The Do's and Don'ts of Fighting a Fever

It's natural to worry when your child's body temperature rises. But fevers can actually be beneficial since they kick the immune system into high gear to help the body fight infection, says Anne Tran, M.D., a pediatric hospitalist at Kaiser Permanente in Hawaii.

Still, fevers can feel scary, especially when there is so much conflicting advice on how to treat them at home. Do you feed a cold and starve a fever? And when is a fever too high?

We'll break down the do's and don'ts of treating a fever in kids, including when to call a doctor. Read on to learn what to do when your child has a fever.

Do Know the Signs of a Fever

The natural range of a regular body temperature can be between one degree below or above 98.6 degrees Fahrenheit. Most pediatricians define a fever in young children as a body temperature above 100.4 F, according to the American Academy of Pediatrics (AAP). The AAP notes that a fever is usually an indicator of infection; however, not all infections will present with a fever as a symptom.

Common signs of fever in kids include:

• Feeling feverish
• Feeling warm to the touch
• Flushed cheeks and face
• Chills and cold sweats
• Glassy eyes
  

Don't Immediately Reach for Medication

If the fever is mild and your child otherwise looks and acts well, many pediatricians will advise you to monitor the fever and simply let it run its course without medication. Low fevers, while unpleasant, do serve a purpose and aren't typically dangerous.

Contrary to common belief, medications mask symptoms rather than break a fever. "At most, the meds will bring a fever down a degree or two—just enough to make your child feel better," says Ari Brown, M.D., author of Baby 411.

So if your child is feeling really unwell, you can relieve some of their discomfort with acetaminophen (for babies over 3 months) or ibuprofen (for babies over 6 months), says Dr. Tran. Check with your doctor for the appropriate dosage for your little one.

Do Keep Your Child Hydrated

Fever sweats can dehydrate a child, so do your best to keep them hydrated. For babies under 6 months, continue to offer breast milk or formula for hydration (avoid other beverages unless recommended by your pediatrician).

For babies over 6 months who are eating solids, breast milk and formula are still recommended but you can also incorporate other sources of hydration like water or hydrating fruits. For toddlers and older kids, offer lots of water. If your child is vomiting or has diarrhea, give them an electrolyte drink like Pedialyte instead.

If your child is resisting water, try:

• Offering your child popsicles, which can also help with a sore throat (for babies, try using a mesh bag feeder with an ice cube, breast milk, or formula and for older children try popsicles made from 100% fruit juice)
• Adding some novelty to make drinking water more enjoyable like drinking from a fancy cup, using straws, or adding a squeeze of lemon
• Offering soup, which is a great way to keep your child hydrated plus get vitamins and nutrients
• Offering Jello as a treat as it is surprisingly hydrating

Contrary to popular belief, milk is a hydrating drink that does not cause mucus to thicken. Research has long shown that milk and other dairy products do not cause respiratory problems like congestion or nasal secretion.

It turns out that the sensation of milk on the throat, which is naturally a bit thick compared to water, is often confused with mucus. Also, milk is an excellent source of hydration because it is packed with protein, vitamins, sugar, and water. So, if your child prefers milk, try offering it when they're sick to help prevent fever-related dehydration.

Don't Starve a Fever

Ignore the old saying, "Feed a cold, starve a fever," says pediatrician David L. Hill, M.D., author of Dad to Dad: Parenting Like a Pro. Children with a fever may be less hungry than normal, but when they do want to eat, offer a generally healthy, well-balanced diet. Nourished kids may be better able to fight infections.

Do Consider Using a Lukewarm Compress

People have used lukewarm compresses to help reduce a fever for eons. The theory is that putting something cooler than the fever on the skin can bring a fever down.

Unfortunately, the science doesn't back this up. Researchers have found that lukewarm compresses do not help bring a fever down and, in some cases, increased irritability and crying. That said, for some kids, a lukewarm compress or tepid bath can provide some comfort, but the result is likely to be temporary.

Don't Underdress (or Overdress) Your Child

It's natural for a kid developing a fever to want to dress more warmly than others in the room. But Dr. Tran says to make sure they're not overdressed or covered in thick blankets, as this can prevent body heat from escaping and cause their temperature to rise even more.

Your child will also want to cool down as their fever breaks, but don't overdo it, warns Dr. Hill.

Here are some suggestions for keeping your child comfortable when they have a fever:

• Dress them in lightweight, breathable clothes like cotton pajamas.
• Limit extra blankets to avoid overheating.
• Keep the room at a comfortable temperature.
• If your child has fever sweats and feels hot, use a cool, damp cloth on their forehead or the back of their neck to help them feel more comfortable.
• If your child is sweating, make sure their clothes stay dry and change them when necessary.
  

Do Know When to Call the Doctor

While most fevers in young children aren't worrisome, it's important to know when to call the doctor about a fever. When evaluating whether you should pick up the phone or seek medical care, you'll want to consider your child's age, how high their fever is, how long they've had a fever, and what other symptoms they have.

Of course, even if your child doesn't meet the criteria below, don't hesitate to call their doctor to check in or if you're worried. It's never a bad idea to be in contact with a health care provider when your child is sick.

Your child's age

Generally, the younger your child is, the more worrisome a fever is. Always call the doctor for the following:

• Newborns up to 3 months with a fever of 100.4 F or higher
• Babies aged 3 to 6 months with a fever of 102 F or higher
• Children older than 6 months with a fever of 103 F or higher

The duration of the fever

For a baby 3 to 12 months old, call the doctor for any fever 100.4 F or higher that lasts more than 24 hours. If your child is between 1 and 2 years old, call your doctor if the fever lasts two or more days with no improvement, and for kids older than 2 if it hasn't improved after three days.

Their other symptoms

Call a health care provider if you spot symptoms that suggest your child has an illness that requires more treatment, such as strep throat, an ear infection, or a urinary tract infection (UTI). Worrisome symptoms include repeated vomiting and/or diarrhea, severe ear pain, headache, sore throat, stiff neck, listlessness, trouble breathing, unexplained rash, and signs of dehydration (fewer wet diapers, decreased or no tears).

Also, get your child checked out if they're acting unusual or if they are dealing with chronic health conditions (such as asthma or diabetes). In rare cases, a fever may cause febrile seizure, "but these are mostly harmless and do not cause lasting damage," says Dr. Tran.