Fever - When to worry

Many parents are concerned when their child develops a fever -- namely, that it will damage the brain.  Rest assured that a fever is just a sign of illness, and is not harmful.  Thankfully, most feversare caused by common conditions which will cause your child no harm.  In healthy kids, fevers usually don't indicate anything serious. Although it can be frightening when your child's temperature rises, fever itself causes no harm and can actually be a good thing — it's often the body's way of fighting infections. Also, not all fevers need to be treated. High fever, however, can make a child uncomfortable and worsen problems such as dehydration.  Please keep in mind that all kids get fevers, and in the majority of cases, most are completely back to normal within a few days. For older infants and children (but not necessarily for infants younger than 3 months), the way they act is far more important than the reading on your thermometer. Everyone gets cranky when they have a fever. This is normal and should be expected.  However, 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 the office for an appointment.

Children whose temperatures are lower than 102° F (38.9° C) often don't require medication 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 Dr. Simon or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in very young infants.

For children and infants older than three months, 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

Also, 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 normally, not eating as much as usual is OK.

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 the office or seek emergency care if you have an:

  • infant younger than 3 months old with a temperature of 100.4° F (38° C) or higher

Call the office for an appointment if your older child or baby has a fever and also:

  • refuses fluids or seems too ill to drink adequately
  • has persistent diarrhea or repeated vomiting
  • has any signs of dehydration (urinating less than usual, not having tears when crying, less alert and less active than usual)
  • has a specific complaint (e.g., sore throat or earache)
  • still has a fever after three days.
  • has recurrent fevers, even if they only last a few hours each night
  • has a chronic medical problem such as heart disease, cancer, lupus, or sickle cell anemia
  • has a rash
  • has pain with urination

Seek emergency care if your child shows any of these signs:

  • inconsolable crying
  • extreme irritability
  • lethargy and difficulty waking
  • 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
  • seizure
  • abdominal pain