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If its over 102 or if they are miserable and just some relief. Usually though my kids get happy fevers!

eta: when younger and they couldn't talk I ALWAYS treated if they were over 101!

If they are miserable and/or in pain.
I can usually bring down a fever with a bath/shower and fluids.

ETA: @2PeasinaPod: That's probably why I try other methods with J - I don't take Tylenol for when I have a fever unless I've tried the fluids/shower and they aren't working. We just do what we know

When he had an ear infection and was just miserable without it.

I give medicine based on behavior instead of the fever itself. Our ped told us to do that instead of relying on a number. If he's miserable, we do medication, if he's warm but doing just fine, then we don't!

Mid 101 and up

@mrbee: A fever is a first line of defense against a contagion. Your body is literally raising its temperature to kill or slow down the replication of the virus/bacteria. It's a good thing! You only need to bring down the temperature if you aren't handling the fever well - if it's making you miserable or unable to drink fluids, or sleep etc. That's why it's more important to look at your kid's behaviour, not the number on the thermometer.

We give Tylenol if he is upset/hysterical and seems sick. Sometimes we give him some right before bed if he has a very high fever (102 or so?) just so we're not so worried overnight. Otherwise, if he just has a fever, even a high one, we try comforting him in other ways.

Recently, he had a stomach bug and the nurse we spoke to at his pediatrician's office said to avoid giving medicine if at all possible because it could further upset his stomach. It seemed strange not to give him anything, but he was fine just nursing and napping for 24 hours.