Fever in Infants

When we do not feel well and have a fever, our temperature rises above its normal range.

The average body temperature is 37°C (which can fluctuate by 0.5°C) or 98.6°F (which can fluctuate by 1°F). Generally, a child is considered to be significantly feverish if the oral temperature is above 102°F (38.8°C) or the rectal temperature is above 103°F (39.4°C). A temperature higher than 103°F is extremely serious and proper care is needed.

When your child has a fever, the body temperature will be above the normal range (37°C or 98.6°F). Using a thermometer will give you an accurate reading. The child may have other symptoms based on the cause of the fever and age, for example sweating, shivering, headache, muscle aches, loss of appetite, dry mouth, thirst, or weakness.

High fevers between 103-106°F (39.4 – 41°C) may also cause hallucinations, confusion, irritability or seizure in some children (occurs in 2-5% of children under the age of 5 especially children who have a family history of febrile seizure). After checking your child’s temperature, if it is over 38°C or 100°F, you should give your child the appropriate dose of fever-reducing medication.

When in doubt, it’s better to consult a doctor or seek medical attention. If the child’s temperature is 101.5°F (38.5°C), you may give him/her a sponge bath with warm water or room temperature water by using a sponge or washcloth to wet the skin of the body, nape of the neck, armpits and groin, so as to bring a high temperature down for at least 20 minutes until the temperature is lower than 100°F (38.5°C). Please check the temperature every 30 minutes and keep your child from becoming dehydrated by giving fruit juice or snowflake, so as to ensure that the child consumes enough fluids. If you follow these steps and the child’s temperature is still high or other problems exist, including seizure, inactivity, unusual crying, excessive irritability, loss of appetite, vomiting, severe headache, stomachache or other abnormalities, please consult a doctor or seek medical attention immediately. For an infant younger than 3 months, if the rectal temperature is 100.5°F (38°C) or higher, please consult a doctor immediately even if there are no abnormal symptoms.

A slightly higher body temperature in young children can possibly mean a serious infection. When the child has a fever with other symptoms, it may indicate the cause of the fever. Fever with nausea and vomiting may be caused by gastrointestinal infection. Fever with coughing and difficulty breathing may indicate pneumonia.

Without knowing the exact cause of the fever, diagnosis can be more difficult if fever-reducing medication has given immediately. Fever-reducing medication can actually work against the immune system according to many specialists. Depending on the age of the child and cause of the fever, additional signs and symptoms may include sweating, shivering, headache, muscle aches, poor appetite, dry mouth, dehydration and weakness.

Fevers by themselves may not be a cause for alarm. However, you should seek medical advice in the following circumstances:

• Child is younger than 3 months and has a rectal temperature of 100.5°F (38°C) or higher even if no other symptoms are present.
• Child is older than 3 months and has a temperature of 102°F (38.8°C) or higher without any known cause, such as after receiving a vaccine.
• Child has a fever with irritation and is grumpy without any known cause, such as excessive crying during nappy or cloth changes or any bodily movement, being inactive, and lacking responsiveness. When in doubt, please consult a doctor or seek medical attention immediately without waiting until the morning or after a holiday or the weekend.
• Older children are more tolerant to fever than younger ones. If the child can drink and play well, the fever is not serious. However, if the symptoms include irritability, grumpy, vomiting, severe headache and stomachache, medical advice should be sought immediately. If the child has a low grade fever between 99-100°F (37 – 38°C), please give him/her a sponge bath and monitor the fever. Fever-reducing medication should not be given without medical advice immediately

• During a fever, people lose extra water through the skin. It is important to keep the child from becoming hydrated. When he/she does not drink enough water, you may give him/her fruit juice or small ice cubes.
• If the temperature is lower than 100°F (38°C), please do not give fever-reducing medication unless recommended by a doctor.
• The child can have a bath in warm water and dress in a single layer of clothing.
• If the temperature is about 100°F (38°C) or higher, please give fever-reducing medication such as Paracetamol or Ibuprofen in accordance with the child’s weight (using 10-15 mg/kg/dose).
• If in doubt, please ask a doctor about the appropriate dosage and type of medications (there are many types of fever medications). Overdoses can cause liver and kidney damage.
• If the child’s temperature is still high after giving him/her fever-reducing medication, please do not give additional medication but seek medical advice.

If the child’s temperature is higher than 101.5°F (38.5°C), you may give him/her fever-reducing medication based on the child’s weight and for the period recommended by the doctor. You may also give the child a sponge bath with warm water or room temperature water using a sponge or washcloth to wet the skin of the body, nape of the neck, armpits and groin. Keep checking the child’s temperature until it is 38°C (100°F) or lower, at which point you may stop the sponge baths. Then, check the temperature every 30 minutes. If the child shivers during the sponge bath, you may dry the skin of the body and wait for a while. If the temperature is still high or there are seizures, please seek immediate medical attention.

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