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38°C / 100.4°Fthe temperature that defines fever in children

40%of emergency paediatric visits in India are for fever

15 mg/kgcorrect paracetamol dose per body weight per dose

90%of childhood fevers resolve without antibiotics

Fever is not a disease — it is the body fighting one. It is the immune system doing exactly what it is designed to do. Most fevers in children are caused by viral infections that the body will beat on its own. The goal is not to eliminate the fever — it is to keep the child comfortable and catch the rare serious fever early.

What Is Fever and Why Does It Happen?

A temperature above 38°C (100.4°F) is considered a fever. The hypothalamus — the body's thermostat — deliberately raises body temperature in response to infection. A higher temperature slows virus and bacteria replication and speeds up immune cell activity. Fever is helpful, not harmful, in most cases.

How to Measure Temperature Accurately

Method	Age	How to use
Rectal (digital thermometer)	0–3 months	Most accurate for newborns. Insert 2.5 cm into rectum, hold still
Axillary (underarm)	All ages	Convenient but reads 0.5°C lower than actual. Hold arm down for 2 full minutes
Oral	Above 5 years	Hold under tongue, mouth closed for 1 minute. Wait 30 minutes after hot/cold drink
Ear (tympanic)	Above 6 months	Fast and convenient. Aim correctly into ear canal for accuracy

Avoid: Forehead strips, mercury thermometers (mercury is toxic if broken), or feeling the forehead with your hand — all are inaccurate.

When Is a Child's Fever Dangerous?

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Go to the doctor or hospital immediately if your child has ANY of these

Any fever in a baby under 3 months (even 38°C) — this is always an emergency | Fever above 40°C in any child | Fever with difficulty breathing or fast breathing | Fever with rash (especially red spots that don't fade when pressed — meningococcal emergency) | Fever with stiff neck or severe headache | Fever with seizure (febrile convulsion) | Child cannot be woken up or is unusually unresponsive | Fever lasting more than 5 days | Fever that comes back after being gone for 24 hours

How to Manage Fever Safely at Home

Fluids — most important step

Fever causes significant fluid loss. Offer water, ORS, coconut water, diluted fruit juice, or dal water every 30 minutes. A feverish child who is drinking well rarely needs hospitalisation.

Dress lightly

One layer of light cotton clothing. Do not bundle the child in blankets — this traps heat and worsens fever. Let the body release heat through the skin.

Keep the room cool

24–26°C is comfortable. Fan at low speed is fine — circulating air helps the body cool itself.

Give fever medicine if the child is uncomfortable

Paracetamol if temperature is above 38.5°C AND the child is miserable. A child with 39°C who is playing and drinking normally does not urgently need medication — watch and monitor instead.

Rest

Keep the child home from school. Screen time is fine during recovery — it is not true that screens worsen fever. Sleep is the real healer.

Medicines for Fever: Doses and Safety

Paracetamol (Crocin, Dolo, Meftal-P for paediatric):

Dose: 10–15 mg per kg body weight per dose
Frequency: Every 4–6 hours as needed. Maximum 5 doses in 24 hours
Example: A 10 kg child — give 100–150 mg per dose

Ibuprofen (Ibugesic, Brufen suspension):

From 6 months of age only
Dose: 10 mg per kg per dose, every 6–8 hours
Give with food to avoid stomach upset
Do not use if the child has dengue fever, is dehydrated, or has kidney problems

Do not use: Aspirin in children | Nimesulide (banned for children under 12 in India) | Two fever medicines at the same time without a doctor's advice.

Common Fever Myths in India — Busted

Myth	Truth
"Sponge with cold water to bring fever down"	Cold water causes shivering, which actually raises core temperature. Lukewarm sponging may provide comfort but does not treat fever
"Fever means antibiotics"	90% of childhood fevers are viral. Antibiotics do not work on viruses and unnecessary use creates antibiotic resistance
"High fever causes brain damage"	Fever from infection does not cause brain damage. Only heat stroke (not infection-related fever) at extreme temperatures is dangerous to the brain
"Don't feed during fever"	Nutrition supports immune function. Offer small, light meals. Never withhold food — only force-feeding is harmful
"Applying onion, potato, or turmeric reduces fever"	No evidence. Turmeric paste on skin can cause rash. Focus on fluids and paracetamol