Fever Fears: What to Do if Your Child Has a Fever

When to worry, when to relax — and when to call your doctor

A sick child with a fever lies down to rest while an adult takes his temperature with a thermometer.

A fever is an oral reading greater than 99 degrees Fahrenheit (37.2 degrees Celsius) or a rectal temperature greater than 100.4 degrees Fahrenheit (38 degrees Celsius).

A symptom of an illness, a fever is not by itself an illness. It is the body’s way of fighting infection and can actually stimulate the body’s immune system to help to fight off the infection.

Fever most commonly accompanies respiratory illnesses such as croup or pneumonia, ear infections, influenza (flu), severe colds and sore throats.

It also may occur with infections of the bowel, blood or urinary tract, inflammation of the brain and spinal cord (meningitis), and a wide variety of viral illnesses.

It is important to note that fevers are not dangerous by themselves (sometimes certain infections can be extremely serious) and a fever is not a cause of brain damage. About 4 percent of the population of young children (usually between the ages of 6 months and 5 years) may have a tendency for something called febrile seizures.

Although a scary event, this is usually a brief seizure — a minute or so — and is not harmful. Unless a febrile seizure is prolonged (more than 15 to 20 minutes) or there is something else going on, a simple febrile seizure is also not a cause of brain damage.

When to see your pediatrician

If your child has a fever and exhibits the following symptoms, he or she will need an evaluation:

  • Infants under 2 months of age with a documented rectal fever need to be evaluated immediately. Call your child’s doctor’s office right away. Infants under 6 months generally need to be seen during office hours or taken to urgent/emergency care.
  • Any infant or child who is acting sick or is getting dehydrated from not drinking fluids. Many children with fever will not be very interested in foods, but focus on keeping them hydrated with fluids.
  • Ongoing fevers more than 4 days without other symptoms
  • A specific complaint (such as an earache, sore throat, pain with urination, trouble breathing or other concerning symptoms)

How sick is my child?

How your child is acting is more important than how high the fever is going.

A baby or child is probably not seriously ill if:

  • A baby will coo, make eye contact, smile or reach for an object
  • A toddler will pay attention to activities, smile, or walk around to get things
  • An older child will engage in quiet activities like coloring or reading

A child may be more seriously ill if, despite reducing the fever (after a dose of acetaminophen or ibuprofen):

  • A baby is not making eye contact, refuses to feed, cries or cannot be comforted
  • A toddler refuses to play, cries inconsolably, moans, appears very weak, turns away and stares repeatedly, or is very hard to awaken if sleeping
  • An older child refuses to talk and won’t interact, or is unable to get out of bed
  • Keeps dropping off to sleep without periods of activity; remember sick children do tend to sleep more

During office hours, triage nurses are available to answer your questions.

This Scripps Health and Wellness information was provided by Scripps Coastal Medical Center Pediatrics in Encinitas.