Prepared by Aktif International Hospital Editorial Board .

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What is fever in children? How many degrees should it be?

Fever in children is often the body’s natural response to infections and does not mean there is a disease when seen on its own. In clinical evaluation, not only the temperature shown on the thermometer is considered, but also the child’s general condition, age, fluid intake, breathing, level of consciousness, and accompanying symptoms. Fever should be evaluated more carefully, especially in babies younger than 3 months.

Since fever in children is a situation that worries many parents, questions such as “What should a child’s temperature be?” or “Why does my child’s temperature come out different every time I measure it?” often come to mind. In this article, we will address this question, as well as other topics frequently wondered about high fever in children, in an explanatory way.

Why do different values appear depending on where fever is measured in children?

Fever may appear as a symptom of the body’s response to bacteria, viruses, post-vaccination reactions, teething periods, or different triggers. Therefore, in clinical evaluation, the child’s age, general appearance, fluid intake, sleepiness, breathing, skin color, and symptoms accompanying fever are assessed together.

In general, body temperature in children may vary depending on the measurement site. In underarm measurements, 37.5°C and above may be considered fever, while in rectal measurements, 38°C and above may be considered fever. However, the important point here is that fever should not be evaluated based on a single measurement alone, but together with the child’s general condition. Therefore, when asking “What degree should fever be in children?” or “Which temperature is dangerous?”, the child’s age and accompanying complaints are decisive. In particular, in babies younger than 3 months, or in cases of fever, high fever, confusion, shortness of breath, bluish discoloration, inability to take fluids, or seizure-like episodes, a specialist doctor should be consulted without delay.

Why do children develop fever?

Fever is often the body’s natural response to infections or different triggers. In children, especially upper respiratory tract infections, flu, throat infections, ear infections, urinary tract infections, and intestinal infections may cause fever. Some children may experience short-term fever after vaccination. Although a mild increase in temperature may also occur during teething, high fever or deterioration in general condition cannot be explained only by the teething process.

When evaluating the question of why fever occurs in children, how the fever started, how many days it has lasted, whether it rises again during the day, and the symptoms accompanying the fever are as important as the temperature itself. Findings such as cough, runny nose, sore throat, ear pain, vomiting, diarrhea, abdominal pain, burning during urination, rash, or fatigue may give an idea about the source of the fever.

If the child can take fluids despite having a fever, is interested in their surroundings, and breathes comfortably, the follow-up process may proceed in a more controlled way. However, if the fever lasts for a long time, recurs frequently, or if the child has one or more of the symptoms mentioned above, a doctor should be consulted. Instead of only trying to reduce fever in children, understanding the condition that causes the fever is the foundation of the correct approach.

What do symptoms accompanying fever clinically indicate?

Symptoms seen together with fever often provide clues about the source of the fever. For example, while runny nose, cough, and sore throat clinically suggest a respiratory tract infection, abdominal pain, vomiting, or diarrhea may point to a condition related to the digestive system. Some children may experience symptoms such as chills while the fever is rising. Dressing the child too thickly or wrapping them in layers of blankets may cause the fever to rise even more. Instead, room temperature should be balanced, the child should be monitored in thin and comfortable clothing, and fluid intake should be supported.

One of the questions frequently asked to doctors is why a child with fever has cold feet, and this situation may worry families. While fever is rising, coldness may be felt in the hands and feet due to narrowing of the blood vessels. This is not always dangerous on its own. However, if coldness is accompanied by bluish discoloration, confusion, breathing difficulty, extreme fatigue, or seizure-like contractions, a doctor should be consulted without delay.

What is good for fever in children? Can I reduce high fever at home?

When high fever is seen in children, the first goal should not only be to lower the number on the thermometer. Therefore, steps that can be taken at home should be careful and measured. First of all, the child should not be dressed too thickly or covered with many layers. Thin and comfortable clothing should be preferred, and the room should not be excessively hot or cold.

One of the most important supports in reducing a child’s fever is fluid intake. In cases of high fever, the body may lose more fluid. For this reason, the child should be supported with water, breast milk, soup, or age-appropriate fluids. However, if the child does not want to drink fluids, instead of forcing them, it may be more appropriate to encourage small amounts of fluid at frequent intervals. The child should be allowed to rest, fever should be measured at regular intervals, and the values should be noted. This follow-up provides clearer information about the course of fever when consulting a doctor.

Medicines used to reduce high fever are prescribed according to the child’s age, weight, existing diseases, and medications previously used. Therefore, fever-reducing medicines should not be given randomly, at frequent intervals, or by mixing different medicines. Medicines recommended by the doctor should be used as instructed by the doctor.

Although some home practices may help the child feel more comfortable, methods such as vinegar, iced water, and cold showers are not recommended. These practices may cause skin irritation, chills, or uncontrolled fluctuations in fever. Safe follow-up, appropriate clothing selection, fluid support, balancing room temperature, and using medicine in accordance with a doctor’s recommendation are among the ways to reduce fever in children. If the fever does not go down, recurs frequently, or the child is unable to take fluids, a specialist doctor should be consulted.

Warnings and recommendations from Aktif International Hospital pediatricians

One of the most common mistakes families make when monitoring fever in children is focusing only on the fever level. However, there are other data that should be monitored besides the temperature. In this regard, our pediatricians at Aktif International Hospital recommend that:

the measured values in a child with fever should be noted regularly
the times when the fever rises should be identified
the child’s condition after fever-reducing medicine should be observed
and accompanying symptoms should be monitored.

Recording these follow-ups and data helps understand the cause of fever during physical examination.

Another warning from our hospital doctors is about medication use. The dose of medicines used in children with fever varies according to the child’s age and weight. Therefore, medicines previously recommended for another child should not be used in the same way for a different child.

In addition, giving different fever-reducing medicines at short intervals and in an uncontrolled way is not appropriate. If the child has a chronic disease, a problem related to the immune system, or a previous history of febrile seizures, fever follow-up should be carried out more carefully.

According to our doctors, another important point for families is noticing changes in the child’s behavior. Even if the fever goes down, if the child appears noticeably weak, drowsy, pale, restless, or different from usual, this should not be ignored. If the fever lasts for a long time, recurs frequently, or the child’s general condition deteriorates, a pediatric specialist should be consulted.

Why does my child’s fever not go down and how many days does it last?

It may be worrying for families when fever in children does not go down immediately. However, in some infections, fever may continue at different levels for several days. Therefore, the answer to the question of how many days fever lasts in children varies depending on the condition causing the fever, the child’s age, and general health status. Especially in viral infections, fever may go down for a while and then rise again. Fever rising again after using fever-reducing medicine does not always mean a serious illness on its own.

So why does a child’s fever not go down? In some cases, persistent fever may indicate that the infection is continuing, and sometimes it may show that a different underlying focus needs to be investigated. It may be useful for families to note fever measurements and accompanying complaints during this process. How many days the fever has lasted, the highest temperature reached, the times when it rises, and whether there is any change in the child’s general condition help the doctor’s evaluation. If the fever lasts for a long time, recurs frequently, or the child’s general condition gradually worsens, a pediatrician should be consulted.

How can I measure fever correctly in children?

In order to evaluate fever correctly in children, the measurement must first be done properly. Checking the forehead or body only by hand may be misleading. This is because room temperature, sweating, or the child’s clothing may make it feel as if there is a fever. Therefore, a digital thermometer should be used whenever possible.

Some points that may affect accurate measurement can be listed as follows:

Underarm measurement is one of the most commonly preferred methods at home, but it is important for the thermometer to be in full contact with the skin and for the measurement time to be completed.
Ear measurement gives quick results; however, incorrect placement of the device or the child being very young may affect the result.
Forehead measurement is practical, but it may give variable results due to sweating, room temperature, and the way the device is used.
Rectal measurement may show body temperature more accurately, especially in small babies.
Before measuring fever, make sure the child is not dressed too thickly.
Measurements taken after a hot bath, running, crying, or intense movement may be temporarily high. In such cases, the measurement should be repeated after the child calms down and rests for a few minutes.

Can high fever and chills be seen at the same time in children?

Some children may experience feeling cold and shivering while fever is rising. Although this may be worrying for families, not every episode of shivering means a seizure on its own. The first step for proper intervention in a child shivering due to fever should be to measure the child’s temperature correctly and observe their general condition. Even if the child says they are cold, dressing them in thick clothes or covering them with layers of blankets is not correct. This may cause body temperature to rise even more.

If shivering is accompanied by loss of consciousness, bluish discoloration, contractions, breathing difficulty, extreme fatigue, or difficulty waking the child, this requires urgent evaluation. In such a situation, it would be right to go to the hospital without delay instead of waiting at home.

When is fever dangerous in children?

High fever in children does not always mean a dangerous condition. However, in some cases, fever may be a finding that needs to be evaluated more carefully. Fever should definitely be taken seriously, especially in babies younger than 3 months. Since the immune system is not yet fully mature in this age group, the cause of fever should be investigated more quickly.

In older children, fever approaching 40°C or reaching 40°C requires consulting a pediatrician, especially if there is deterioration in the child’s general condition.

So, what should be done for a child with a fever of 40°C?

Since this is clinically considered a very high value, only trying to reduce the fever at home may not be enough. Therefore, the child’s level of consciousness, breathing, fluid intake, and skin color should be carefully monitored.

Drowsiness, difficulty waking, difficulty breathing, bluish discoloration, marked paleness, neck stiffness, persistent vomiting, or seizure-like contractions together with fever may suggest that the fever is associated with a more serious condition other than a simple infection. Therefore, it is right to consult a doctor without delay.

Should I wake a child with fever if they are sleeping?

You do not need to wake a sleeping child only to give fever-reducing medicine. If the child is sleeping comfortably, rest helps the recovery process. However, in the following situations, the child should be checked and, if necessary, a doctor should be consulted:

If the child is difficult to wake or has confusion
If breathing has become difficult or there is bluish discoloration
If the child cannot take fluids or urine output has noticeably decreased
If the child has had a seizure
If there is a rash, neck stiffness, or persistent vomiting
If there is fever in a baby younger than 3 months
If the fever is very high or the child’s general condition looks poor

If the child wakes up restless or very uncomfortable, you can act according to your doctor’s recommendation for a fever-reducing medicine suitable for the child’s age and weight.