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JAMA Patient Page
March 10, 2004

Fever in Infants

JAMA. 2004;291(10):1284. doi:10.1001/jama.291.10.1284

Fever is an increased body temperature above the normal level of about 98.6° Fahrenheit or 37° Celsius. Fever usually indicates an infection but may also occur in other disorders, such as some types of cancer or arthritis. Fever in infants (babies younger than 1 year old), especially those younger than 3 months, can signal a serious infection. Such young infants who have fever should be seen by a doctor to determine the cause and treat it. The March 10, 2004, issue of JAMA includes an article about fever in early infancy.

How to take your baby's temperature

• Use a rectal thermometer with the bulb end coated with petroleum jelly.

• Insert it one inch into your baby's rectum while the baby rests on his or her stomach (on your lap or on a changing table).

• Do not let go of the thermometer because if the baby moves, the thermometer can move also and possibly injure the baby. Proper use of a rectal thermometer will not harm your baby.

• Leave the thermometer in place for 2 minutes, remove it, and read it.

• If it is impossible to use a rectal thermometer, an axillary (armpit) temperature can be taken. Usually axillary temperatures are one full degree less than rectal temperatures.

Treating fever

Keep the room temperature comfortable and dress your infant in loose, lightweight clothing. Do not wrap the baby tightly in blankets. Provide plenty of fluid for the baby to drink. If the fever is high or the infant appears uncomfortable, you may sponge the baby with tepid water (barely warm to the back of your wrist). Do not use alcohol to sponge him or her because it can be absorbed through the skin and cause harm. Antipyretic (fever-lowering) medications, such as acetaminophen, may be given on the advice of your doctor. Do not give aspirin to lower a child's fever because aspirin may be associated with development of Reye syndrome, a potentially fatal medical problem.

When to contact the doctor

  • Fever in an infant younger than 3 months

  • High fever (greater than 101° Fahrenheit or 38.3° Celsius)

  • Fever associated with abnormal drowsiness, a stiff neck, or the child appearing severely ill—this may signal meningitis, a serious infection of the covering of the brain and spinal cord

  • Fever with drooling or difficulty breathing—this may indicate epiglottitis, a serious infection of the back of the throat

  • Fever with a seizure

Febrile seizures

About 4% of children younger than 5 years experience a seizure (convulsion) while they have a fever. These are called febrile seizures. Usually they are harmless to the child, with no lasting effects, but should be evaluated by a physician. These seizures are not considered epilepsy (recurrent seizures that occur without a fever).

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on meningitis in children was published in the April 28, 1999, issue.

Sources: American Academy of Pediatrics, American Academy of Family Physicians, National Institute of Neurological Disorders and Stroke

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.