Fever in children can be a scary thing for parents, often causing them to wonder if a trip to the emergency room is necessary.

Pediatrician Noel “Kip” Frizzell, MD, Le Bonheur’s medical director of Coordination of Care, says that a fever – even a high one -- is not always critical, but there are signs for which you should watch.

“The best thing that parents can do is get to know their child’s normal behavior and gauge the situation from there,” says Frizzell.

He offers three important questions to ask yourself when your child has a high temperature:
1. Is your child’s breathing labored?
2. Is he/she having any forceful vomiting?
3. Is your child crying inconsolably?

If you answer yes to any of these questions, he says it’s best to call your pediatrician’s office, no matter your child’s degree of fever.

Frizzell stresses that if you have an infant younger than 3 months with a rectal temperature of 100.4 degrees Fahrenheit you need to call your pediatrician immediately. Fever in newborns does require an exam, as newborns are more fragile and susceptible to serious illness.

Even if your child does not show signs of serious illness, a fever can make him or her uncomfortable. To make your child as comfortable as possible, you can provide temporary relief by administering a dosage of acetaminophen or ibuprofen if he or she is 6 months or older. Most children with a temperature of lower than 102 degrees Fahrenheit don’t need medication, but if you notice that your child is uncomfortable, it won’t hurt to give them an over-the-counter medicine. You should also keep your child dressed in light clothing, keep the house at a comfortable temperature, offer plenty of fluids and make sure he or she is resting.

Knowing your child’s normal behavior and the symptoms that are accompanying the fever is the most important information for you to consider. As long as you don’t notice any of the three red flags, a trip to the doctor’s office probably isn’t necessary. Just remember to monitor your child closely. If the fever has not reduced after 24 hours on medication, call your child’s pediatrician.

When does fever begin?
100.4 degrees Fahrenheit measured rectally; 99.5 degrees Fahrenheit measured orally; and 99 degrees Fahrenheit measured under the arm.

What does fever mean?
Fever is the body’s natural defense against infection.

When should I call the doctor?
Call the doctor if you have an infant younger than 3 months with a rectal temperature of 100.4F or if your child is experiencing any of the following:
• Labored breathing
• Forceful vomiting
• Inconsolable crying

You should also call your doctor if you have a child with a temperature higher than 104 degrees Fahrenheit.

What should I do if my child has a temperature of 104 degrees Fahrenheit but is acting normally?
If your child is not exhibiting any of the behavioral red flags, give your child a dosage of acetaminophen or ibuprofen if he or she is at least 6 months old. Continue to monitor your child’s behavior and call the doctor if the fever has not gone down after 24 hours with medication.

What type of thermometer and method gives the most accurate temperature reading?
A digital thermometer administered rectally will give you the most accurate temperature.