In a very few cases, usually when the temperature rises rapidly, children younger than four may have what is known as febrile (meaning feverish) convulsions. This is terrifying for the parents, to be sure, but febrile convulsions are seldom harmful to the child. They are not usually an emergency, but do call your doctor know if your child has a febrile convulsion. It's also a good idea for parents to be learn in advance how to handle convulsions, even though the chances your child will have one are slim.

You should always call the doctor when:

• Fever of 101 degrees F or higher is present in babies younger than three or four months
• The fever is higher than 104 degrees F and doesn't respond to acetaminophen or ibuprofen and other home treatments within four or five hours
• If a child younger than three years (but older than three months) has a high fever that lasts for 24 hours
• The fever is accompanied by any extreme or unusual symptoms, for example: breathing problems, rash, drooling, stiff neck, vomiting, delirium, hallucinations
• There are signs of dehydration
• There's a lot of pain, especially in the abdomen
• The child acts very sick
• You're unsure about the symptoms and what to do
• Maybe something just doesn't seem right, or you need some reassurance
• Don't be afraid to call and ask questions, even if you feel silly or embarrassed.

In these days of automatic, high tech everything, it may surprise you that a no-tech method is a reliable way of detecting fever in children. Studies have shown that putting your lips (or the back of your hand) to the child’s forehead detects fever nine of ten times. Yet there are times when a yes or no answer on fever is not enough information, and that's when you'll need a thermometer at the ready. The rectal mercury thermometer made of glass remains the gold standard in terms of accuracy of measurement. A rectal thermometer is the one with the stubby little silver bulb at the end. A glass oral thermometer has a long, narrow tip. It is unsafe to use an oral thermometer in the rectum. Before taking a child's temperature, shake the thermometer down to below 96 degrees F. For a rectal temperature, first clean the thermometer with soapy cold water and then with rubbing alcohol. The child should lie face down; babies can lie across your lap. Coat the bulb end with petroleum jelly and insert the thermometer about an inch into the rectum. Place your hand across the buttocks, holding the thermometer in the "V" between your index and middle fingers. Wait two or three minutes, then remove and read.