When should a child’s fever be reduced?

This is possibly one of the more important lessons on this website:
It is not the fever itself that is concerning, and it is not the reduction of fever that is important but the treatment of the symptoms accompanying fever, including:
– Agitation
– Non-specific pain, including headaches and muscle pain
– Accelerated breathing
– Pallor and more

So, how high of a fever should you treat?

The answer to this is not a specific number, but rather depends on the general appearance of the child.
Some kids can run around the house looking great at a fever of 38.5 degrees Celsius (101.3 Farenheit). Others may look awful already at a fever of 38.2 degrees Celsius (100.8 Fahrenheit), and in these kids it is worthwhile giving antipyretics and analgesics even if the fever is not very high.
There is no doubt that the majority of children will not feel well with a high fever (above 39 degrees Celsius or 102.2 Fahrenheit). So, when the fever is as high as 39, we tend to always give antipyretics and analgesics.
In children who have a medical history significant for febrile seizures (read more about this here) there is a tendency to be slightly more “aggressive” with reduction of fever and to administer antipyretics even if the fever is low and the child is well-appearing.
Note that despite the logic behind this approach, it hasn’t proven successful in the prevention of febrile seizures…
Before we end off, I’d like to just remind you once again that the one important measure of the severity of the disease is how the child appears and feels after the fever has been reduced. If he is well appearing, smiling, playing and his skin colour is normal – there is no reason for concern.