Weiss Pediatric Care

Fever - Facts Versus Myths

Definition

  • Fever is a body temperature of 100.4 F (38 C) or higher
  • Fever is a symptom, not a disease
  • It happens whenever your child gets a new infection
  • Fever helps fight the infection by turning on the immune system
  • This topic reviews the known facts about fever

Call or Return If

  • You have other questions or concerns

About This Topic

Fever Phobia

  • Parents often think fever will hurt their child. They worry and lose sleep when their child has a fever. This is called fever phobia.
  • In fact, fevers are harmless. Here are some of the myths that cause fever phobia.

Fever Myths

  • All fevers are bad for children.
  • Fevers can cause brain damage.
  • Fever can cause seizures in anyone.
  • If the fever is high, the cause is serious.
  • All fevers need to be treated with fever medicine.
  • Without treatment, fevers will keep going higher.
  • If you can't "break the fever", the cause is serious.
  • Treating the fever will make the infection go away faster.

After Care Advice

Fevers are temperatures 100.4 F (38 C) or higher.
Doctors and nurses don't always agree on when to treat fevers. Here are some general guidelines.
Temperatures below 100.4 F (38 C) are normal.  They are not a fever. The body temperature normally goes up during the day and comes down during the night. Don't make the mistake of treating normal temps.
Fevers only need to be treated if they cause discomfort. Most fevers don't cause any discomfort until they go above 104 F (40 C). Discomfort at a lower fever is probably due to some pain (such as from a sore throat).
Fevers 100.4 to 102 F (38-39 C) are low grade fevers. Many doctors and nurses call them "good fevers".
Start medicines for fevers only if higher than 102 F (39 C). Remember that fevers are needed to fight the infection.
Fever helps the body fight infections. It turns on the body's immune system. Fever is a defense response found in all animals. Fevers between 100 and 104 F actually help sick children get better.
Treat fevers with one fever medicine. Use either acetaminophen (such as Tylenol) or ibuprofen, in the correct dosage. Don't give both fever medicines together. Reason: it is not needed. Remember, fever is helping your child's body fight the infection.
High fevers are 104 F (40 C) or higher. While we call them "high", they are not harmful.
With treatment, most fevers come down about 2 degrees F (about 1 degree C). They often don't come down to normal. That's fine. When the fever medicine wears off, expect the fever to go up again. That's also normal.
Most fevers with infections stay below 104 F (40 C). Reason: the brain has a thermostat that keeps the body at the best temperature to fight the germs. They sometimes go to 105 F (40.6 C), but that temp is also harmless. The brain knows when the body is too hot.
If your child's doctor tells you to treat fevers differently, follow their advice.
Fevers from infections don't cause "brain damage". Only fevers above 108° F (42°C) can cause brain damage. Temperatures that high are very rare. They are caused by human error. An example would be a child left in a closed car during hot weather.
Seizures triggered by fever are uncommon. Only 4% of children can have a seizure from fever. While these seizures are scary to watch, most stop within 2 minutes. And they don't cause any permanent harm, such as learning problems or seizures without fever.
Most fevers with viral infections last 2 or 3 days. The fever will go away and not return once the body overpowers the virus. Most often, this is day 3 or 4. When using fever medicines, expect the fever to keep coming back after the medicine wears off. That's normal.
If your child is well and feels warm to touch, they probably don't have a fever. Children can feel warm for many reasons. Examples are playing hard, crying hard, getting out of a warm bed, or hot weather. They are "giving off heat." Their skin temperature should return to normal within 20 minutes after exercise.
If your child acts sick and feels warm to touch, they probably have a fever. If you want to be sure, take their temperature. But you don't need to keep taking it.
Summary: Look at your child, not the thermometer. How your child looks is what's important. The exact temperature number is not. If your child looks or acts very sick, the cause is more likely to be serious. But the level of fever tells us very little. Viruses and bacteria can both cause high fevers.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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