Fevers: Your Questions Answered

In our last blog post on fevers, we explained what a fever is and why it happens. These are a few of the most common questions that parents have for their doctors when it comes to fevers.

How High Is Too High?

There’s no panic number since an elevated temperature is the body’s natural response to infection. A higher fever does not always mean a more serious illness. It’s important to consider both the child’s temperature AND the child’s overall condition. For instance, is your child interested in playing? Is your child drinking and still having wet diapers or urinating normally? Are you able to calm your child’s fussiness or does your child perk up when the temperature goes down? Is your child’s skin color normal? As a physician, I would be reassured if you answered ‘yes’ to these questions, because it would mean your child’s condition is good, even though he or she might have a high temperature.

When Should I Call the Doctor?

Here are some situations that may mean you need to call your doctor right away:

Symptoms: Call your child’s doctor if any of the following symptoms occur along with the fever.

• If your answer is ‘no’ to any of the questions above regarding drinking, activity, urination, color.
• If your child is having difficulty breathing.
• If your child has specific pain complaints that aren’t improving with over the counter medications such as ibuprofen or acetaminophen.
• If your child has pain with urination.
• If your child has a new rash that looks like bruises on the skin and this rash began after your child became sick.
• If your child has a severe headache or is having neck pain that causes significant neck stiffness.

Medical conditions: If your child has a chronic medical problem and fever of 100.4F or higher, then call your pediatrician or specialist right away.

Infants: Call your doctor right away if your child is less than 3 months of age and has a fever of 100.4 or higher.

Older infants and toddlers: If your child is between 3 months and 2 years and they are otherwise doing well (see questions above), monitor the fever for 24 hours and call your doctor if your child still has a fever or if your child’s condition worsens.

Older toddlers: If your child is over the age of 2 and they are otherwise doing well, monitor your child’s fever for 72 hours and call your doctor if your child is still feverish or if your child’s condition worsens.

When Should I Give Medicine to My Child?

If your child is less than 3 months of age, then please talk to your pediatrician or see your pediatrician before giving them medicine to reduce their fever. If your child is older than 3 months with a fever and is uncomfortable, then you can give them medications to bring down the fever and make them more comfortable.

But, if your child is not uncomfortable and sleeping well or playing happily, then medication is not necessary. A high temperature or fever is the body’s natural response to infection and is not harmful to your child’s body. If fever-reducing medication is not working for your child, you can call your pediatrician for advice on the correct dose for your child’s weight.

Many families worry about fevers triggering seizures, but higher fevers do not mean a higher risk of febrile seizures, and fever-reducing medications do not have any impact on the risk of a febrile seizure

What Should I Use to Keep My Child More Comfortable When They Have a Fever?

For children that are older than 6 months, ibuprofen helps with fever, pain and inflammation. Some common brand names for ibuprofen are Advil and Motrin. For children of all ages, acetaminophen is safe to use and also brings down fevers. Common name brands for acetaminophen include Tylenol and Pediacare.

NEVER use ice or cold water to bring your child’s fever down. It is not safe and will make your child uncomfortable. Also, avoid bundling your child in more layers of clothing or blankets, because this makes it more difficult for the body to release the extra heat and cool down.

If your child does not meet any of the general rules above, but you are still worried about their fever and illness, then don’t hesitate to call your pediatrician. Your pediatrician is there to help you!