It always seems to happen at the worst time — your child feels warm, the thermometer confirms a fever and you’re wondering what to do next. Whether it’s the middle of the night or the start of a busy school day, fevers can be stressful. But if you know how to manage them, they don’t have to be scary.
As respiratory virus season picks up, Atrium Health Levine Children’s is here to help you feel prepared. With expert insights from pediatricians and our trusted nurses, we’ll walk you through what fevers mean, how to manage them safely and when to reach out for care.
Understanding fevers: a natural defense
“Fever is the body’s natural response to infection,” says Dr. Lyn Nuse, senior medical director at Atrium Health Levine Children’s. “It’s a sign that the immune system is doing its job.”
A child’s normal body temperature hovers around 98.6°F (37°C), and a fever is generally considered to be present when the temperature reaches 100.4°F (38°C) or higher. Everyone’s body temperature can vary a bit throughout the day, and age, activity level and other factors can have an impact.
Fevers help the body fight viruses more effectively. While they can be uncomfortable, they’re not inherently harmful. What matters most is how you respond.
Managing fevers safely at home
When a fever strikes, the first step is making sure you have an accurate reading. “My first recommendation to parents is confirming their child’s temperature with a reliable thermometer and method,” says Jill Healy, nurse at Levine Children’s Perspective Pediatrics. “One degree can be the difference between our advice to take your child to an emergency department or not.”
For most children, fevers can be managed with rest, fluids and over-the-counter medications. But it’s important to know that not all medicines are suitable for children.
“Acetaminophen is safe for children of any age when dosed appropriately by weight,” says Nuse. “Ibuprofen is also effective, but should only be given to children six months and older.”
Aspirin, however, should never be given to children due to the risk of Reye’s Syndrome — a rare but serious condition that can cause brain and liver damage.
If you’re unsure about which medication to give or how much, don’t guess. Reach out to your pediatrician’s office or use Nurse Chat through MyAtriumHealth for real-time guidance. Discover more tips for keeping your child’s fever under control.
Why hydration matters
When your child has a fever, it’s natural to focus on the thermometer. It’s also important to remember fluids are just as essential for comfort and recovery.
“Hydration becomes very important during times of fever at any age because at higher body temperatures, fluid loss is more rapid,” says Healy. “Children are especially vulnerable to fluid loss, particularly infants and younger children.”
Dehydration can sneak up quickly, making it harder for the body to fight infection. Here’s how to help:
- Offer small sips often: Water, crushed ice or an electrolyte drink can help replace lost fluids. For infants, continue breastmilk or formula, and ask your provider about syringe feeding if they’re not taking enough.
- Make it appealing: Use a favorite cup or straw to encourage drinking.
- Watch for warnings: Dry lips, fewer wet diapers or lack of tears when crying can signal dehydration.
How high is too high?
For infants under 3 months old: Contact a health care provider if they have any fever (a temperature of 100.4°F or higher) or if their temperature drops below 97.7°F (36.5°C) rectally.
In babies and children over 3 months of age: Contact a health care provider if their fever is higher than 104°F (40°C), or if the fever doesn’t come down with a fever-reducing medication. If your child still isn’t acting like themselves after the fever lowers, you should reach out to a health care provider — even if the original temperature wasn’t very high.
Where to turn for help
Atrium Health Levine Children’s offers a variety of ways to get the care you need, whether it’s 2 a.m. or 2 p.m., and whether you need a quick answer or an emergency visit.
- Primary Care: When fevers strike, having a trusted pediatrician makes all the difference. Your child’s primary care team can guide you through everything from routine checkups to important immunizations.
- Nurse Chat: Nurse Chat is available seven days a week from 7 a.m. to 7 p.m. Securely message a nurse who will help assess your child's symptoms, provide guidance and answer any questions from the MyAtriumHealth app.
- Virtual Primary Care: Schedule a video visit with a pediatrician who knows your child and can help manage fevers, colds and more — without leaving the comfort of home.
- Urgent Care: In-person and virtual urgent care visits provide your child with prompt care for mild to moderate symptoms, helping you avoid long emergency room wait times.
Wondering where to turn for other symptoms? Click here.
Why untreated fevers can be risky
While not every fever needs medication, prolonged or high fevers can lead to dehydration, fatigue, and in rare cases, febrile seizures. Untreated fevers may also hide underlying infections that require medical attention.
If your child has a fever along with neck stiffness, a rash, mood changes or is under 2 months old with a temperature of 100.4°F or higher, seek emergency care right away. Atrium Health offers expert emergency care across the region — including three emergency departments dedicated just for kids, one of which is our newest location in Union County.
“No one knows your child better than you and their health care team,” says Healy. “We’re here to give you clear, trusted guidance that is tailored to your child so you can feel confident about every decision.”
Have a sick kid? We’re here to help. Find access to our symptom checker, nurse chat, eVisits and more.
