Fever often triggers worry and anxiety among parents, primarily due to common false beliefs (myths). The fact is, fevers are harmless and usually helpful. They are part of your child’s natural defenses. Fever is your friend! We want to empower parents with knowledge and confidence to avoid stress and anxiety when caring for a feverish child. This article will clarify the most widespread misconceptions about childhood fevers.
Myth: Fevers are bad for children.
Fact: A fever is the body’s natural response to an infection; it helps your child’s immune system fight germs and may slow their reproduction. It means your child has a healthy, active immune system. Fevers themselves are harmless. The cause of the fever may be harmful, but the fever itself is not.
Myth: All fevers need to be treated.
Fact: Since a fever is part of the body’s immune system response to infection, treating it may hinder the body’s efforts to fight it. A fever is harmless and should be treated only if it makes your child uncomfortable. Discomfort in toddlers may be manifested as crankiness, fussiness, or clinginess. Treat discomfort, not the fever itself. Children under three months old should not take fever-reducing medication without speaking to a healthcare professional first.
Myth: A fever too high is dangerous.
Fact: While a body temperature of 108° F or higher can be dangerous, fever does NOT go this high. The body does not elevate its temperature this high in response to infection. Temperatures high enough to cause injury can occur with heat stroke, overheating (in a hot car, for example), and rare reactions to certain medications. These are not fevers; they are elevated body temperatures due to other causes.
Myth: A high fever can cause brain damage.
Fact: Fevers do not cause brain damage. This myth may come from the fact that some children have what are called febrile seizures. These are harmless and affect only certain children with certain kinds of fevers; it has nothing to do with the height of the fever. As stated above, fever in response to an infection will not harm the body. The brain’s thermostat will not let the body have a fever high enough to cause brain damage.
Myth: A fever means that the child needs an antibiotic.
Fact: Both viral and bacterial infections can cause fevers; viral infections are much more common and cannot be treated with antibiotics. Most children with a fever will not benefit and may be harmed by giving an antibiotic. The fever itself tells us nothing about the cause of the fever.
Myth: If the fever is not treated, it will keep going higher.
Fact: The brain’s thermostat will keep the fever from going too high.
Myth: A very high fever means that the infection is serious.
Fact: The height of the fever is unrelated to the cause. Bacterial infections are slightly more likely in younger children (less than two) with a fever higher than 104° F. However, viral infections can cause very high fever, and serious bacterial infections can cause low-grade fever or even decreased body temperature. Children under three months old should have any fever (rectal temperature 100.4° F or higher) evaluated immediately.
Myth: If the fever does not respond to medication (“break”), that is a bad sign.
Fact: It does not mean anything about the fever’s severity or cause if it does not respond to fever-lowering medications.
Myth: Alternating fever medications is safe and helpful.
Fact: Since fevers are harmless and helpful, they do not need to be treated at all. Treating with two medications is not necessary. In addition, it is very easy to overdose a child when alternating medications. The safety of using both medications at the same time is unknown, and there are reports of harm in some children who received alternating medications.
Myth: The exact temperature or height of the fever is important.
Fact: How the child is acting overall is far more important. Children who perk up periodically, especially when the fever comes down, who are drinking, and who remain alert can be safely observed. Children who are lethargic, who stop drinking, or who do not periodically perk up, smile, and play a little should be examined immediately, as should children who are lethargic, irritable, or inconsolable. The height of the fever is not important.
Myth: Normal body temperature is 98.6° F.
Fact: A normal body temperature ranges from 97° to 100.3° F. It varies during the day and is higher in the afternoon or evening in most people. It also varies due to hormone cycles, environment, and other causes.
Myth: A temperature of 99-100° F is a low-grade fever.
Fact: These are normal temperature variations. Everyone’s temperature changes throughout the day and is higher in the evenings. A low-grade fever is 100.4° -102° F. Some people suggest adding a degree to an axillary temperature, meaning that a temperature of 99° F would be a fever; however, there is little evidence that this is accurate. Besides, knowing if your child has a low-grade fever is not important since it is harmless; how your child feels is more important.
Myth: My child typically “runs low,” so 99° F would be a fever in her.
Fact: Everyone’s temperature varies throughout the day. You would have to measure your child’s temperature every 4-6 hours, 24 hours a day, for a month or more, to determine that your child’s temperature never goes to a certain height unless they are sick. Besides, fever itself is harmless, and none of us, parents or doctors, should worry that much about defining a fever.
Myth: My child feels warm, so they must have a fever.
Fact: Children can feel warm for many reasons, usually due to activity. They also feel warm from being bundled, in bed, or using a blanket, being in a warm car or outside on a warm day, or crying. They may really have an elevated body temperature, but that is not a fever. Their body is releasing extra heat through the skin, which is how our bodies work!
Myth: Treating the fever will bring the temperature back to normal.
Fact: Medications will reduce the fever by 1-2 degrees; it will not usually return to “normal” unless it is initially low.
Myth: The fever returning when the medicine wears off is a bad sign.
Fact: This is to be expected. Fever-reducing medications only lower the body’s thermostat for a few hours; they do not treat what is causing the brain to set the thermostat higher and cause a fever. Fever will come and go until the cause goes away. With most viral infections, fever lasts from 1-4 days.
Myth: Teething can cause a fever.
Fact: Teething does not cause fever. Teething causes… teeth. It may cause mild, brief fussiness.
Myth: Any child with a high fever is at risk of having a seizure.
Fact: Febrile seizures are most often caused by certain viruses that raise the temperature quickly, and certain children are more prone to febrile seizures than others. Only about 4% of children ever have a febrile seizure, and treating the fever has never been shown to prevent febrile seizures.
References
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- Poirier MP, Collins EP, McGuire E. Fever Phobia: A Survey of Caregivers of Children Seen in a Pediatric Emergency Department. Clin Pediatr (Phila). 2010;49(6):530-534. doi:1177/0009922809355312
- Kayman H. Management of Fever: Making Evidence-Based Decisions. Clin Pediatr (Phila). 2003;42(5):383-392. doi:1177/000992280304200501
- Kramer MS, Naimark L, Leduc DG. Parental Fever Phobia and Its Correlates. Pediatrics. 1985;75(6):1110-1113. doi:1542/peds.75.6.1110
- Schmitt BD. Fever in Childhood. Pediatrics. 1984;74(5):929-936. doi:1542/peds.74.5.929
- Sullivan JE, Farrar HC, the Section on Clinical Pharmacology and Therapeutics, Committee on Drugs. Fever and Antipyretic Use in Children. Pediatrics. 2011;127(3):e20103852. doi:1542/peds.2010-3852
- Hiller MG, Caffery MS, Bégué RE. A Survey About Fever Knowledge, Attitudes, and Practices Among Parents. Clinical Pediatrics. 2019;58(6):677-680. doi:1177/0009922819834276