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Fevers – Toddlers and Teens (2-18 years)

You’re not alone – we all fear the dreaded fever. It’s typically the first sign that something is going on with our kiddo and we rush around, grabbing all the medicine, preparing for the worst. Let’s start instead by congratulating our love’s immune system for doing its job and see how this plays out.

Fevers are caused by:

  • Illnesses (viral or bacterial)
  • Vaccinations
  • Overheating
  • Certain medications

What is a normal temperature for kids?

As a whole, our body temperature can range quite a bit throughout the day. It is lowest in the morning and highest in the late afternoon. A normal rectal temperature reading can range from 96.8℉ to 100.3℉ (average of 98.6℉). A normal oral temperature reading can range from 95.8℉ to 99.9℉ (average of 97.6℉).

When is a fever too high for a child?

For our kids who are 2-18 years old, we can let their fever hit 104℉ before we start to worry. You don’t even need to medicate them before they hit the 102-103℉ mark! If they are uncomfortable, you may give them Tylenol or ibuprofen, but otherwise it’s okay to let that fever get rid of the virus for them. No aspirin for any children under the age of 18. Keep your kiddo hydrated and make sure she’s not overdressed or lying in a pile of blankets.

It is a common misconception that we must rotate Tylenol and ibuprofen, but choosing just one is actually preferred. If the one you chose does not bring the fever down 2-3 ℉ within an hour, you may switch to the other medication. Our biggest concern is accidentally overdosing our kids – the less we give, the less we need to worry!

How to take temperature?

Two to four year olds: Temporal artery temperature, armpit (axillary) temperature, ear (tympanic) temperature, or rectal. If you’re ever questioning the results, rectal is the most accurate when in doubt. Axillary is the least accurate and not recommended.

Four years and beyond: All of the above will work for this age but hopefully by now, they can hold a thermometer under their tongue for an oral reading. Again, axillary is the least accurate. Rectal readings should be a distant memory for them now (and you, Mom and Dad!), thank the heavens.

Call your pediatrician if:

  • Temperature goes higher than 104℉
  • Any fever present more than 3 days
  • Your kiddo is lethargic
  • You notice signs of dehydration (dry mouth, no tears, no urinating >8 hrs)
  • Burning or pain with urination
  • Fever is accompanied by other symptoms that concern you (ear pain, vomiting, diarrhea)

When to go to the ER with fever?

  • Difficulty breathing
  • Disoriented/confused
  • Seizures
  • Stiff neck

When is a fever dangerous?

A truly dangerous fever is >108℉ and is extremely rare, only seen in situations such as a heat wave. However, all fevers >105℉ should be investigated with a doctor. That said, less than 1% of fevers go higher than 105℉.

How to break a fever?

Rest, drink lots of fluids, and stay cool! Remember: that fever is on our side, fighting off our infections. So unless our child’s fever hits 103℉ as discussed, there is no ‘breaking’ necessary.

Are fevers contagious?

Not necessarily. If a virus is the reason your child has a fever, then yes, they are considered contagious. But as discussed in the beginning here, vaccines or overdressing can also cause a fever – not contagious. And there are plenty of illnesses that may NOT cause a fever, so in general, don’t use fever as your guide on whether or not it can be spread to others.

Keep in mind that how your kiddo is behaving is always more important than the actual number on your Kinsa thermometer. Follow your gut if you feel like something is wrong, but otherwise don’t be afraid to let your kiddo’s immune system be the champion!

Blake Wageman

Blake Wageman, RN, BSN has over 14 years of nursing under her belt, primarily focused on NICU babies and, just as importantly, their worried parents.