If your intuition is overall telling you that your child is really sick, by all means, please bring them in.
I get passionate about fever education because fevers are a HUGE source of anxiety, time, money, and resources for so many families. The next time that your child feels hot, no need to freak out or rush to the nearest ER. 🥰
