Baby Fever Guide: Temperature Taking to Medication

When your baby has a fever, it's easy to panic. But fever is actually your baby's normal response to fighting infection. Here's how to handle it calmly and effectively.

What Counts as a Fever?

According to the American Academy of Pediatrics (AAP), fever thresholds vary by measurement method:

• Rectal (most accurate): 100.4°F (38.0°C) or higher
• Ear (tympanic): 100.4°F (38.0°C) or higher
• Armpit (axillary): 99.0°F (37.2°C) or higher
• Forehead (temporal): 100.4°F (38.0°C) or higher

Rectal temperature is the gold standard for babies under 3 months. For older infants, ear thermometers are reliable and easier to use.

How to Take Your Baby's Temperature

Rectal Temperature (Most Accurate)

• Apply petroleum jelly to the thermometer tip
• Lay baby on their back with legs bent toward chest
• Insert thermometer 1/2 to 1 inch into the rectum
• Hold in place until the thermometer beeps
• Best method for babies under 3 months per AAP guidelines

Ear Temperature (Recommended for Older Babies)

• Gently pull the ear back to straighten the ear canal
• Point the thermometer toward the eardrum
• Compare both ears and use the higher reading
• May be inaccurate if baby has an ear infection

Armpit Temperature

• Dry the armpit before measuring
• Ensure the thermometer is fully against the skin
• Hold arm snugly against the body for 5 minutes (or until beep)
• Add 1°F (0.5°C) for a more accurate estimate

Forehead (Non-Contact) Temperature

• Hold 1-2 inches from the center of the forehead
• Avoid areas with sweat or hair
• Wait 15 minutes after coming indoors to measure
• Good for screening but less accurate than other methods

What to Do When Your Baby Has a Fever

Step 1: Remove Extra Layers

• Take off heavy clothing and blankets
• Dress baby in a single light layer
• Keep room temperature comfortable (68-72°F / 20-22°C)

Step 2: Keep Baby Hydrated

• Offer breast milk or formula more frequently
• For babies 6+ months: offer water or an electrolyte solution
• Watch for wet diapers (at least 4-6 per day)
• Signs of dehydration: fewer tears, dry mouth, sunken soft spot

Step 3: Lukewarm Sponge Bath

• Use lukewarm water (85-90°F / 29-32°C)
• Sponge the neck, armpits, and groin areas
• Never use cold water (causes shivering, which raises temperature)
• Never use rubbing alcohol (can be absorbed through skin)

Fever Medication Guidelines

Types of Fever Reducers

• Acetaminophen (Tylenol): Safe from 2 months old
• Ibuprofen (Advil, Motrin): Safe from 6 months old

When to Give Medication

• Temperature of 101°F (38.3°C) or higher
• If baby is uncomfortable at 100.4°F (38°C)
• Always dose by weight, not age
• Wait at least 4-6 hours between doses

Alternating Medications

If fever doesn't respond to one medication, you can alternate between acetaminophen and ibuprofen every 3-4 hours. Always consult your pediatrician before alternating medications.

Dosing Guidelines (By Weight)

• Acetaminophen: 10-15 mg/kg every 4-6 hours
• Ibuprofen: 5-10 mg/kg every 6-8 hours
• Check the concentration on your specific product's label
• Use the measuring device that comes with the medication

When to Go to the Emergency Room

Go Immediately If:

• Baby under 3 months with temperature 100.4°F (38°C) or higher
• Temperature of 104°F (40°C) or higher at any age
• Seizure (febrile seizure)
• Unusually drowsy, limp, or unresponsive
• Difficulty breathing or rapid breathing
• Purple or red spots on the skin
• Stiff neck
• Signs of severe dehydration (no wet diaper for 6+ hours, no tears when crying)

See Your Pediatrician Same Day If:

• Baby is 3-6 months old with fever 101°F (38.3°C) or higher
• Fever lasts more than 3 days
• Fever doesn't come down with medication
• Other symptoms: rash, vomiting, diarrhea
• Baby is fussy and won't eat
• Your parental instinct says something is wrong

Febrile Seizures: What to Know

Febrile seizures can occur when temperature rises rapidly. They typically affect children 6 months to 5 years old and usually last less than 5 minutes.

• Stay calm and note the time
• Place baby on their side on a safe surface
• Do not put anything in their mouth
• Do not try to hold them down or restrain them
• Call 911 if seizure lasts more than 5 minutes
• After the seizure ends, see your pediatrician

While frightening, simple febrile seizures don't cause brain damage or epilepsy. About 1 in 3 children who have one will have another with a future fever.

What NOT to Do

• Bundle baby up in heavy blankets
• Give ice baths or cold water baths
• Use rubbing alcohol to cool the skin
• Never give aspirin (risk of Reye's syndrome)
• Overdose on fever medication
• Ignore a fever in a baby under 3 months
• Wake a sleeping baby just to give fever medicine

The Bottom Line

Most fevers in babies are caused by viral infections and resolve on their own within a few days. Focus on how your baby is acting rather than the number on the thermometer.

If your baby is alert, feeding well, and responsive, a moderate fever is usually nothing to worry about. Keep them comfortable, hydrated, and watch for warning signs.

When in doubt, trust your instincts and call your pediatrician. You know your baby best.