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

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

A child with a fever gets his temperature taken.

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

It’s normal to worry when your child is running a fever. The younger your child is the more worried you are likely to be. Fever in children, especially babies, will do that.

First-time parents may want to call their doctor right away. But it’s important to know that most fevers are harmless. They usually run their course within a few days with proper treatment at home. There are exceptions of course and knowing when to call your doctor can make a difference in case of an emergency.

“Learning what causes fevers and how to reduce fever in children with or without medication will help ease your anxiety,” says Karen Wilson, MD, a pediatrician at Scripps Clinic Carmel Valley. “Knowing when to call your doctor is an important part of that learning.”

Fever in children

A fever is a body temperature that is higher than normal. It is not an illness, but a sign or symptom of one. “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,” Dr. Wilson says. Compared to adults, children are more likely to develop a fever in reaction to an infection.

Fever in children is defined as a rectal temperature above 100.4 degrees Fahrenheit or 100.4 F (38 degrees Celsius or 38 C), or an oral temperature above 99 degrees F (37.2 C).

Fever most commonly accompanies respiratory illnesses, such as:

  • Croup
  • Pneumonia
  • Ear infections
  • Influenza (flu)
  • Severe colds
  • Sore throats

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

Only about 1 out of 100 children with fever have a serious medical problem that needs to be treated by a doctor, according to the National Institutes of Health.

Home remedies for children with fever

Medication is generally not needed to treat fever in children unless the child is experiencing discomfort or has another condition. Acetaminophen or ibuprofen may be given to reduce fever and improve your child’s comfort. Follow instructions on the package for recommended dose. Avoid giving aspirin.

Pediatricians recommend the following home remedies for fever in children:

  • Keep things comfortably cool in the house and dress your child lightly
  • Encourage your child to drink liquids, including water, diluted fruit juices, electrolyte solutions, gelatin, popsicles
  • Prevent over exertion

Check if your child is eating and sleeping well and is able to play before deciding to give medication. He or she may not need it.

“How your child is acting can often tell you more about the fever,” says Dr. Wilson.

Your child’s behavior can often indicate when a potentially more serious illness is involved. Keep an eye on:

  • A baby who is not making eye contact, refuses to feed, cries or cannot be comforted
  • A toddler who 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 who refuses to talk and won’t interact or is unable to get out of bed

“Your child is probably not seriously ill if, for example, he or she is a baby and still coos, makes eye contact, smiles or reaches for an object,” Dr. Wilson says. “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.”

When to call your doctor

The exact temperature that should trigger a call to your doctor depends on the child’s age and in some cases the presence of other symptoms, according to the American Academy of Pediatrics (AAP).

Call your doctor if you have:

  • An infant younger than 2 months with a rectal temperature of 100.4 F
  • A child under the age of two with a fever that persists for longer than 24 hours
  • A child age two and older with a fever that persists for more than 72 hours or 3 days
  • If the fever rises above 104 F repeatedly for a child of any age

Call your doctor if your child, in addition to fever, exhibits the following symptoms:

  • Drowsiness, fussiness
  • Stiff neck, severe headache, severe sore throat, severe ear pain, unexplained rash, repeated vomiting or diarrhea
  • Has signs of dehydration but is unable to take in fluids
  • Has had a febrile seizure

What is a febrile seizure?

Febrile seizures are fever-induced convulsions in children. They are usually harmless and don’t indicate a serious health problem. Still, parents are urged to call their doctor as soon as possible after the first febrile seizure. “While this is a scary event, most febrile seizures are brief and do not cause long-term health problems,” says Dr. Wilson.

Febrile seizures occur in 2 to 5% of children before five years of age, according to AAP. During a convulsion, the child may have a high fever, lose consciousness and shake or jerk their arms and legs. Unless a febrile seizure is prolonged (lasting more than 15 minutes) or there is something else going on, a febrile seizure does not mean the child has epilepsy.

“Fever in children and the symptoms that follow can be alarming, but in an otherwise healthy child, it usually is not something serious,” Dr. Wilson says.