Fevers are a common concern for parents when their child is unwell. While a fever is often a sign that your child’s body is fighting off an infection, it’s natural to worry and wonder when it’s serious enough to seek medical attention. As a pediatrician, I often address parents’ concerns about fever. Let’s clarify what fever means, its benefits, and, most importantly, when you should take your child to the doctor.
Understanding Fever in Children
A child’s normal body temperature typically ranges from 97°F (36.1°C) to 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. It’s crucial to understand that fever itself is not an illness, but rather a symptom indicating the body’s immune system is active.
The Positive Role of Fever
Fever, while causing discomfort, actually plays a beneficial role in helping your child recover from illness. Dr. Christopher Tolcher, a pediatrician with Agoura-West Valley Pediatrics, explains, “Fever helps the immune system by slowing down the multiplication 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, fever is a natural defense mechanism that boosts your child’s ability to fight off infections.
When Does a Fever Become Too High?
It’s understandable to be concerned about how high a fever can rise. Generally, fevers are not dangerous unless they reach extreme levels, such as in cases of hyperthermia, where the body overheats due to external factors like a hot environment, not infection. “A fever would have to reach 107°F (41.7°C) to potentially cause tissue damage, which is exceptionally rare in typical fever caused by illness,” Dr. Tolcher reassures.
However, a temperature of 105°F (40.6°C) warrants a call to your pediatrician. While it doesn’t necessarily indicate immediate danger, Dr. Tolcher advises, “At 105°F, it’s important to have your child evaluated by a doctor on the same day to determine the underlying cause and ensure appropriate care.”
Specific Scenarios: When to Go to the Doctor for Fever
Knowing when to seek medical help is crucial. Here are specific guidelines on when to call your child’s doctor for fever:
Call Your Doctor Immediately If:
- Fever Duration: The fever lasts for more than four to five days.
- Newborn Fever: Your child is under 2 months old and has a fever of 100.4°F (38°C) or higher. For infants this young, any fever requires immediate medical attention. If you cannot reach your pediatrician, go to the emergency department.
- Extremely High Fever: A fever of 105°F (40.6°C) or higher in a child of any age, including teenagers.
- Infant Fever (Prolonged): An infant (under one year old) has a fever over 102°F (38.9°C) for more than two days without an obvious reason.
Fever Accompanied by These Symptoms Requires Urgent Medical Attention:
If your child has a fever AND any of the following symptoms, it’s crucial to call your doctor immediately or go to the emergency department:
- Widespread Rash: A red or purple rash spreading across the body.
- Stiff Neck and Severe Headache: These can be signs of meningitis and require immediate evaluation.
- Intense Pain: Severe pain, particularly abdominal pain, that is persistent and worsening.
- Breathing Difficulties: Shortness of breath or labored breathing.
- Extreme Weakness or Altered Mental State: Significant lethargy, confusion, or unresponsiveness.
- Dehydration Signs: Reduced urine output (fewer wet diapers, less frequent urination), dark urine, and signs of dry mouth.
Fever and Seizures in Children
Febrile seizures can occur in children under 5 years old during a fever. While alarming, Dr. Tolcher clarifies, “Febrile seizures are frightening to witness, but in most instances, they are not emergencies requiring an immediate ER visit.”
- Seizure Less Than Two Minutes: If a seizure lasts less than two minutes, contact your pediatrician for guidance.
- Seizure More Than Four to Five Minutes: If a seizure persists for more than four to five minutes, call emergency services (911 in the US) immediately.
Fever, COVID-19, MIS-C, and Kawasaki Disease
It’s important to be aware of specific conditions related to fever, especially in the context of recent health concerns. If your child experiences a fever lasting more than four to five days, it warrants a call to your doctor. Additionally, be vigilant for the following symptoms alongside a high fever, as they could be associated with conditions like MIS-C (Multisystem Inflammatory Syndrome in Children) or Kawasaki disease, particularly in the context of or following a COVID-19 infection:
- Cracked red lips
- Red tongue
- Red eyes
- Swollen hands and feet
- Rash
- Abdominal pain
- Enlarged lymph nodes
Dr. Tolcher emphasizes, “MIS-C is rare, and while awareness is important, parents should remain informed but not overly alarmed.”
Tips for Managing Fever at Home
When caring for a child with a fever at home, focus on their overall well-being rather than solely on the thermometer reading. Dr. Tolcher advises, “Treat the child, not the number. If your child has a low-grade fever but is clearly uncomfortable with a headache or earache, administering pain relief is appropriate. Conversely, a higher fever in a child who is relatively comfortable may only require fluids and supportive care.”
Here are practical tips for managing fever at home:
- Avoid Overdressing: Over-bundling with excessive layers or heavy blankets can trap heat and elevate the fever, increasing discomfort. Dress your child in lightweight, comfortable clothing and use light blankets as needed.
- Ensure Hydration: Fever increases fluid loss, making hydration crucial. “The body utilizes water more rapidly when a fever is present, so ample fluid intake is essential to prevent dehydration,” Dr. Tolcher explains. Monitor urine output; dark urine or decreased urination frequency indicates the need for more fluids. Good choices include water, clear broths, electrolyte solutions, or popsicles.
- Focus on Comfort: The goal of fever management is to improve your child’s comfort, not necessarily to eliminate the fever entirely. “Reducing the fever by a couple of degrees can significantly alleviate discomfort without completely suppressing the body’s natural immune response,” notes Dr. Tolcher.
- Medication Dosing: If using fever-reducing medication like acetaminophen (Tylenol) or ibuprofen (Advil), adhere strictly to the recommended dosage and intervals. Avoid exceeding the recommended dose or frequency. Never give aspirin to children. For suspected or confirmed COVID-19, acetaminophen is preferred as the first-line medication.
Ultimately, rest is a vital part of recovery. “Rest is beneficial when ill,” Dr. Tolcher concludes. “Fever serves a purpose by encouraging rest, allowing the body to focus on healing.”
In summary, while fever is a common symptom in children and often a sign of the body fighting infection, knowing when to go to the doctor for fever is crucial. Trust your instincts as a parent, observe your child’s overall condition, and don’t hesitate to seek medical advice when you have concerns, especially if any of the warning signs mentioned above are present.
