Body temperature is measured differently depending on a child’s age. If measured rectally, a child is said to be running a fever when the body temperature is over 100.4. Orally, that measurement is 98.6. I always figure in a few (2-3) tenths of a degree if it is late in the day (not night when child is sleeping) if they have been active and running around. If an infant under 2 months has a body temperature over 100.4, they need to be brought to the ER. For an infant 2-6 months, contact doctor for advice. Fevers very commonly run between 100-103 with illness like flu, strep throat, bronchitis, ear infections, etc. An older child (over a year) does not need to be brought to the doctor for a simple fever. If they display other symptoms (rubbing the ear, cough, complaints of sore throat, not drinking or eating), then I would bring a child to the doctor even if their fever is in the not so high range.
I would say that if a child has a fever of 103-104 and is acting sick, give a dose of children’s Advil, use heat-reducing therapies like a lukewarm bath (not cold as this will induce shivering and can raise the fever higher) and wait an hour and measure again. It will hopefully have come down to 102 or below. As hudi said, if the child has a sustained fever of 103 or higher, then a doctor’s attention is necessary. I would say if it goes over 104, then contact the doctor and ask whether to bring the child to the ER.
For fevers that keep going back up, I was told in the ER that it is OK to rotate different types of fever-reducing medications, such as Advil and Tylenol. Advil is given no more than every 6 hours (preferably 8 when doing a rotation, 6 if given alone) and Tylenol every 4 hours. If you have to do this for 24 hours or more, I would not hesitate to contact the doctor about the fever that won’t stay down for more than an hour or two.
Febrile seizures (the ones associated with fever) usually happen when the fever is spiking (more often happens at the beginning of an illness but can also even in the middle). These need medical attention immediately.
Just as a last comment – the doctor doesn’t mean that it’s normal to have kids with fever over 103, just that it has become common in his practice because of the illnesses running around.
Everybody should have a healthy winter!!!