Fever in children can be unsettling for any parent. It’s a common symptom, but knowing when it’s just a normal part of fighting off illness and when it’s time to seek professional help from a Kids Doctor is crucial. This guide, based on insights from pediatrician Dr. Christopher Tolcher, FAAP, of Agoura-West Valley Pediatrics, part of the CHLA Health Network, will help you understand fever in children and when to consult with your pediatrician.
Understanding Fever in Children: When to Worry?
It’s essential to first understand what constitutes a fever. A child’s normal body temperature usually fluctuates between 97 to 100 degrees Fahrenheit, averaging around 98.6°F. A fever is medically defined when a child’s temperature reaches 100.4°F (38°C) or higher.
Fever is Not Always the Enemy
It might be surprising, but fever often plays a beneficial role when your child is sick. Dr. Tolcher explains, “Fever is actually helpful to the immune system. It’s a sign that the body is working to fight off an infection.” A fever helps slow down the propagation of viruses and bacteria, boosts the production of antibodies and infection-fighting chemicals, and improves the mobility of immune cells throughout the body. So, in many cases, a fever is a sign your child’s body is doing exactly what it should be doing.
How High of a Fever Requires a Kids Doctor Visit?
While fever is generally a helpful response, parents naturally worry about how high is too high. Dr. Tolcher reassures that “Fevers themselves are rarely dangerous, with the exception of hyperthermia, which is overheating due to external heat, not infection.” Actual tissue damage from fever is extremely rare, typically only occurring at temperatures reaching 107°F (41.7°C).
However, a very high fever does warrant attention from a kids doctor. If your child’s temperature reaches 105°F (40.5°C), Dr. Tolcher advises, “Call your doctor. It doesn’t automatically mean danger, but it’s important to have your child checked out that day to determine the cause.”
When to Immediately Contact Your Kids Doctor for Fever
There are specific situations when you should promptly call your kids doctor. Don’t hesitate to reach out if your child experiences any of the following:
- Fever Duration: A fever that persists for more than four to five days.
- Newborn Fever: Any fever (100.4°F or higher) in a baby younger than 2 months old. If you cannot reach your pediatrician, seek immediate care at the emergency department.
- Extremely High Fever: A temperature of 105°F (40.5°C) or higher at any age, including in teenagers.
- Infant Fever Concerns: In an infant under one year old, a fever over 102°F (39°C) lasting more than two days without an obvious cause.
Moreover, regardless of the fever’s exact temperature, certain accompanying symptoms are red flags that require immediate medical attention from a kids doctor or a visit to the emergency room:
- Unusual Rash: A widespread red or purple rash.
- Neurological Symptoms: Stiff neck combined with a severe headache.
- Intense Pain: Severe pain, especially significant abdominal pain.
- Breathing Difficulties: Shortness of breath or labored breathing.
- Altered Mental State: Extreme weakness or any change in mental alertness or confusion.
- Dehydration Signs: Signs of dehydration such as dry diapers, reduced urination, and dark urine.
Fever and Seizures: Knowing When to Seek Help
Febrile seizures can occur in children under the age of 5, triggered by fever. Dr. Tolcher acknowledges, “Seizures are very frightening for parents to witness. However, most of the time, a brief seizure does not necessitate an emergency room visit.”
- Short Seizure: If a seizure lasts less than two minutes, contact your pediatrician for guidance.
- Prolonged Seizure: If a seizure lasts for more than four to five minutes, it is crucial to call 911 immediately.
Fever, COVID-19, MIS-C, and Kawasaki Disease: What to Watch For
In the context of recent health concerns, it’s important to be aware of specific conditions potentially linked to fever. If your child has a fever lasting more than four to five days, or a high fever accompanied by any of the following symptoms, it’s important to consult with your kids doctor:
- Cracked red lips
- Red tongue
- Red eyes
- Swollen hands and feet
- Rash
- Abdominal pain
- Enlarged lymph nodes
These symptoms can be associated with conditions like Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease. Dr. Tolcher emphasizes, “MIS-C is rare, and while it’s important to be vigilant, parents shouldn’t panic. Awareness is key.” Your pediatrician can assess these symptoms and determine the appropriate course of action.
Practical Tips for Managing Fever at Home (and When to Call Your Kids Doctor)
Managing a child’s fever at home involves focusing on their comfort and hydration. Dr. Tolcher advises, “Treat the child, not the thermometer reading. Pay attention to how your child is acting, not just the fever number.” If your child is uncomfortable due to headache or body aches, even with a lower fever, consider giving pain relief medication. Conversely, a higher fever in a child who is otherwise relatively comfortable might only require fluids and rest.
Here are some helpful tips for home care:
- Avoid Overdressing: Overdressing or using heavy blankets can actually raise the fever and make your child more uncomfortable. Dress your child in light, comfortable pajamas and use light blankets.
- Ensure Hydration: Fever increases fluid loss, so hydration is vital. Dr. Tolcher explains, “The body uses water much faster when there’s a fever. Dehydration is a significant concern.” Encourage fluids like water, clear broths, electrolyte solutions, or popsicles. Monitor urine output; dark urine or less frequent urination are signs of dehydration, indicating a need for more fluids.
- Focus on Comfort, Not Just Lowering the Number: The goal of fever management is to improve your child’s comfort, not necessarily to bring the temperature down to a perfect 98.6°F. Reducing the fever by a couple of degrees can significantly improve comfort. Aggressively trying to eliminate the fever entirely may not be beneficial and could potentially interfere with the body’s natural immune response.
- Medication Dosages: If using fever-reducing medications like acetaminophen (Tylenol) or ibuprofen (Advil), always carefully follow dosage instructions. Keep track of when and what medication you administered to avoid accidental overdosing and adhere to the recommended dosing intervals on the label. Aspirin should never be given to children. If COVID-19 is suspected, acetaminophen is typically the preferred first choice.
Ultimately, keeping your child comfortable, well-hydrated, and rested at home is often the best approach for a typical fever. “Rest is crucial when we are sick,” Dr. Tolcher notes. “Fever helps slow us down, encouraging the body to rest and recover.” However, always trust your parental instincts and when in doubt, or if you observe any of the concerning signs mentioned, do not hesitate to contact your kids doctor for advice and care. Your pediatrician is your best resource for ensuring your child’s health and well-being.
