How to Reduce Fever in Toddlers

Fever is a natural response of the body to infection or injury. It stimulates the immune system to produce more white blood cells and antibodies to fight off infections. Some researchers believe that mild fevers should resolve on their own. However, when a toddler is experiencing a fever, it can cause confusion. Although mild fever usually doesn't require treatment, you may still want to reduce the fever to make your child feel more comfortable. High fever can be dangerous and, in rare cases, life-threatening. It is best to consult a pediatrician for examination.

Assess the Fever. Use a digital thermometer to check the child's temperature. You will get the most accurate reading by measuring it rectally, but you can also place it under their arm (though this method is the least accurate). Never use the same thermometer for both rectal and underarm measurements.

• You can also measure the temperature on the child’s forehead with a temporal artery scanner or ear thermometer.
• Infants and toddlers typically have higher body temperatures and a wider range of temperature fluctuations compared to adults. This is partly due to the higher surface-area-to-body mass ratio and because their immune systems are still developing.
• The normal body temperature for this age group ranges from 36°C to 37.2°C.
• A mild fever in toddlers is between 37.3°C and 38.3°C.
• A temperature between 38.4°C and 39.7°C usually requires attention. Most fevers in this range are caused by viruses or minor infections.
• A temperature of 39.8°C or higher needs to be treated or reduced (see the next steps). If you reduce the fever using the methods outlined in the next section, you may wait until the next day to see a doctor. Otherwise, you should take your child to the emergency room immediately.
• Note: This article discusses fever as a standalone symptom. If other concerning symptoms arise or if the child has a pre-existing health condition, it is important to seek medical attention immediately.

Give your child a bath. Bathing is an effective method to reduce fever as water helps to dissipate heat from the body faster than air, making it a quicker solution than medication. You can also bathe the child while waiting for the effects of acetaminophen (Tylenol) or other pain/fever-reducing medications.

• Use lukewarm water. Do not use cold water to reduce fever. A temperature slightly lower than the body’s temperature is most effective for cooling the body down.
• Avoid using alcohol in the bath water, as this is an outdated method no longer recommended by medical professionals.
• You can also place a cool, damp towel on the child’s forehead or body to help reduce the fever.

Encourage your child to drink plenty of fluids. Fever can lead to dehydration, a serious medical concern, so it's crucial to keep your child hydrated.

• Water is always the best option, but other liquids can be helpful if appropriate. You can offer fruit juice diluted with water or water flavored with fresh fruit.
• You can also give the child herbal teas with ice, caffeine-free (such as chamomile or peppermint tea), or electrolyte solutions like Pedialyte, safe for children of all ages.
• Be mindful of signs of dehydration. The higher the fever, the greater the risk of dehydration.
• Signs of dehydration include dark, concentrated urine, infrequent urination (more than 6 hours between urinations), dry mouth and lips, crying without tears, and sunken eyes.
• If your child shows signs of dehydration, seek medical attention immediately.

Optimize skin and room temperature. Dress your child in just a single layer of light clothing to maintain optimal temperature regulation. Each layer helps retain heat close to the body. Loose, lightweight clothing allows better airflow.

• Place a thin blanket nearby to use if the child feels cold or shivers.
• A fan, either electric or manual, can help circulate air and aid in cooling. If you use a fan, ensure the child is continuously monitored to avoid making them too cold. Direct the fan away from the child.

Administer fever-reducing medication. You should only give fever-reducing medication when necessary to alleviate discomfort or to control a high fever that could lead to serious complications.

• Mild to moderate fevers should generally be left untreated unless other symptoms develop, while higher fevers or fevers with additional symptoms may require medication.
• Acetaminophen (like Tylenol) or paracetamol can be used for infants and toddlers. Always consult a doctor for the correct dosage.
• Ibuprofen (like Advil or Motrin) can be given to children over 6 months of age. Consult a doctor for proper dosage.
• Aspirin is no longer recommended for anyone under 18 due to the risk of Reye's syndrome.
• Fever-reducing medications come in both tablet and liquid forms for children. Ensure you follow the recommended dosage based on the child's age and weight.
• Never exceed the recommended dosage or duration. Keep track of how much medication you've administered and when.
• If your child is on prescription medication, confirm with a doctor before administering any fever-reducing drugs.
• If your child is vomiting and unable to keep down medication, consider using suppositories. Check the label for appropriate dosage.
• If fever-reducing medication does not lower the temperature temporarily, seek medical care immediately.

Consult your doctor about the need for antibiotics. Antibiotics are used to treat bacterial infections, not viral ones.

• Using unnecessary high doses of antibiotics can promote antibiotic resistance. Therefore, antibiotics should only be prescribed in moderate doses when necessary.
• If your child is prescribed antibiotics, ensure they complete the entire course as directed.

Understand the causes of fever. In certain cases, fever can be our ally. It is the body's natural response to various triggers, including:

• Bacterial infections, such as strep throat or ear infections, which often cause fever and are usually treated with antibiotics.
• Viral infections like the common cold, flu, and specific childhood illnesses (chickenpox and measles). Viral infections cannot be treated with antibiotics, and the best course is to let the fever run its course while managing its symptoms. Viral infections are the most common cause of fever in toddlers, and the fever may last 3-4 days.
• Teething often causes mild fever.
• Vaccinations can lead to a mild fever as the immune system responds to the shot.
• Fever may result from the child becoming overheated in hot environments or experiencing heat exhaustion or heatstroke. This is a serious medical condition.
• Fever may also occur due to inflammation, such as from arthritis, or other severe medical conditions, including cancer.

Know when to call the doctor. Managing fever in toddlers requires balance—don’t overreact, but also don't underestimate the situation. Generally, the younger the child, the more serious the situation may be. Here are some general guidelines based on the child's age:

• 0-3 months: If your baby has a fever of 38°C, you should call the doctor immediately, even if there are no other symptoms. Any baby under 2 months should be seen right away.
• 3 months to 2 years: A fever below 38.9°C can typically be treated at home (refer to the previous section).
• 3 months to 2 years: A fever above 38.9°C requires medical treatment. Call your child’s pediatrician for further guidance, especially if the child has other symptoms, if the fever doesn’t go down with medication, or if the fever lasts for more than one or two days.

Recognize signs of more serious symptoms. Parents often have a sense when something is seriously wrong with their child. Likewise, children often react to illness in ways that parents quickly recognize as abnormal.

• A fever accompanied by lethargy and/or weakness may signal a more serious problem.
• If your child has severe symptoms like confusion, blue-tinged lips or fingertips, seizures, severe headache, stiff neck, difficulty walking, or trouble breathing, call emergency services immediately!

• If you're unsure whether your child’s fever is severe or how to treat it, call your doctor. It’s always better to be safe than sorry.

• Consult your doctor or pharmacist before using multiple medications together; many medicines can contain the same active ingredients, potentially leading to an accidental overdose.
• Never attempt to reduce a child’s fever by rubbing them with alcohol. While it might cool them down quickly, it can actually raise their body temperature in the long run.
• If your child’s fever is due to overheating in a hot environment, take them to a medical facility immediately.
• Never give aspirin to children under 18. It’s linked to Reye’s syndrome, a dangerous condition that can cause liver damage.