I am already beginning to see a bit of an increase in office visits for fever and with those visits the parents often ask ...how high a fever is too high? Remember, that fever is just a symptom, not an illness. Fever is also a good sign that your body is fighting the infection, and in most cases it is one of those pesky viruses that are causing your child to have a fever. Keep practicing the mantra..."fever is your friend"...as we have a lot of months ahead with viruses and with that lots of children with fevers.
A fever is defined as a temperature above 100 degrees orally or above 100.4 degrees rectally. 99.6 degrees is not a fever (even if you think your child's body temp "runs lower than usual"). I also know that the school may call you to pick up your child even if we doctors don't really consider 99 degrees to be a fever. Oh well.
It is important to document that your child indeed has a fever. This needs to be done with a thermometer, and not the back of a "trained" hand. I tell my own children that I am sometimes wrong when judging with my own pediatric/mother hand, and I too rely on a thermometer. You also do not need to take a temperature every hour.
If your child has a 102 degree temperature in the morning, there is no need to take it off and on all day. Once documented, you can treat the fever as needed. Your doctor will usually want to know about documented fever on a daily, rather than hourly basis.
The height of the fever does not necessarily mean that your child is sicker! I know that seems counter intuitive right? I mean, you must be sicker if your temperature is 104 rather and 101 degrees. You may feel worse (especially if you are talking about yourself rather than a child), but many children run high temperatures with a viral illness. It is not unusual to see a toddler with 103-104 degree temperature still running around the exam room, and that is a good thing.
Behavior is so important when evaluating a sick child. The number on the thermometer is not nearly as important as how your child is behaving. They may be "pitiful" and whiny but are they playing off and on? Although they are not "as hungry" will they still take part of their bottle or pick at a sandwich or eat a Popsicle? Fluids are more important for your child than the amount of food they are eating while they are sick. No one wants a full meal when you are running a fever and just feel pathetic.
Watch your child and see if their activity level goes up and down, which often correlates with their fever, especially if they have been given some acetaminophen or ibuprofen to help with their symptoms. These medicines t do not "mask" a serious illness, so treat their fever with the appropriate dose of an anti-pyretic (fever reducing medication). Don't withhold their medicine so that the doctor can see them with the fever, better to treat them and get their fever down and they may feel a lot better.