Fevers

Fever Policy and Information for Parents

Normal Body Temperature

Healthy children typically have a body temperature between 36.5°C (97.7°F) and 37.5°C (99.5°F). Body temperature naturally changes throughout the day and is usually about 0.5°C higher in the evening than in the morning. While 37°C (98.6°F) is often considered the average normal temperature, any reading between 36.5°C and 37.5°C is generally normal.

A fever is defined as a body temperature of 38°C (100.4°F) or higher.

Fevers are most often a sign that the body is responding to an infection caused by microorganisms such as viruses or bacteria.

Daycare Policy on Fever

Because fever is commonly associated with infection and possible contagious illness, it is the policy of this daycare—consistent with most daycare and school environments—that children with a fever must remain home and may only return after being fever-free for at least 24 hours.

This exclusion period helps:

Protect other children and staff from possible infection
Allow the child time to recover while their body fights the illness

Over the years, there have been many occasions where a child has been sent home after developing a fever at daycare, only for their temperature to appear normal once they arrive home. This can happen for a variety of reasons. However, a temporary fever spike can often be the early sign of an illness, such as a virus, ear infection, or another infection that has not fully developed yet.

In many cases, when several children begin experiencing fever spikes, it is not long before multiple children become sick and need to stay home. For this reason, when a fever occurs at daycare, we may send a child home as a precautionary measure to help prevent the possible spread of illness and to allow the child time to rest and recover.

Even if the fever does not persist once the child returns home, the initial spike may still represent the early onset of an infection, which is why the standard 24-hour fever-free policy remains in place.

Treatment

Most children with a fever do not necessarily need fever-reducing medication.

In many cases, allowing a mild to moderate fever to run its course can be beneficial because fever is part of the body’s natural immune response. An elevated temperature can help the body fight infection by:

Slowing the growth of some germs
Supporting the immune system’s response
Triggering an inflammatory reaction that sends protective substances to the infected area to limit spread and promote healing

Research has also explored the role of fever in recovery. In one study involving 72 children, those who were not given fever-reducing medication recovered more quickly. Another study of 56 people infected with common cold virusesfound that individuals who used certain fever-reducing medications remained contagious for a longer period.

For this reason, the decision to use fever-reducing medication should focus primarily on improving the child’s comfort, rather than simply lowering the temperature.

For more information on this topic, you may wish to read “The Fever Paradox.”

When to Seek Medical Care

Seek immediate medical care if your child has a fever and:

Is younger than three months old
You have recently returned from international travel
Develops a rash with small purple spots that do not fade when pressed
Cannot keep fluids down, is not urinating, or appears dehydrated
Has very pale, grey, cool, or mottled skin
Appears to be in constant pain
Is very lethargic or difficult to wake
Has a stiff neck
Has a first-time seizure associated with fever or a prolonged seizure
Appears confused or has unusual behaviour changes
Is not using an arm or leg normally or refuses to stand
Has difficulty breathing
Is crying constantly and cannot be comforted

See a doctor within 1–2 days if your child:

Is between three and six months old
Has specific pain, such as ear or throat pain
Has had a fever lasting more than three days
Had a fever that went away and then returned after one or two days
Has a bacterial infection being treated with antibiotics but the fever remains after two to three days
Cries or experiences pain when urinating
Or if you have any other concerns

Common Myths About Fever

Seeing your child with a fever can be frightening for parents and caregivers. However, many common beliefs about fever are not accurate. The most important thing to observe is how your child looks and behaves, not just the number on the thermometer.

Myth: Fever must always be treated with medication

Fever is a normal immune response that helps the body fight infection. The fever itself is not harmful and does not always require treatment. Fever-reducing medication should mainly be used to improve a child’s comfort, not simply to lower the temperature.

If a child is comfortable and resting, medication may not be necessary.

Myth: The exact temperature tells how sick a child is

The child’s overall condition is more important than the specific temperature reading.

A child with a high fever who is alert and drinking fluids may be less concerning than a child with a lower fever who appears very ill or lethargic.

Some viral illnesses, such as influenza, can produce high fevers, while some serious infections may produce only mild fever or even a lower-than-normal temperature.

Tracking the number of days a fever lasts is often more useful than focusing on the exact temperature.

Myth: Fever causes brain damage

Many parents worry that a high fever will cause brain damage. Fevers caused by infections typically remain below 42°C (107.6°F) and do not cause brain damage.

Brain injury from temperature occurs only in extreme situations where body temperature exceeds 44°C (111.2°F), such as severe heat stroke or rare reactions to certain medications or drugs.

Myth: Fever is harmful for children

Fever is actually a protective response. Many bacteria and viruses do not grow as well at slightly higher body temperatures, so fever helps the body fight infection. The primary goal of treatment is simply to make the child more comfortable.

Myth: Fever should always go away after ibuprofen or acetaminophen

Fever-reducing medications can make children feel better, but they typically lower temperature by only 1–2°C (2–3°F)and may not return the temperature to normal. A fever continuing after medication does not necessarily indicate a more serious illness.

Myth: Antibiotics should quickly eliminate a fever

Antibiotics work only against bacterial infections. Even when antibiotics are appropriate, it can take two to three daysbefore the fever resolves. Since most childhood infections are caused by viruses, antibiotics are often unnecessary and will not reduce fever in those cases.

Myth: Treating fever prevents febrile seizures

Research shows that fever-reducing medications do not prevent febrile seizures. These seizures often occur early in an illness and may happen before a parent even realizes the child has a fever. They also tend to run in families.

Final Note

While fever can be concerning, it is usually a normal and helpful response of the immune system. Monitoring your child’s behaviour, comfort, and hydration is often more important than focusing solely on the thermometer reading. When in doubt, consult your child’s healthcare provider.