When Should You Worry About Your Child’s Fever?

Your knee-jerk reaction when your child develops a fever may be to immediately start ringing the alarms. Fevers can be scary for parents, especially first-timers. You might wonder how high is too high or if you should call the doctor immediately if your child has one or head straight to the emergency room. Certainly, something must be done, right?

Well, not always. It turns out that not all fevers are something to fret about. And knowing the difference between a fever that needs treatment and a fever that can be left to run its course can help your child get better faster — and with less stress on you.

“Every child will eventually experience a fever, no matter how careful you are,” says pediatrician Tracy Lim, MD.

And it’s important for parents and caregivers to know what to do when this happens. Dr. Lim explains how to spot a worrisome fever in children and when to take your baby to the hospital for a fever.

Child fever temperature chart

A “normal” body temperature is 98.6 degrees Fahrenheit, or 37 degrees Celsius, but that doesn’t mean you have to hit the panic button if your child’s temperature inches above that.

Everyone’s temperature will vary a little throughout the day. It can also differ by age, activity level and other factors. The type of thermometer you use will change the definition of what’s actually a fever for your child, too. Different kinds of thermometers have different levels of accuracy.

“It’s most accurate to use a rectal thermometer for infants and young children, but if you feel uneasy doing this, use whichever device makes you most comfortable,” Dr. Lim advises. “In older children, an oral temperature is most accurate, if the child is able to tolerate it.”

Recognizing fever symptoms in children

A fever may be a sign that your child is fighting an infection from the common cold, flu, ear infection, stomach bug or a urinary tract infection (UTI).

It can be difficult to spot certain symptoms in your baby or child. But your child may also experience the following symptoms if they have a fever:

• Chills.
• Body aches.
• Headaches.
• Earache.
• Fatigue.
• Sweating.
• Fussiness.
• Flushed or pale complexion.
• Increased heart rate.
• Not eating or drink well.
• Excessive thirst.
• Decreased urination.
• High-pitched crying.

“If your child experiences any of these symptoms when the fever comes down, you should contact your pediatrician’s office,” instructs Dr. Lim.

How to treat a fever at home

It can be worrying to see your kid spike even a mild fever. We get it. But the truth is that a fever is actually a sign that your child is fighting off germs. It’s doing what it’s supposed to. And that’s a good thing.

Dr. Lim says doctors tend not to worry about a fever if it’s mild, lasts fewer than five days and doesn’t affect your kid’s day-to-day activities. Mild fevers can be monitored at home. If needed, you can also treat them or safely break a fever with:

• Fever-reducing medication such as infant or children’s acetaminophen (Tylenol®).
• Cool compresses.
• Plenty of liquids to prevent dehydration.
• Rest.

When to see a doctor for a fever

Now, for the important question: When should you be worried about your baby’s fever? Do you know when to take your toddler to the ER for a fever?

Call your doctor in these cases:

• Your infant under 3 months has a fever: Fevers may be your infant’s only response to a serious illness. Especially in newborns, a low temperature can also be a sign of serious illness. Call a healthcare provider if your baby has any fever or if their temperature drops below 97.7 F (36.5 C) rectally.
• Your infant or child over 3 months has a fever: In babies and children over 3 months, call a healthcare provider if your child’s fever is higher than 104 F (40 C), or if the fever doesn’t come down with a fever-reducing medication.
• Your child’s fever lasts more than five days: Your pediatrician may need to investigate further for underlying causes.
• Your child’s fever doesn’t come down with fever reducers: Infant and children’s versions of medications like acetaminophen can be used at home in babies and children if OK’d by their healthcare provider. The medications should work quickly to reduce your child’s fever. Contact your doctor if your child’s fever continues even after using a fever-reducing medication.

Emergency situations

In certain cases, a fever can be present with other symptoms that may be a sign of a serious illness.

Head to the ER or call 911 or emergency services, if your child has a fever and any of the following:

• Extreme sluggishness or drowsiness.
• Lack of appetite.
• Excessive drooling or difficulty swallowing.
• Continuous crying.
• Stiff neck.
• Fever rash.
• Difficulty breathing.
• Blue lips, tongue or nails.
• Pain or tenderness in their abdomen.
• Redness or swelling.
• Dehydration.
• Decreased urination.
• Strange behavior.
• Altered speech.
• Difficulty waking or extreme sleepiness.
• Convulsions or seizures.

Seizures can be a very scary side effect of fevers in some children. Febrile seizures occur in 2% to 4% of all children under age 5. Not all seizures cause jerking movements in the body. Dr. Lim says some seizures look like “passing out.”

If your child develops a seizure:

• Put your child on their side.
• Do NOT put anything in your child’s mouth.
• Call 911 or emergency services if the seizure lasts more than five minutes.

If the seizure lasts fewer than five minutes, call your physician or seek immediate medical attention.

Bottom line?

It can be scary when your child has a fever and it can be nerve-racking to know when to take your child to the ER for a fever.

While most fevers are considered mild and can be treated at home, Dr. Lim says if you’re concerned or have questions, don’t hesitate to call your child’s pediatrician to ask for guidance and advice.

“Your pediatrician’s office can help determine if your child’s symptoms require evaluation in the office,” she says.