It’s unsettling when your child feels warm to the touch, and the thermometer confirms it: fever. As parents, we naturally worry. Is it just a common cold, or something more serious? While fever is often a sign that your child’s body is fighting off an infection, knowing when to seek medical advice is crucial. This guide, based on expert recommendations, will help you understand fever in children and when it’s time to take your toddler or child to the doctor.
Understanding Fever in Children
A normal body temperature for a child typically ranges between 97°F (36.1°C) and 100°F (37.8°C), averaging around 98.6°F (37°C). When your child’s temperature reaches 100.4°F (38°C) or higher, it’s considered a fever.
It might seem counterintuitive, but fever is often a good sign. It’s a natural defense mechanism, indicating that your child’s immune system is working to combat an illness, usually an infection.
Dr. Christopher Tolcher, a pediatrician, explains, “Fever helps the immune system. It slows down the spread of viruses and bacteria. It helps the body make more antibodies and chemicals that fight the infection, and it helps the immune system’s cells move around better in the body.” So, in many cases, a fever is a helpful response, not something to immediately suppress entirely.
When is a Fever Too High in Children?
Parents often worry about how high a fever is. However, it’s reassuring to know that fevers themselves are rarely dangerous. The exception is hyperthermia, which is a dangerously high body temperature caused by external heat, not infection, such as being trapped in a hot car.
“Fevers are almost never dangerous, with the exception of ‘hyperthermia’, or a high body temperature from the body’s being unable to cool off in a very hot environment,” Dr. Tolcher clarifies. “A fever has to reach 107 to cause damage to tissues. That’s extremely rare.”
While tissue damage from fever is extremely unlikely, a very high fever does warrant medical attention. If your child’s temperature reaches 105°F (40.6°C), it’s recommended to call your doctor. “It doesn’t mean the child is in danger,” Dr. Tolcher adds, “but the child should be checked by the doctor that day to see what’s going on.” This ensures any underlying issues are addressed promptly.
Key Times to Call the Doctor for Your Child’s Fever
Knowing specific thresholds can help you decide when to seek medical advice. Call your child’s doctor promptly in these situations:
- Prolonged Fever: A fever that lasts for more than four to five days.
- Newborn Fever: Any fever (100.4°F or higher) in a baby younger than 2 months old. For newborns, fever can be a sign of serious infection, and they need immediate medical evaluation. 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 without Clear Cause: A fever in an infant (less than one year old) over 102°F (38.9°C) for more than two days, especially if there’s no obvious reason for the fever, like a mild cold.
Warning Signs with Fever: Seek Immediate Medical Help
Beyond the temperature itself, certain accompanying symptoms are red flags and require immediate medical attention. If your child has a fever AND any of the following signs, call your doctor right away or go to the emergency department:
- Rash: A widespread, red or purple rash, especially if it doesn’t blanch (fade) when you press on it. This could indicate a serious infection like meningitis or sepsis.
- Stiff Neck and Severe Headache: These can be signs of meningitis, an infection of the membranes surrounding the brain and spinal cord.
- Severe Pain: This includes intense pain, particularly bad abdominal pain, which could signal appendicitis or other serious conditions.
- Breathing Difficulty: Shortness of breath or labored breathing is always a serious symptom that needs immediate evaluation.
- Altered Mental Status: Extreme weakness, lethargy, confusion, or unusual drowsiness are concerning signs.
- Dehydration: Signs of dehydration include dry diapers (less frequent urination), not peeing much, and very dark urine. Dehydration can become serious quickly in children, especially when they have a fever.
Fever and Seizures in Children
Febrile seizures, seizures triggered by fever, can occur in children, particularly those under the age of 5. While frightening to witness, most febrile seizures are brief and do not cause lasting harm.
“Seizures are scary as heck to watch, but most of the time, you don’t need to go to the ER,” Dr. Tolcher reassures.
Here’s what to do if your child has a seizure with a fever:
- Short Seizure: If the seizure lasts less than two minutes, call your doctor for advice.
- Prolonged Seizure: If a seizure lasts more than four to five minutes, call 911 or your local emergency number immediately.
Fever, COVID-19 and MIS-C
With the emergence of COVID-19, parents have additional concerns. It’s important to be aware of potential complications, although they are rare.
Call your doctor if your child has any fever that persists for more than four or five days. Additionally, be vigilant for the following symptoms, especially in conjunction with a high fever, as they could be signs of Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition linked to COVID-19:
- Cracked red lips
- Red tongue (sometimes called “strawberry tongue”)
- Red eyes
- Swollen hands and feet
- Rash
- Abdominal pain
- Enlarged lymph nodes
“I want to reassure parents that MIS-C is rare,” Dr. Tolcher emphasizes. “We need to watch for it, but don’t freak out.” Being informed and observant is key, but remember that MIS-C remains uncommon.
Tips for Managing Fever at Home
For most fevers, home care is sufficient to keep your child comfortable while their body fights off the illness. Here are some helpful tips:
- Treat the Child, Not Just the Number: Focus on how your child is feeling and acting, not just the thermometer reading. If they are uncomfortable, even with a lower fever, you can consider fever-reducing medication. Conversely, a higher fever in a child who is otherwise comfortable might not require medication. “If the fever is 100.5, but the child is crying from a headache or earache, give a pain reliever. But if they have a 104 and aren’t that bad, just give them fluids and keep them comfortable,” advises Dr. Tolcher.
- Avoid Overdressing: Over-bundling your child with too many layers or heavy blankets can trap heat and raise their temperature further, making them more uncomfortable. Dress them in lightweight, comfortable pajamas and use light blankets if needed.
- Encourage Fluids: Fever increases fluid loss, so it’s crucial to keep your child well-hydrated. “The body burns through water a lot faster when it has a fever, which is why extra fluids are important,” Dr. Tolcher explains. Offer water, clear broths, electrolyte solutions, or popsicles. Monitor urine output – dark urine or decreased urination are signs of dehydration.
- Focus on Comfort: The goal of fever management isn’t necessarily to bring the temperature down to a perfect 98.6°F. Reducing the fever by a few degrees can significantly improve your child’s comfort. “If a child has a 104 and a lot of body aches, giving one medicine will bring it down two or three degrees. That’s enough. You just want to make the child more comfortable.” Remember that fever is part of the body’s healing process, and suppressing it too aggressively might not be beneficial.
- Administer Medication Carefully: Use acetaminophen (Tylenol) or ibuprofen (Advil) as directed for fever and pain relief. Always follow the dosing instructions on the label and be careful not to give extra doses or exceed the recommended frequency. Never give aspirin to children, especially during a fever, due to the risk of Reye’s syndrome. If COVID-19 is suspected or confirmed, acetaminophen is the preferred first choice.
In conclusion, while a fever can be concerning, it’s often a sign that your child’s body is working to get better. By understanding when to monitor at home and when to seek medical help, you can confidently care for your child during a fever. Remember to prioritize their comfort, keep them hydrated, and allow them to rest. “We all need to rest when we’re sick,” Dr. Tolcher concludes. “That’s one of the benefits of fever. It slows you down and gets you to take a break.”
Disclaimer: This article provides general information and should not be considered medical advice. Always consult with your pediatrician or healthcare provider for any health concerns or before making any decisions related to your child’s health and treatment.
