By Rachel Olis
Many parents have experienced waking in the middle of the night to find your child flushed, hot, and sweaty. Your little one’s forehead feels warm. You immediately suspect a fever, but are unsure of what to do next. Should you get out the thermometer? Call the doctor? Visit an emergency room?
Fever occurs when the body’s internal “thermostat” raises the body temperature above its normal level. This thermostat is found in the part of the brain called the hypothalamus. to keep it that way.
In 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. And not all fevers need to be treated. High fever, however, can make a child uncomfortable and worsen problems such as dehydration.
“Fevers are the number one reason parents bring their child to the emergency room,” said Dr. Mark Baker, an Emergency Medicine Physician at Children’s of Alabama and Assistant Professor at UAB. “They account for 20 percent of all patient visits, and typically, can be treated at home.”
So how should you treat your child’s fever? When is it appropriate to seek medical attention? Here are three recommendations:
1 – Simply Monitor Your Child at Home
Kids 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 your doctor or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in young infants, Baker said or some other attribution needed.
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 common with infections that cause fever. For kids who still drink and urinate normally, not eating as much as usual is okay.
2 – Contact your physician or visit and Emergency Room
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.
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, says Baker.
Sometimes kids with fever breathe faster and may have a higher heart rate. You should call the doctor if your child is having difficulty breathing, is breathing faster than normal, or continues to breathe fast after the fever comes down.
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 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 24 hours (in kids younger than 2 years) or 72 hours (in kids 2 years or older)
- 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
3 – Visit an Emergency Room
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
- abdominal pain
Also, ask your doctor for his or her specific guidelines on when to call about a fever.