Of all the frightening moments in parenthood, few match the first time you realize your child has a fever (okay, maybe the first time she drives a car). There is just something about that warm little forehead that seems wrong. But are fevers really a cause for alarm, or are they just a normal part of getting sick? The answer depends on three things: the child’s age, the height of the temperature, and the timing of the fever.
The next thing we want to know is how high the temperature is. As a general rule, if a child’s temperature is over 104° F we like to check her out within 24 hours to see if we can determine the cause of the fever. When it’s over 105° F, we like to see children even sooner, even if that means going to an urgent care center or emergency department. That’s not because the fever itself is dangerous to the child; it’s not (more on that in a moment). It’s simply because higher fevers sometimes make us worry about more serious types of infections. That said, even very high fevers most often result from harmless viral infections.
Next we want to know how long the fever has lasted. As a general rule, many viral illnesses will produce 1-3 days of fever early in the infection. Fevers that last four or more days or that begin several days into a cold are more likely to indicate bacterial infections like ear infections or pneumonia, so your child’s doctor is probably going to want to see her at that point.
Bottom line: if you’re worried your child seems unusually ill, it’s never wrong to seek care!
Fevers may accompany other conditions for which a call to the doctor is quite urgent, regardless of the child’s temperature. If your child has breathing difficulty, chest pain, or wheezing, it’s time to seek care. Confusion, seizures, or severe and unexplained pain or fussiness should also prompt a call, possibly to emergency medical services (EMS). Neck stiffness, severe headache, repeated vomiting, or severe diarrhea are always concerning. Bottom line: if you’re worried your child seems unusually ill, it’s never wrong to seek care!
Know that fevers go up and down naturally as the levels of our bodies’ stress hormone (cortisol) rise and fall. We see parents all the time who are afraid that if their child doesn’t have a fever at the moment of the office visit we won’t take them seriously. Don’t worry: we know that fevers occur most often in the early morning hours and again in the early afternoon.
Many parents worry that fever will somehow harm their child, possibly causing brain damage. You can relax! This cannot and does not happen. The body’s core temperature has to get up to around 108° F in order to cause damage, and fevers arising from illness cannot get this high. Temperatures like these may arise when children are locked in hot cars or when athletes are forced to exercise in warm weather without adequate hydration.
Febrile seizures are scary as all get-out for a parent, but they are generally harmless. They sometimes accompany fevers in children between the ages of six months and five years. If your child has a febrile seizure that lasts more than fifteen minutes, call EMS, otherwise call her doctor when it’s over. Febrile seizures can occur just as easily with low fevers as with high ones, and aggressively treating children with fever-reducing medicines or tepid baths doesn’t make them any less likely to occur.
Dr. Hill is a paid spokesman for PediaCare®, a brand of Prestige Brands, Inc. or its affiliate (Prestige). The content of his posts represents his own thoughts and opinions. Such content is merely informational and is not intended as medical advice. If readers require medical advice or have particular medical needs for themselves or anyone else, they should consult a doctor or other appropriate medical professional.