When your baby or infant has a fever

Fever - infant; Fever - baby

Description

The first fever a baby or infant has is often scary for parents. Most fevers are harmless and are caused by mild infections. Overdressing a child may even cause a rise in temperature.

Regardless, you should report any fever in a newborn that is higher than 100.4°F (38°C) (taken rectally) to the child's health care provider.

What to Expect at Home

Fever is an important part of the body's defense against infection. Many older infants develop high fevers with even minor illnesses.

Febrile seizures occur in some children and can be scary to parents. However, most febrile seizures are over quickly. These seizures do not mean your child has epilepsy, and do not cause any lasting harm.

Eating and Drinking

Your child should drink plenty of fluids.

  • Do not give your baby any fruit juice.
  • Babies should drink breast milk or formula.
  • If they are vomiting, then an electrolyte drink such as Pedialyte is recommended.

Children can eat foods when they have a fever. But do not force them to eat.

Children who are ill often tolerate bland foods better. A bland diet includes foods that are soft, not very spicy, and low in fiber. You may try:

  • Breads, crackers, and pastas made with refined white flour.
  • Refined hot cereals, such as oatmeal or cream of wheat.

Treating Your Child's Fever

Do not bundle up a child with blankets or extra clothes, even if the child has the chills. This may keep the fever from coming down, or make it go higher.

  • Try one layer of lightweight clothing, and one lightweight blanket for sleep.
  • The room should be comfortable, not too hot or too cool. If the room is hot or stuffy, a fan may help.

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever in children. Your child's provider may tell you to use both types of medicine.

  • In children under 3 months of age, contact your child's provider first before giving them medicines.
  • Know how much your child weighs. Then always check the instructions on the package.
  • Take acetaminophen every 4 to 6 hours.
  • Take ibuprofen every 6 to 8 hours. Do not use ibuprofen in children younger than 6 months old.
  • Do not give aspirin to children unless your child's provider tells you it is OK.

A fever does not need to come all the way down to normal. Most children will feel better when their temperature drops by even one degree.

A lukewarm bath or sponge bath may help cool a fever.

  • Lukewarm baths work better if the child also gets medicine. Otherwise, the temperature might bounce right back up.
  • Do not use cold baths, ice, or alcohol rubs. These often make the situation worse by causing shivering.

When to Call the Doctor

Contact your child's provider or go to the emergency room when:

  • Your child does not act alert or more comfortable when their fever goes down
  • Fever symptoms come back after they had gone away
  • The child does not make tears when crying
  • Your child does not have wet diapers or has not urinated in the past 8 hours

Also, contact your child's provider or go to the emergency room if your child:

  • Is younger than age 3 months and has a rectal temperature of 100.4°F (38°C) or higher.
  • Is 3 to 12 months old and has a fever of 102.2°F (39°C) or higher.
  • Is under age 2 and has a fever that lasts longer than 48 hours.
  • Has a fever over 105°F (40.5°C), unless the fever comes down readily with treatment and the child is comfortable.
  • Has had fevers come and go for up to a week or more, even if they are not very high.
  • Has other symptoms that suggest an illness may need to be treated, such as a sore throat, earache, diarrhea, nausea or vomiting, or a cough.
  • Has a serious medical illness, such as a heart problem, sickle cell anemia, diabetes, or cystic fibrosis.
  • Recently had an immunization.

Call 911 or the local emergency number if your child has a fever and:

  • Is crying and cannot be calmed down
  • Cannot be awakened easily or at all
  • Seems confused
  • Cannot walk
  • Has difficulty breathing, even after their nose is cleared
  • Has blue lips, tongue, or nails
  • Has a very bad headache
  • Has a stiff neck
  • Refuses to move an arm or leg
  • Has a seizure
  • Has a new rash or bruises appear

References

Marcdante KJ, Kliegman RM, Schuh AM. Fever without a focus. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 96.

Mick NW. Pediatric fever. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 161.

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Review Date: 11/6/2023

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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