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Fever can cause a seizure (SEE-zher) in some young children. Seizures are scary, but usually harmless. Your child may look strange, shake, then stiffen and twitch.

His or her eyes may roll. If this happens:

  • Lay your child down on the floor or a bed.

  • Turn your child's head to the side. That way, spit or vomit can drain out.

  • Don't put anything in your child's mouth.

  • Call the doctor.

The doctor should always check your child after a seizure.

Copyright © 2008


Fever

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What is fever?

Fever is an elevation of the normal body temperature. Fever is most commonly caused by the body’s response to a viral or bacterial infection, but it can have causes other than infection, such as juvenile idiopathic arthritis, a reaction to a vaccine or medication, or cancer.

What is considered a fever?

For infants and children older than 2 months, a body temperature above 101°F (38.3°C) from any site (axillary, oral, or rectal) is considered meaningfully elevated above normal. For infants younger than 2 months, a body temperature above 100.4°F (38.0°C) is considered meaningfully elevated above normal. These temperature elevations are not necessarily an indication of a significant health problem.

Children’s temperatures may be elevated for a variety of reasons, most of which do not indicate serious illness.

Does fever mean a child is contagious?

  • Children with fever are not always contagious. Noncontagious causes of fever include urinary tract infections, ear infections, and causes unrelated to infections.

  • The most common cause of fever is a viral upper respiratory infection (the common cold). Although the common cold is contagious, it is not particularly harmful to others. Some children have a fever and never develop other symptoms, and the fever resolves by itself. Many infections cause a child to be contagious for several days before a fever develops. Some infections cause a child to remain contagious long after the fever has resolved. Finally, many children spread germs without ever developing a fever or other symptoms.

Is fever harmful to the child?

  • No. Most (virtually all) fevers that occur because of infectious diseases are not harmful. The very high body temperatures in heatstroke are harmful. Children should never be left unattended in a car because the temperature can rise quickly and cause heatstroke and even death in a young child. Exercising in excessively hot weather or in overheated indoor rooms can also be harmful.

  • Children with fever are usually less active.

  • Children with fever need to drink more to avoid dehydration. Dehydration may occur because fever depletes body fluids, which should be replaced with increased fluid intake.

  • Some young children with fever may have a brief seizure called a febrile seizure. Most brief seizures associated with fever last less than 15 minutes, occur in children younger than 6 years, and are not harmful. They are frightening to witness but do not result in any kind of brain damage. However, a child who has experienced a seizure with fever for the first time should be referred to a pediatric health care provider for evaluation. Referral to a pediatric health care provider is not needed only if the child’s seizure fits the pattern of a previously identified febrile seizure disorder for that child and the program has been taught by a health professional how to manage a febrile seizure for that child.

  • Fever is one way the body may respond to an infection. When fever develops, all the infection-fighting mechanisms tend to speed up and can help the body fight the infection. Children may have high elevations in body temperature and appear relatively well. Therefore, fever is not a good indication of severity of illness.

  • Behavior is a much more reliable indicator of the significance of illness than the presence and height of fever. However, high elevations in body temperatures can sometimes affect behavior. Children who appear to be moderately ill with a fever should be referred for a medical evaluation.

What are the roles of the teacher/caregiver and the family?

  • Measure a temperature only if a child is acting ill (ie, has a behavior change).

  • If a child who is acting ill has a fever, notify the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, should alert the parents/guardians to pick up the child.

  • Treating the fever is not necessary unless the child is uncomfortable. Evidence suggests fever helps the body fight infection. Acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil, Motrin) may be considered for the child’s comfort if the child feels ill. Generally, there is no rush to reduce a child’s temperature. Aspirin should never be administered to children with fever because of the potential risk of Reye syndrome. Reye syndrome is a serious complication associated with the use of aspirin in someone infected with a viral illness.

  • Any child receiving a medication should have a note from the child’s health care provider. The medication bottle should have the child’s name and clear dosing instructions on it. If a child is uncomfortable and has a fever and the requirement for a note and clearly labeled medication is met, the program can administer fever-reducing medication while waiting for parents/legal guardians to come pick up the child.

  • There is no need to cool the child to try to bring down an elevated body temperature. A known exception is if the child’s elevated temperature is not a fever but the result of exposure to extreme heat, often associated with vigorous exercise (heat exhaustion or heatstroke); such instances are medical emergencies that require immediate first aid and health professional care.

  • Infants younger than 4 months with an unexplained fever should be evaluated by a health professional. Any infant younger than 2 months with a temperature above 100.4°F (38.0°C) should get medical attention immediately—within an hour if possible. The fever is not harmful; however, the illness causing it may be serious in this age group.

Exclude from group setting?

Only if

  • Fever is noted in an infant younger than 2 months (60 days).

  • Unexplained fever occurs in an infant who is younger than 4 months.

  • Fever is associated with behavior change or other signs of illness or other conditions that require exclusion. The signs of illness are anything (other than the fever) that indicates the child’s condition is different from what is usual when the child is healthy. Exclusion for fever and signs of illness transfers the responsibility from the group care facility to the family to monitor the child.

  • The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.

  • The child has not completed the recommended vaccine series, until it is clear the child does not have a vaccine-preventable illness.

Readmit to group setting?

Yes, when all the following criteria are met:

When exclusion criteria are resolved, the child is able to participate, and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group. A health care provider visit is not required after every exclusion for fever.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Quick Reference Sheet from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

© 2017 American Academy of Pediatrics. All rights reserved.

Health Center

Related Articles

  • Other symptom is present with the fever, see that topic (e.g., Colds
  • If Cold symptom is present with Fever, see Colds
  • Other symptom is present with the fever, see that topic (e.g., Cough
  • If Cough symptom is present with Fever, see Cough
  • Other symptom is present with the fever, see that topic (e.g., Diarrhea
  • If Diarrhea symptom is present with Fever, see Diarrhea
  • Other symptom is present with the fever, see that topic (e.g., Earache
  • If Earache symptom is present with Fever, see Earache
  • Fever onset within 24 hours of receiving vaccine, OR Fever onset 6-12 days after measles vaccine OR 17-28 days after chickenpox vaccine, see Immunization Reactions
  • Other symptom is present with the fever, see that topic (e.g., Rash or Redness - Widespread
  • Other symptom is present with the fever, see that topic (e.g., Sinus Pain or Congestion
  • Other symptom is present with the fever, see that topic (e.g., Sore Throat
  • If Sore Throat symptom is present with Fever, see Sore Throat
  • Other symptom is present with the fever, see that topic (e.g., Vomiting Without Diarrhea


Fever

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Fever is a sign that your child is fighting an infection. It is usually harmless. Your child's fever should go away in about 3 days. If it doesn’t, call your child's doctor.

What Is a Fever?

A fever is a body temperature (TEM-pruh-chur) that is higher than normal. Most doctors agree that anything over 100.4°F or 38°C is a fever. (See “Words to Know” for “F” and “C.”)

Your child may feel warm, shiver, or look flushed. You will need to take your child's temperature to know for sure. (See the AAP handout “How to Take Your Child's Temperature” if you need help.)

Fever is not a sickness. It is a sign (symptom) of sickness. It can be caused by lots of things, like a cold, the flu, or an ear infection. Look for other symptoms to figure out what is causing your child's fever. (Antibiotics only help if they are the right treatment for what your child has.)

Call the Doctor Right Away If…

…your child:

  • Is 2 months or younger and has a fever, OR

  • Has a high fever, over 103°F (39.4°C), OR

  • Has a fever more than 3 days.

You also should call the doctor if your child has a fever and any of these signs:

  • Looks very sick, is very sleepy or very fussy

  • Has other symptoms, like a stiff neck, rash, bad headache, sore throat, ear pain, throwing up, or diarrhea*

  • Has had a seizure (See “What to Do for a Seizure” on the second page of this handout.)

  • Has sickle cell disease, cancer, or another disease that makes it hard to fight infections

  • Takes steroids

  • Has been in a very hot place, like a closed car in summer

What to Do

Making children feel better helps them drink and eat. This helps them get better. They often get more active too. That's OK. They don't have to rest to get better.

To help your child feel better:

  • Comfort your child.

  • Give your child water, juice mixed with water, or an electrolyte drink* for children. Breast milk is fine for nursing babies.

  • Help your child rest if he or she feels tired.

  • Cool your child down if the fever is over 101°F or 38.3°C and your child is uncomfortable. See “Tips to Cool Down a Fever” on the second page of this handout.

Tips to Cool Down a Fever

  • Give your child medicine to bring down the fever:

    • – For a baby 6 months or younger, give acetaminophen*.

    • – For a baby or child older than 6 months, give either acetaminophen or ibuprofen*.

Both of these medicines help with fever. But they are not the same. Be sure to get the right kind of medicine for your child's age. Follow what the label says. Ask your child's doctor how much to give if your child is younger than 2 years.

Note: Never give your child aspirin.

  • Give your child a bath. Try this if the fever is 104°F (40°C) or higher, and your child can't take fever medicine.

    The water should be cooler than your child is, but still warm (lukewarm).

    Sponge the water over your child's body (5 or 10 minutes is enough).

    If your child starts to shiver during the bath, then the water is too cold. And shivering can make a fever worse.

    Take your child out of the bath if he or she shivers.

What Not to Do

  • Don't give your child aspirin. It's dangerous for children younger than 18 years.

  • Don't rub or bathe your child with rubbing alcohol. Rubbing alcohol can make children sick.

  • Don't make your child cold enough to shiver. Shivering warms the body up more.

What to Do for a Seizure