It can be scary to wake up to a crying baby in the middle of the night, only to realize that they’re flushed or hot to the touch. The thermometer confirms your suspicions: Your baby definitely has a fever. But what should you do?

It’s important to learn how to comfort your feverish baby and recognize when you need to seek medical care.

Caring for a sick baby

A rectal temperature of more than 100.4°F (38°C) is considered a fever. Over 101°F (38.3°C) is certainly considered a fever. In most cases, a fever is a sign that your baby’s body is fighting an infection.

A fever can stimulate certain bodily defenses to protect against invading bacteria. While this is a positive step in fighting infection, a fever can also make your baby uncomfortable. Your baby will need more fluids. You may notice that they’re breathing faster.

Fever is typically associated with the following illnesses:

  • croup
  • pneumonia
  • ear infections
  • influenza
  • colds
  • sore throat
  • blood, bowel, and urinary tract infections
  • meningitis
  • a range of viral illnesses

If your baby is 6 months or older and has a temperature below 101°F (38°C), they may not need to be treated for a fever. Unless your baby seems uncomfortable and isn’t sleeping, eating, or playing normally, it’s probably fine to wait and see if the fever goes away on its own.

How can I make my feverish baby comfortable?

Speak with your pediatrician about administering a dose of acetaminophen or ibuprofen. These usually reduce fever. Your pharmacist or doctor can give you the correct dosage information for your baby. Do not give your baby aspirin.

Make sure your baby isn’t overdressed, and be sure to offer fluids regularly. Dehydration can be a concern for a feverish baby. Comfort your baby with a cool sponge bath or a lukewarm bath, a cooling fan, remove extra clothing, and offer extra fluids.

Check your baby's temperature again after you have tried these things. Continue to check the temperature to see if is going away or getting higher.

Fevers can lead to dehydration and children can get dehydrated quickly.

Symptoms of dehydration may include:

  • crying without tears
  • dry mouth
  • fewer wet diapers

If your baby is breast-feeding, try to nurse more often to prevent dehydration.

While you may be able to feel a temperature difference through touch alone, it’s not an accurate method of diagnosing fever. When you suspect that your baby has a fever, take your baby’s temperature with a thermometer.

Try to keep your child’s room comfortably cool. Use a fan to circulate air if the room is overly warm or stuffy.

When should you call the doctor if your child has a fever?

Call your pediatrician immediately if your baby has a fever that is accompanied by any of the following symptoms:

  • vomiting
  • diarrhea
  • an unexplained rash
  • a seizure
  • acting very ill, unusually sleepy, or very fussy

What if my newborn has a fever?

If your baby is younger than 2 months and you’ve taken a rectal temperature of 100.4°F (38°C) or higher, call the doctor.

Newborn babies can have difficulty regulating body temperature when they’re sick. This means they may become cold instead of hot. If your newborn has a temperature lower than 97°F (36°C), call the doctor.

Seizures and fever in infants

Sometimes, babies older than 6 months can have seizures that are triggered by fever. They’re called febrile seizures, and they usually run in the family. In many instances, a febrile seizure will take place during the first few hours of the illness.

They can be just seconds long, and usually last less than one minute.

A baby may stiffen, twitch, and roll their eyes before becoming limp and unresponsive. They may have skin that looks darker than usual. It can be a very frightening experience for parents, but febrile seizures almost never result in long-term damage. Still, it’s important to report these convulsions to your baby’s doctor.

If your baby seems to be having trouble breathing, call 911 or your local emergency services immediately. Also call immediately if the seizure continues for more than five minutes.

Does my baby have a fever or heatstroke?

In rare cases, a fever may be confused with heat-related illness, or heatstroke. If your baby is in a very hot place, or if they’re overdressed in hot and humid weather, heatstroke may occur. It’s not caused by infection or an internal condition.

Instead, it’s the result of surrounding heat. Your baby’s temperature can rise to dangerously high levels above 105°F (40.5°C) that must be brought down again quickly.

Methods for cooling your baby include:

  • sponging them with cool water
  • fanning them
  • moving them to a cooler place

Heatstroke should be considered an emergency, so immediately after cooling down your baby, they must be seen by a doctor.

Next steps

A fever can be frightening, but it’s important to remember that it’s not usually a problem. Keep a close eye on your baby, and remember to treat them, not the fever. If they seem uncomfortable, do what you can to offer comfort. If you’re feeling unsure about your baby’s temperature or behavior, don’t hesitate to speak with the doctor for guidance.