Fever in children can be a cause for parental concern, but it’s often a sign that their little bodies are fighting off an infection. As a parent, it’s crucial to understand when a fever warrants a call to the pediatrician and how to care for your child at home. This guide, based on expert advice, will help you navigate fever management and recognize when it’s time to seek professional medical help.
Understanding Fever in Children
A normal body temperature for a child typically fluctuates between 97°F (36.1°C) and 100°F (37.8°C), averaging around 98.6°F (37°C). A fever is defined as a temperature of 100.4°F (38°C) or higher.
The Beneficial Role of Fever
It might seem counterintuitive, but fever is often a good thing. It’s a natural defense mechanism that plays a vital role in helping your child recover from illness.
Dr. Christopher Tolcher, a pediatrician with Agoura-West Valley Pediatrics and part of the CHLA Health Network, explains, “Fever helps the immune system by slowing down the growth of viruses and bacteria. It also aids the body in producing more antibodies and infection-fighting chemicals, and improves the mobility of immune cells throughout the body.” In essence, a fever is a sign that your child’s body is actively working to get better.
When Does a Fever Become Dangerously High?
While fevers are generally not harmful, very high temperatures due to external factors can be an exception. “Fevers are almost never dangerous unless it’s hyperthermia, which is a dangerously high body temperature caused by the body overheating in hot environments,” Dr. Tolcher clarifies. “A fever would have to reach 107°F (41.7°C) to cause tissue damage, which is extremely rare in typical illness-related fevers.”
However, a fever reaching 105°F (40.6°C) should prompt a call to your doctor. “It doesn’t necessarily mean the child is in immediate danger,” Dr. Tolcher assures, “but it warrants a same-day check-up to determine the underlying cause.”
Recognizing When to Seek Medical Attention for Fever
Knowing when to call the doctor is crucial. Here’s a guide to help you decide when professional medical advice is necessary for your child’s fever:
Call Your Child’s Doctor Immediately If:
- Prolonged Fever: The fever lasts for more than four to five days.
- Newborn Fever: Your newborn, under 2 months old, has a fever of 100.4°F (38°C) or higher. For infants in this age group, fever can be a sign of serious infection and requires immediate medical evaluation. If you cannot reach your pediatrician, seek emergency department care.
- Extremely High Fever: Your child, regardless of age, reaches a temperature of 105°F (40.6°C) or higher.
- Infant Fever without Clear Cause: An infant (less than one year old) has a fever over 102°F (38.9°C) for more than two days without an obvious reason, such as a cold.
Seek Immediate Medical Attention If Fever is Accompanied By These Symptoms:
If your child has a fever AND experiences any of the following symptoms, it’s essential to contact your doctor right away or go to the emergency department:
- Unusual Rash: A widespread, red or purple rash. This could indicate various infections, some of which require prompt treatment.
- Stiff Neck and Severe Headache: These symptoms can be signs of meningitis, a serious infection of the membranes surrounding the brain and spinal cord.
- Intense Pain: Severe pain, especially bad abdominal pain, which could be a sign of appendicitis or other serious conditions.
- Breathing Difficulties: Shortness of breath or labored breathing. Respiratory distress needs immediate evaluation.
- Extreme Weakness or Altered Mental State: Lethargy, unresponsiveness, confusion, or significant changes in behavior. These can be signs of serious illness affecting the brain or body systems.
- Dehydration: Signs of dehydration, such as fewer wet diapers than usual, infrequent urination, dark urine, dry mouth, and lack of tears when crying. Dehydration can be a serious complication of fever, especially in young children.
Fever and Seizures in Children
Febrile seizures, seizures triggered by fever, can occur in children under 5 years old. While frightening for parents to witness, most are not dangerous.
- Brief Seizures: If a seizure lasts less than two minutes, call your pediatrician for guidance.
- Prolonged Seizures: If a seizure lasts longer than four to five minutes, call emergency services (911 in the US) immediately.
Fever and COVID-19, MIS-C, and Kawasaki Disease
With ongoing concerns about COVID-19 and related conditions, it’s important to be aware of specific fever-related symptoms that require medical attention.
Call your doctor if your child has a fever lasting more than four or five days. Additionally, seek medical advice if a high fever is present alongside any of these symptoms:
- Cracked Red Lips, Red Tongue, Red Eyes: These can be symptoms of Kawasaki disease or Multisystem Inflammatory Syndrome in Children (MIS-C), rare but serious conditions that can sometimes occur after infections, including COVID-19.
- Swollen Hands and Feet: Another potential sign of Kawasaki disease or MIS-C.
- Rash: Various types of rashes can be associated with these conditions.
- Abdominal Pain: Abdominal pain can be a symptom of MIS-C.
- Enlarged Lymph Nodes: Swollen glands in the neck area.
Dr. Tolcher reassures parents, “MIS-C is rare. We need to be vigilant, but there’s no need to panic.” However, awareness and prompt medical evaluation of these symptoms are crucial.
Tips for Managing Fever at Home
For many fevers, home care is sufficient to keep your child comfortable while their body fights off the illness. Here are some helpful tips:
- Focus on Your Child’s Comfort, Not Just the Thermometer Reading: “Treat the child, not the number,” advises Dr. Tolcher. “Pay attention to how your child is acting. If they have a low-grade fever but are clearly uncomfortable due to headache or ear pain, administer pain relief. Conversely, a higher fever with a child who is relatively comfortable might only require fluids and rest.”
- Avoid Overdressing: Over-bundling with heavy clothing or blankets can trap heat and further elevate body temperature, making your child more uncomfortable. Dress your child in lightweight, comfortable pajamas and use light blankets if needed.
- Ensure Adequate Hydration: “The body loses fluids more rapidly when it has a fever, making hydration crucial,” Dr. Tolcher emphasizes. Monitor urine output. Dark urine or decreased urination frequency are signs of dehydration, indicating the need for more fluids. Offer water, clear broths, electrolyte solutions, or popsicles to encourage fluid intake.
- Prioritize Comfort Measures: The goal isn’t to eliminate the fever entirely, but to make your child more comfortable. “You don’t need to bring the fever down to a perfect 98.6°F (37°C),” Dr. Tolcher explains. “Reducing a high fever by a couple of degrees can significantly improve comfort. Aggressively trying to suppress the fever to normal levels might actually hinder the immune response.”
- Administer Medication Carefully: If using fever-reducing medication like acetaminophen (Tylenol) or ibuprofen (Advil), strictly adhere to dosage instructions and intervals on the label. Avoid exceeding recommended doses or frequency. Never give aspirin to children, especially during fever, due to the risk of Reye’s syndrome. For suspected or confirmed COVID-19, acetaminophen is generally recommended as the first-line medication.
Ultimately, the key to managing fever in children is to prioritize their comfort, ensure they are well-hydrated, and allow them to rest. “Rest is essential when we are sick,” concludes Dr. Tolcher. “Fever can actually be beneficial in this regard, encouraging rest and allowing the body to recover.” Knowing when to seek professional medical advice is equally important for ensuring your child’s well-being.
