Fevers: When to Call a Doctor
As a parent, few things cause more concern than feeling your child's forehead and discovering they have a fever. While fevers are incredibly common in children and are usually a sign that the body is fighting an infection, knowing when to seek medical help can be challenging. This guide will help you understand when a fever requires a doctor's attention and when home care is appropriate.
A fever is generally defined as a rectal temperature of 100.4°F (38°C) or higher. While fevers themselves are not dangerous and are actually a beneficial part of the immune response, certain situations require professional medical evaluation. Understanding these key indicators will help you make informed decisions about your child's health and give you peace of mind during those worrying moments.
Call 911 or Go to the Emergency Room If:
- Your child has a fever and won't wake up or is difficult to arouse
- Your child has a stiff neck, severe headache, or purple rash that doesn't blanch when pressed
- Your child is having difficulty breathing or turning blue
- Your child has a seizure lasting more than 5 minutes
- Your child appears severely ill or you feel something is seriously wrong
- Your infant under 3 months old has a rectal temperature of 100.4°F (38°C) or higher
Call Your Doctor Within 24 Hours If:
- Your child is 3-6 months old with a fever of 101°F (38.3°C) or higher
- Fever lasts more than 3 days (72 hours)
- Fever goes away for more than 24 hours and then returns
- Your child has pain with urination or burning when urinating
- Your child has a fever and recently received an immunization that seems excessive
- Your child has a chronic medical condition (heart disease, cancer, sickle cell disease, etc.)
- Your child is acting very irritable or unusually lethargic
Age-Specific Temperature Guidelines
Newborns (0-3 months)
Call immediately for any rectal temperature of 100.4°F (38°C) or higher. Infants this young have immature immune systems, and fevers can indicate serious infections like meningitis or sepsis. Never give fever-reducing medication without consulting your doctor first.
Infants (3-6 months)
Call your doctor for temperatures of 101°F (38.3°C) or higher. While these babies have slightly more developed immune systems, fevers still warrant medical evaluation. Your doctor may want to examine your baby to rule out serious infections.
Infants and Toddlers (6 months - 2 years)
Call if fever persists for more than 24-48 hours or if temperature exceeds 103°F (39.4°C). Pay attention to your child's behavior and other symptoms. If they're drinking fluids, playing normally, and the fever responds to medication, home care is often sufficient.
Children (2 years and older)
Call if fever lasts more than 3 days or exceeds 104°F (40°C). Focus on how your child is acting rather than the exact temperature. If they're drinking, urinating normally, and responsive between fever episodes, continue monitoring at home.
Frequently Asked Questions About Fevers
What temperature is considered a fever?
A fever is generally defined as a rectal temperature of 100.4°F (38°C) or higher. For oral temperatures, 99.5°F (37.5°C) or higher is considered a fever. Axillary (underarm) temperatures are typically about one degree lower than oral readings. Rectal temperatures are the most accurate for infants and young children.
How should I take my child's temperature?
Well Visit ScheduleFor children under 3 years old, rectal temperatures are most accurate. For older children, oral or temporal artery (forehead) thermometers work well. Avoid using ear thermometers for babies under 6 months, as the ear canal is too small for accurate readings. Always wait 30 minutes after your child eats or drinks before taking an oral temperature.
Does the height of the fever indicate how sick my child is?
Not necessarily. A child with a 104°F fever and a viral infection may be less sick than a child with a 100.5°F fever and a serious bacterial infection. How your child looks and acts is more important than the actual temperature number. Focus on symptoms like lethargy, dehydration, difficulty breathing, or extreme irritability rather than the fever itself.
Should I alternate between acetaminophen and ibuprofen?
This is a common question, and the answer depends on your child's comfort. The American Academy of Pediatrics states that you can use either medication alone or alternate them if fever is causing significant discomfort. However, never give aspirin to children due to the risk of Reye's syndrome. Always follow dosing instructions carefully and consult your pediatrician if you're unsure.
Can fevers cause brain damage?
No. This is one of the most common fever myths. Fevers caused by infections do not cause brain damage. Only body temperatures above 107.6°F (42°C) can cause harm, and such temperatures are almost never caused by infections. They typically result from heatstroke or other environmental factors.
What about febrile seizures?
Febrile seizures occur in about 2-5% of children between 6 months and 5 years old. While frightening to witness, they're generally harmless and don't cause long-term problems. They're more likely to occur when temperature rises rapidly. If your child has a febrile seizure, place them on their side, ensure they're safe from injury, and call your doctor after the seizure ends. If it lasts more than 5 minutes, call 911.
Should I wake my child to give fever medication?
No. Sleep is more important for healing than lowering a fever. If your child is sleeping comfortably, let them rest. Fever medication is for comfort, not to eliminate the fever completely. The goal is to help your child feel better, not to achieve a "normal" temperature.
When can my child return to school or daycare?
Most schools require children to be fever-free for 24 hours without fever-reducing medication before returning. This helps prevent spreading illness to other children. Check with your child's school or daycare for their specific policies.
What home care should I provide for a child with a fever?
Ensure your child drinks plenty of fluids to prevent dehydration. Dress them in lightweight clothing and keep the room at a comfortable temperature. You can give appropriate doses of acetaminophen or ibuprofen for comfort. Avoid cold baths or alcohol rubs, which can cause shivering and actually raise body temperature. Most importantly, watch for concerning symptoms and trust your parental instincts.
Trust Your Instincts
You know your child best. If something doesn't seem right or your child appears seriously ill, don't hesitate to call your pediatrician or seek medical attention. It's always better to err on the side of caution when it comes to your child's health.
