Kids and Fever: When Do You Call the Doctor?

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If your child has a high temperature, it’s not necessarily cause for alarm. We asked our experts when it’s time to worry, or when to let a fever run its course.

It can be frightening for any parent, especially first-timers: Your child feels warm, panic quickly sets in and you reach for the thermometer.

But a child’s fever — which is any temperature above 100.4 degrees — isn’t necessarily cause for alarm. Fevers serve an important purpose. “Fevers are a side effect of the body trying to fight an infection — either viral or bacterial,” explains Vanessa Slots, M.D., a pediatrician with Renown Medical Group

Just Chill

Once a child is over the age of 3 months, a fever has less cause for concern, Dr. Slots says.

Still, be mindful of symptoms in conjunction with the fever, which may require medical attention. In general, you’re in the safe zone if your child’s fever aligns with the following:

  • Duration: If your child’s fever lasts less than five days, their behavior is relatively normal and they are eating and drinking, you can relax. Your child will, however, show signs of fatigue.
  • Low-Grade: If your child was recently immunized, expect a low-grade fever that shouldn’t last more than 48 hours.
  • Temperature: A temperature up to 102.5 degrees is not cause for alarm in children age 3 months to 3 years. For older children, the temperature can reach 103F.

When to Worry

Fevers in children under the age of 3 months are cause for alarm and should always be evaluated, generally in an ER where testing can be done quickly and easily,  Dr. Slots says. Their immune systems are not fully developed, leaving them vulnerable to infections. Sometimes a fever is the only sign that something is amiss. You should also seek medical attention in the following situations:

  • Duration and Treatment: The fever lasts longer than five days and is not responding to medications, including Tylenol or Motrin.
  • Return: A fever returns after several days. Your child should be evaluated for potential secondary infections such as ear or sinus infections.
  • Immunizations: Your child was recently immunized and has a fever that is above 102 or lasts longer than 48 hours.
  • Behavior: Your child’s behavior is not normal, you have difficulty rousing them or they’re not consuming enough liquids.
  • Temperature: A fever rises above 104 degrees.

Seizures from Fever

While jerking movements often denote a seizure, sometimes children experiencing a febrile seizure simply look like they’ve passed out.

If a seizure occurs or your child is not fully responsive, it’s important to first make sure your child is safe, then work to reduce the fever, Dr. Slots says. Do not administer oral medication to a child experiencing a seizure. Use a cool compress or place ice in the armpit or groin to lower body temperature.

“The cause of febrile seizures is linked with how quickly a child’s temperature rises — not about how high the temperature goes,” Dr. Slots says. 

Reducing a Fever

A child with a high fever and typical behavior may not need intervention, while a child with a low-grade fever who appears low-energy and uncomfortable might need treatment.

“Fevers do not always need to be medicated,” Dr. Slots says. “I recommend treating the child, not the fever.”  

Dr. Slots recommends the following to reduce fevers:

      • Cool compresses
      • Placing ice in the armpit or groin
      • Lukewarm baths
      • Tylenol for children over 2 months old

Ibuprofen is not recommended until a child is over 6 months old. Check with your primary care provider to get the most accurate, weight-based dose for your child.

More Than Fever

As Dr. Slots noted, be mindful of your child’s entire health picture, not just their temperature. Watch for other symptoms that may point to the flu or a stomach bug, for example. If in doubt, always seek medical attention.

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