The majority of children will develop a fever at some point during their childhood. This post will discuss various causes of fever in children and types of fevers in children. Additional topics covered include, when a fever should cause concern, when to treat a fever, and natural ways to reduce a fever.
Definition of Fever in Kids
A fever is any rise in normal body temperature. Normal body temperature is typically 98.6 degrees Fahrenheit. However, an elevated temperature is not considered clinically significant until it hits 100.4 degrees Fahrenheit. A fever is our body’s normal response to a variety of conditions. Infection and illness are the most common causes of fever in children.
Our body is full of good fighters, they work to keep the “bad” germs away. Many of the germs which produce infections and illnesses can survive in normal body temperature. When our body temperature rises the germs have a tougher time surviving in our bodies. This rise in body temperature is a fever. A fever is the fighters responding to the invader, or “bad” germ. It is the body’s natural response to keep itself healthy.
(note: Though I am a pediatric healthcare provider, I am not your child’s healthcare provider. Please see my medical disclaimer.)
Causes of Fever in Kids
There are multiple factors that can cause a fever. In children, we most often see fevers due to infection, illness, or trauma. Though those are not the only causes.
Infection is the number one cause of fever in children. Viral illness and bacterial infections are the most common illnesses to result in fever. Viral illness can include colds, stomach viruses, croup, and bronchitis. Whereas bacterial illness includes ear infections, urinary tract infections, sinus infections, and strep throat.
Though there is no hard scientific evidence that teething is a direct cause of fever, many parents and pediatric healthcare providers feel that they see a correlation between teething and elevated body temperature.
Inflammation is another known cause of fever. Like a fever, inflammation is another part of the body’s immune system response. The part of the immune system that triggers inflammation can also cause a fever.
Trauma may also cause fever. This is due to the body’s automatic response to protect the body. If a place on the body endures trauma, the body’s white blood cells will rush to that area in an effort to fight and protect. This response triggers the response of an elevated temperature to fight.
Overdressing children is another commonly seen cause for elevated body temperature in children. This fever should easily resolve once the clothing is removed and the body temperature is able to reduce back to normal. If the temperature does not go back down to normal, then the fever may be due to other factors.
Immunizations given during childhood can be a reason for a fever. Vaccines contain either live or dead viruses. When administering vaccines you are introducing a foreign item into the body. This can trigger the body to respond by fighting.
Toxin or poisoning can induce a fever. The reason why some poisons cause fever is not well understood. Research believes the body’s response, that leads to fever, is likely a response similar to one triggered by infection.
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Methods for taking your child’s temperature
A child’s temperature can be taken from the forehead, ear, mouth, underarm, or rectally. Some methods are more accurate than others. A rectal temperature is the most accurate. However, it is not always necessary and often shouldn’t be the initial method used. The age of the child will determine the best method for taking their initial temperature.
Types of Thermometers
Digital thermometers are currently the most widely used thermometers. They have replaced glass thermometers, which are considered unsafe due to the potential risk of exposure to mercury. Electronic digital thermometers have proven to be extremely accurate. Research shows that when obtaining rectal temperatures, the electronic thermometer and glass thermometer produced readings that were extremely close.
There are also plastic strip and pacifier thermometers available. However, those are not as accurate as an electronic digital thermometer.
How to take your child’s temperature
Rectal temperatures are the most accurate. Many pediatric providers will ask for the rectal temperature if you obtain an elevated temperature through another method.
To take an accurate rectal temperature you will need a clean dry digital rectal thermometer and a lubricating jelly. You will have the infant or child lie down and insert a lubricated thermometer tip into the rectum until the silver part is no longer visible. Approximately 1/4 to 1/2 inch in. Hold the thermometer in place until either the reading stops or the thermometer beeps. (note: each thermometer is different in how it signifies the reading is complete, follow your manufacturer’s directions).
Oral temperatures can be accurate in children that are older than 4 or 5 and understand how to properly place a thermometer in their mouth. To obtain an oral temperature you need a clean dry digital thermometer. Place the thermometer in the mouth under the tongue. You will want to place it so the silver tip is far back, and off to one side, near the molars. The child will need to lower their tongue and close their mouth. Creating a seal over the thermometer. Either you or your child will need to hold the other end of the thermometer, to prevent it from slipping out of the mouth. Once the thermometer indicates the temperature reading is complete you can remove the thermometer from the mouth.
Oral temperatures are a great method to use as an initial check, for children that are old enough to place the thermometer correctly. However, you must be sure that you do not take an oral temperature if the child has recently had something to drink. You need to wait at least 20-30 minutes after a child drinks something cold or hot. The results may be skewed otherwise.
Axillary or underarm thermometer readings are my typical go-to for my first check. They can be used on children of any age. I’m able to grab a reading on my 9-year-old while he sleeps, without having to wake him for an oral temperature. My affinity for taking a temperature axillary likely comes from my many years spent working overnight in the hospital. I would sneak into patients’ rooms, quietly, hoping to not disturb them as I checked their temperature, blood pressure, respiratory rate, and heart rate.
To obtain an accurate axillary temperature you will need to get access to your child’s underarm. Gently lift the arm and place the clean dry thermometer into the deep pit of the arm. Making sure that the silver part is in the pit. Then bring the arm back down and hold it against the chest, bending the arm at the elbow, until the reading is complete.
Research regarding the accuracy of ear thermometers is mixed. You can read about research findings showing that it is less accurate as well as research showing that is is just as accurate as other methods. An infrared thermometer like this one is best if you do choose to use an ear, or tympanic, thermometer
To measure body temperature with a tympanic thermometer you need to first be sure that the child was not recently outside. Extreme hot or cold temperatures can falsely raise or lower the body temperature.
The tympanic thermometer is slightly more difficult to use correctly. You will need to pull back gently on the child’s ear and then place the tip into the ear canal. The child will need to hold still until the thermometer indicates the reading is complete.
A temporal artery thermometer scans the forehead to obtain a temperature. It may not be as accurate as rectal, oral, or axillary measurements. Though the infrared thermometers are proving to be accurate in research studies. It should not be used in children under the age of 3.
Temporal artery thermometers can work either through contact or with infrared. Depending on which type of thermometer you have, you will either touch the thermometer to the forehead or hold it close to the forehead without touching. You then scan across the forehead to a point by the ear.
Types of Fever
There are three common types of fevers. These are acute, sub-acute, and chronic.
An acute fever is a fever that lasts less than seven days. It is the most common type of fever children experience. Acute fevers are usually seen with childhood illnesses.
A sub-acute fever lasts greater than seven days but less than two weeks. Sub-acute fevers are far less common and seen with some infections.
A chronic fever lasts longer than two weeks. It is a persistent fever, day after day. It is not as common as an acute fever. A chronic fever may be associated with chronic or long-term illnesses.
Classification of fever
There are four classifications for fever, as it relates to temperature. They are low grade, mid-grade, high grade, and hyperpyrexia.
Body temperature is typically defined as normal in a range of 98.6 to 100.4 degrees Fahrenheit. A low-grade fever is 100.5 to 102.2 degrees Fahrenheit. A temperature ranging from 102.2 to 104 degrees Fahrenheit is classified as mid-grade. High-grade fevers occur when the body reaches a temperature of 104.1 to 106 degrees Fahrenheit.
Symptoms that commonly accompany fever
During fever, the body may respond in a variety of ways. Common symptoms that accompany a fever are chills, headache, generalized aches, decreased appetite, and feeling tired. These symptoms are the body’s response to fever. They are not specifically associated with the cause of the fever.
Is a Fever Dangerous?
As stated previously, a fever is the body’s natural response to fight off infection. Technically speaking, a fever is likely to be safe for the body until it reaches 106. Personally, I don’t like to see fevers go above mid-grade or 104 degrees Fahrenheit.
When to Treat the Fever
The decision on whether or not to treat a child’s fever should be based on how the child is feeling and behaving, not just on what the thermometer reads. I will observe a child that has an elevated body temperature but is otherwise in good spirits and acting well.
When you allow the fever to continue, you are not interfering with the body’s fight against whatever germs are causing the fever. However, when a child is uncomfortable because of the fever I will implement comfort measures to help them be more comfortable.
Most fevers can be treated at home. However, it is important that all parents know when they should take their child to be evaluated by a healthcare provider.
When Should I take my child to the doctor?
If your child is experiencing any of the following symptoms, you should contact their healthcare provider for further evaluation. Some of these include symptoms that warrant the need for immediate care, whether or not they are accompanied by a fever. Please note this list is not exhaustive and caregivers should use their best judgement.
- They are non-responsive
- Experiencing difficulty breathing
- They are leaning forward and drooling
- Complaining of a stiff neck and/or severe headache.
- They report severe stomach pain
- Their skin has a rash that looks like purple spots or bruising.
- They are refusing to drink liquids.
- If they are inconsolable.
- They are very cranky.
- Reporting pain when they urinate
- Complaining of sore throat accompanied by headache, stomachache, or vomiting
- They are complaining of a specific symptom.
The following, as related to fever, are of concern and should be a reason for evaluation by a healthcare provider. Again, this list is non-exhaustive and caregivers should use their best judgement.
- A child under three months of age with a rectal temperature of 100.4 or greater.
- A child between three months and three years of age, with a temperature of 100.4 or greater for more than three consecutive days or if their temperature is greater than 102.
- If the child’s temperature is 104 or higher.
- If the fever continues for 7 days.
- A child that is having a seizure accompanied by the fever. This can be a febrile seizure and the child’s healthcare provider should be notified.
- Any child that has a chronic condition.
- If the child has a new skin rash accompanying the fever.
How to Naturally Reduce the Fever
Provide lots of fluids to maintain hydration. We like to create ice popsicles using our Zoku. To make popsicles we use electrolyte or coconut water and fresh fruit.
Dress in light layers.
An Epsom salt bath will help to reduce any muscle aches. Additionally, using tepid or warm water can help to decrease body temperature slowly.
Get plenty of rest. Our body’s immune system is better able to work when it is strong and we are well-rested.
Boost the immune system quickly using probiotics, elderberry syrup, and Vitamin C. You may recall that much of our immune system is housed in our gut. Probiotics help increase the good bacteria in our gut, this helps to boost our immune system.
Use essential oils. I like to diffuse this oil whenever someone is sick in the house. It can also be applied topically if purchased in the roll-on, or properly diluted with a carrier oil, for application to the body.
Medication to treat children’s fever
If it is necessary to use medication to treat the fever, then acetaminophen is the first medication that should be used. Acetaminophen is metabolized through the liver. Therefore I like to be sure to provide plenty of fluids when giving it. This acetaminophen is free from dyes, artificial sweeteners, parabens, and alcohol.
The guide to fevers in children
What do you do when someone is sick in your home? Do you have any favorite natural tips or tricks?
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