When Fever Is a Sign of Something Serious
In the past, doctors advised treating a fever on the basis of temperature alone. But now they recommend considering both the temperature and a child's overall condition.
Kids whose temperatures are lower than 102°F (38.9°C) often don't need medicine unless they're uncomfortable. There's one important exception to this rule: If you have an infant 3 months or younger with a rectal temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in very young infants.
If your child is between 3 months and 3 years old and has a fever of 102.2°F (39°C) or higher, call your doctor to see if he or she needs to see your child. For older kids, take behavior and activity level into account. Watching how your child behaves will give you a pretty good idea of whether a minor illness is the cause or if your child should be seen by a doctor.
The illness is probably not serious if your child:
- is still interested in playing
- is eating and drinking well
- is alert and smiling at you
- has a normal skin color
- looks well when his or her temperature comes down
And don't worry too much about a child with a fever who doesn't want to eat. This is very common with infections that cause fever. For kids who still drink and urinate (pee) normally, not eating as much as usual is OK.
Here are ways to ease symptoms that often accompany a fever:
- If your child is fussy or uncomfortable, you can give acetaminophen or ibuprofen based on the package recommendations for age or weight. (Unless instructed by a doctor, never give aspirin to a child due to its association with Reye syndrome, a rare but potentially fatal disease.) If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out how much to give.
Infants younger than 2 months old should not be given any medicine for fever without being checked by a doctor. If your child has any medical problems, check with the doctor to see which medicine is best to use. Remember that fever medication will usually temporarily bring a temperature down, but won't return it to normal — and it won't treat the underlying reason for the fever.
When to Call the Doctor
The exact temperature that should trigger a call to the doctor depends on the age of the child, the illness, and whether there are other symptoms with the fever.
Call your doctor if you have an:
- infant younger than 3 months old with a rectal temperature of 100.4°F (38°C) or higher
- older child with a temperature of higher than 102.2°F (39°C)
Call the doctor if an older child has a fever of less than 102.2°F (39°C) but also:
- refuses fluids or seems too ill to drink adequately
- has lasting diarrhea or repeated vomiting
- has any signs of dehydration (peeing less than usual, not having tears when crying, less alert and less active than usual)
- has a specific complaint (like a sore throat or earache)
- still has a fever after 24 hours (in kids younger than 2 years) or 72 hours (in kids 2 years or older)
- is getting fevers a lot, even if they only last a few hours each night
- has a chronic medical problem such as heart disease, cancer, lupus, or sickle cell disease
- has a rash
- has pain while urinating (peeing)
Seek emergency care if your child shows any of these signs:
- crying that won't stop
- extreme irritability or fussiness
- sluggishness and trouble waking up
- rash or purple spots that look like bruises on the skin (that were not there before the child got sick)
- blue lips, tongue, or nails
- infant's soft spot on the head seems to be bulging outward or sunken inwards
- stiff neck
- severe headache
- limpness or refusal to move
- difficulty breathing that doesn't get better when the nose is cleared
- leaning forward and drooling
- abdominal (belly) pain
Fever: A Common Part of Childhood
All kids get fevers, and in most cases they're completely back to normal within a few days. For older babies and kids (but not necessarily for infants younger than 3 months), the way they act is more important than the reading on your thermometer. Everyone gets cranky when they have a fever. This is normal and should be expected.
But if you're ever in doubt about what to do or what a fever might mean, or if your child is acting ill in a way that concerns you even if there's no fever, always call your doctor for advice.