Fever Guide: Home Remedies or ER?

As an ER nurse, I’ve seen countless worried parents rush to the ER for a simple viral fever—often because they didn’t know how to manage it at home or weren’t confident in doing so. This guide was created to empower parents with the knowledge and tools to care for their children confidently (and yes, it applies to adults too!).

Fevers can be confusing (and sometimes scary!) because they show up with lots of different illnesses, some serious, some not. This blog post focuses on fevers caused by viral illnesses, the kind most of us deal with at home. If your child has a fever without a clear reason or shows unusual symptoms, it’s always best to check in with your trusted provider or get higher-level care.

What is a Fever?

First off, it's important to recognize that a fever is not an illness, it's a symptom of an illness. A fever is a natural response to an infection or illness controlled by the hypothalamus. It is a good sign, because it means that the body is fighting off the illness or infection. A higher body temperature makes it harder for viruses and bacteria to thrive, while also helping immune cells work more efficiently. Together, that activates the immune symptom and creates a powerful line of defense.

Specifically, the elevated temperature helps by:

• Activating white blood cells: Fever encourages the production and activation of white blood cells, which are essential for identifying and neutralizing harmful pathogens like bacteria, viruses, and toxins.

• Slowing down the replication of viruses and bacteria: Many pathogens thrive in a lower body temperature. The increased temperature helps to inhibit their growth and reproduction, giving the immune system an advantage in fighting off infections.

• Promoting the growth of T-cells: Fever accelerates the production of T-cells, which are critical for the immune system’s ability to recognize and destroy infected cells.

• Enhancing the overall immune response: The rise in body temperature helps to stimulate the production of immune system molecules like interferons, which aid in the detection and destruction of pathogens.

• Improving the efficiency of enzymes: Elevated temperatures can increase the activity of certain enzymes involved in immune system processes, helping them to work more efficiently.

• Inducing heat shock proteins: Fever triggers the production of heat shock proteins, which help to repair damaged cells and proteins, aiding the body’s ability to recover from illness.

Why We Should Let a Fever Do Its Job

Fever is the body’s natural defense against infection. A fever actually signals additional immune support. A higher temperature helps the body activate T-cells, which are key players in the immune response and also helps to produce antibodies for long-term protection. Lowering the fever actually slows down recovery by interfering with how the immune system works. Letting a fever run its course can actually help you or your child recover faster and build stronger immunity for the future.

How to Take a Temperature

The most accurate way to check a temperature is with a rectal thermometer, though it’s also the most invasive. This method is typically recommended for children under 2 years old, or until they’re able to properly use an oral thermometer.

Oral thermometers are the next most reliable option.

After that, accuracy decreases in this order: axillary (underarm), tympanic (ear), and finally temporal (forehead) thermometers.

Although temporal thermometers became widely used in 2020 because of their convenience, they are often less reliable because external factors like room temperature and skin moisture can interfere with the reading.

How High is Too High?

Many parents are told that any fever over 104°F requires an immediate trip to the ER - but that’s not always necessary. If your child is otherwise acting okay (alert, hydrated, and able to rest) even with a high fever, it’s often safe to continue supportive care at home. It is not uncommon for a child's temperature to reach 104°F and the hypothalamus typically prevents the temperature from going any higher. While each person's body is different, a fever up to 106°F is usually harmless. It is not until 108°F that brain damage is possible, which is considered hyperthermia.

Here is a commonly used scale to help classify fever ranges:

• Low-grade: 37.3 to 38.0 C (99.1 to 100.4 F)

• Moderate-grade: 38.1 to 39.0 C (100.6 to 102.2 F)

• High-grade: 39.1 to 41 C (102.4 to 105.8 F)

• Hyperthermia: Greater than 41 C (105.8 F)

If you do choose to visit the ER, it’s a good idea to give a fever reducer beforehand. Once there, your child will typically be given medication to bring the fever down if it’s still elevated. From there, the focus will be on identifying the underlying cause. If its viral, supportive treatment is usually recommended, regardless of whether the fever was 102°F or 104°F, because the exact number doesn’t change the treatment plan.

What to do Overnight for a Fever

When your child is running a fever overnight, it can be worrying, but rest assured, the body is working hard to heal. Here are some tips for supporting them through the night while ensuring they get the rest they need:

1. Allow Them to Sleep

   • Sleep is incredibly important when the body is fighting off illness. It’s during sleep that the immune system works its hardest to heal and restore balance. So, try not to disrupt your child’s sleep unless necessary. Their body is doing the work it needs to fight off the infection, and a good night’s rest can make all the difference in helping them feel better faster.

2. Keep Them Close

   • If your child is still young or if you’re just feeling a little more anxious, consider letting them sleep in your bed or room. Being close allows you to monitor them throughout the night, and it can offer both you and your child comfort. Sometimes, just knowing you're nearby can help them rest easier. Plus, it lets you react quickly if the fever gets higher or they seem more uncomfortable. If the child is older or you are not able to keep them close, be sure to check on them through the night.

3. Use a Smart Monitor for Peace of Mind

   • If you're worried about monitoring their fever or breathing while they sleep, using a smart device like an Owlet can provide extra peace of mind. These devices can track their heart rate and oxygen levels, alerting you if something seems off so you can sleep easier knowing you’re staying on top of things. Of course, this isn't necessary, but a valuable option.

   • As a mom with postpartum anxiety, I used an owlet for both of my children when they were newborns, and I still use it when they are sick! It just gives me piece of mind that I will know if there is a true emergency occurring.

4. When to Medicate

   • If the fever continues to rise or if your child is very uncomfortable, you can consider administering medication. Fever-reducing medicine like ibuprofen or acetaminophen can help bring the fever down and alleviate discomfort, but always follow the dosing instructions carefully. It’s essential to balance reducing the fever while allowing the body to naturally fight the infection. More information about these two medications below. I personally recommend using ibuprofen instead of Tylenol (in children over 6 months old).

5. The Wet Sock Trick

   • A unique and gentle way to help reduce a fever overnight is the “wet sock trick.” This involves soaking a pair of cotton socks in cold water, wringing them out, and then putting them on your child’s feet before bed. Over the course of the night, the socks will warm up naturally, and the cooling effect on their feet can help stimulate circulation and reduce the fever. It’s a great option for gently encouraging the body to bring the fever down without resorting to medication right away.

When to go to the ER:

**Fevers can have many causes, some more serious than others, but this guide focuses specifically on fevers that occur alongside viral illness symptoms**

Febrile Seizures

Febrile seizures are triggered by a rapid rise in temperature, not by how high the fever gets. For example, a quick jump from 99.4°F to 101.9°F within a few minutes can be enough to cause one. That’s also why it’s not recommended to cool a child down too quickly, such as by putting them in a cold bath. Instead, use a lukewarm bath and allow the water to gradually cool while they sit in it.

If your child ever has a febrile seizure, try to stay calm. Note the time so you can report how long it lasts and call 911 for guidance.

Fever in baby under 3 months old

It is recommended to go to the ER for a fever in a baby under 3 months old because it can be a sign of a serious infection, and newborns have immature immune systems that can’t fight illness the same way older children or adults do. Babies can get very sick, very quickly with fever being the only initial clue.

Lethargy - even after medicating

Lethargy means your child is extremely hard to wake and seems completely unresponsive or out of it. They might not be able to keep their eyes open, talk, or respond normally. When lethargy is paired with a fever, it could be a sign that something more serious is going on -something their body may not be able to fight off on its own.

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How to Support a Fever Naturally

Hydration

Staying hydrated is key when your child is sick, especially if they have a fever. Fevers increase fluid loss through sweat and breathing. Offer breastmilk, water, coconut water, herbal teas, or electrolyte drinks. You can make a homemade electrolyte drink with lemon water with a pinch of Himalayan/Celtic salt and honey.

Rest

Your body heals when it sleeps, so if you follow a strict sleep schedule don’t hesitate to throw it out. Let your kiddo nap longer than usual, go to bed earlier if needed, sleep in, etc. Resting allows the body to focus all its energy on healing, cleansing toxins, and immune support. If a fever is keeping your child up at night, that would be a time where you could consider medication if you feel that their body needs to rest and reset.

Homeopathy - promotes comfort, not a fever reducer. Use 30C potency in most home settings

• Belladonna

  • Use with

    • High, sudden fever with a hot, red face

    • Pupils may be dilated

    • Throbbing headache, very sensitive to light or noise

    • Skin feels hot, but hands and feet may be cold

  • Dose: 1 dose (2 pellets) every 10 mins for 30 mins. Repeat if needed

• Aconite

  • Use with

    • Sudden onset fever, especially after cold wind exposure

    • Child is anxious, restless, maybe fearful

    • Often the very first stage of illness

  • Useful within the first 24 hours

  • 1 dose (2 pellets) every 10 minutes for 2-3 doses

• Ferrum Phosphoricum

  • Use with

    • Milder, slow-rising fever

    • Early stage of illness with vague symptoms (slight fatigue, flushing)

  • Not as intense as Belladonna or Aconite

    • Great for when you're not sure what remedy to give yet

• Gelsemium

  • Use with

    • Slow-onset fever with weakness, heaviness, droopy eyelids

    • Dull, tired, wants to lie still

  • Common for flu or viral fevers

    • Chills up the spine, no thirst

  • Give 1 dose (2 pellets) 3-4x per day until 80% better

Herbal Support

• Elderberry: support the immune system, shortens illness duration, relieves fever symptoms

• Yarrow: a diaphoretic herb that can help the body sweat out a fever, anti-inflammatory

• Catnip: a diaphoretic herb that can help the body sweat out a fever and rid the body of toxins

• Lemon balm: reduces fever and anti-inflammatory

• Fennel seed: antibacterial and anti-inflammatory

• Echinacea: supports the immune system and can shorten illness duration

Tinctures I use and love: Feel Better Fast, Elderberry Elixir

Always check with a trusted practitioner or herbalist before using herbs in children.

Immune Support

Supporting the immune system during illness is one of the most important things you can do! Click here to see my Immune Support Guide.

Lymphatic Massage

The function of the lymph system is to filter out toxins, waste, and pathogens, house immune cells (like lymphocytes) that fight infection, and transport immune cells where they’re needed. If the lymphatic system is sluggish or congested, it can delay immune response, impair detox pathways and increase inflammation leading to longer illness duration. Lymph moves through the body by muscular movement. When we're ill, we're typically not moving as much leading to stagnant lymph. Adding in a dry brushing routine or manual lymph massage can greatly improve lymph flow. Here's a video showing where to massage major lymph nodes to allow for optimal drainage

How to Naturally Lower a Fever If Necessary

(Try before medicating)

Peppermint Oil

Peppermint oil can help naturally bring down a fever thanks to its cooling properties. To use it safely, mix 1–2 drops with about ½ to 1 teaspoon of a carrier oil like coconut oil, then rub it on the soles of the feet and along the spine. Always use your discretion and consult with your trusted provider before using oils. John Hopkins Medical does not recommend the use of peppermint oil under 30 months, and CHOP does not recommend any essential oils under the age of 3.

Wet Sock Trick

The wet sock trick is a natural remedy that can help lower a fever and support the immune system. Here’s how it works: when you put on cold, damp socks, your body increases blood flow to your feet to warm them up. This boost in circulation helps your body fight off illness and can gently bring down a fever.

To try it, soak a pair of thin cotton socks in cold water, wring them out, and put them on. Then layer dry, thick wool socks over them. Wear them overnight while you sleep. It’s a simple, safe way to support the body’s natural healing process.

Lukewarm Bath

Placing your child in a lukewarm bath can help the fever to naturally lower. Do NOT place a fevering child in cold water, this increases chance of febrile seizures.

Herbal/Detox Bath

You can add herbs such as yarrow, ginger, or calendula to the bathwater to help the body sweat and lower the fever.

Epsom salts to the bath to help increase detoxing through the skin.

Cool Compresses on Pulse Points

Apply a cool (not ice-cold) cloth to the wrists, neck, or behind the knees to help lower core temperature gently.

Skin to Skin Contact

Skin-to-skin contact helps regulate an infant’s temperature through a process called thermal synchrony, where the caregiver’s body adjusts, warming or cooling, to stabilize the baby’s temperature. This works because a baby’s own temperature-regulating system is still immature, and they rely on the caregiver’s more developed nervous system for support. Skin-to-skin also lowers stress hormones and increases calming oxytocin.

Medications

Medicating a fevering child is up to parents’ discretion as a last resort after supportive care. You can try to reduce the fever if your child is unable to eat, drink, or sleep due to discomfort from the fever.

Acetaminophen (Tylenol) is a widely used medication for pain relief and fever reduction, but it’s important to be aware of its potential downsides, particularly its impact on glutathione levels. Glutathione is a powerful antioxidant produced by the liver that plays a crucial role in detoxification, immune support, and protecting the body from oxidative stress.

• How Acetaminophen Lowers Glutathione

  • When acetaminophen is metabolized in the liver, it creates a toxic byproduct called NAPQI (N-acetyl-p-benzoquinone imine). The body neutralizes this byproduct using glutathione. However, when acetaminophen is used in large doses or frequently, the body’s glutathione stores become depleted. This leaves the liver less able to detoxify and repair itself, potentially leading to liver damage, especially in cases of overdose.

• The Ripple Effect: Long-Term Consequences of Low Glutathione

  • Low glutathione levels can have significant health consequences:

    • Compromised Detoxification: With reduced glutathione, the liver becomes less efficient at detoxifying the body, allowing toxins to build up.

    • Weakened Immune Function: Glutathione is essential for immune health, and low levels can impair your ability to fight infections.

    • Increased Inflammation and Oxidative Stress: Low glutathione can lead to higher inflammation, increasing the risk of chronic conditions like heart disease, diabetes, and autoimmune disorders.

    • Potential Organ Damage: Prolonged acetaminophen use can strain not only the liver but also the kidneys, increasing the risk of damage to these vital organs.

• If you or your child requires a fever reducer and is unable to take ibuprofen, look for a brand that does not have added dyes or ingredients. Genexa is "cleaner" brand.

  
  
  
  

Ibuprofen (Motrin) can also affect glutathione, but not as much as Tylenol does. If you decide to use medication, ibuprofen is usually a better first choice for children over 6 months old. If the fever still isn’t coming down and you’re considering a trip to the ER, acetaminophen can be used as a backup option.

What will happen in the ER

If you’ve tried natural remedies and still feel the ER is necessary, go ahead and give a fever reducer before heading in. Don’t wait to medicate just so the doctor can “see how high it gets.” One of the first things that will be suggested as you enter the ER is a fever reducer. If your child has a fever along with mild respiratory symptoms, the ER will likely want to do a viral swab (tests for viruses such as COVID, RSV, flu) and possibly a chest x-ray. If your child has a fever with urinary symptoms, they will want a urine sample. If your child has a fever with a sore throat, they will want a throat swab to check for strep. If your child has other concerning symptoms in conjunction with a fever (rash, stiff neck, lethargy, respiratory distress, etc.) they may require a much more thorough workup to determine the cause.

Remember - a fever is a symptom and a sign that the immune system is working! When it comes to viruses, a specific diagnosis is not always helpful in supportive care, but a fever can also be a sign of something more serious. Use your intuition and follow your gut!

Remember Mama -

Fevers can feel alarming, but they’re a normal part of the body’s healing process. Treat your child, not the number....and always trust your mama instinct.

Just a reminder: This isn’t medical advice—just information meant to help you feel more informed and empowered. Always check with your pediatrician or trusted healthcare provider if you’re unsure or have concerns. You know your child best!

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