Caring for a Child With a Fever: Part 2

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when to worry about a fever

Contributed by Chelsea Wicks, M.D.

fever-child
Unless your child is in the first two months of life, there is no magic number to worry about in terms of fever. However, in newborns fever is often the only sign that a major bacterial infection occurring.  

Chelsea Wicks, MD, continues her discussion about caring for a child with a fever. Here she explains when a fever is cause for concern and when it’s time to see a doctor or head to the ER.

Is a Newborn’s Fever Cause for Concern

Unless your child is in the first two months of life, there is no magic number to worry about when he or she has a fever. In newborns fever is often the only sign that a major bacterial infection is going on. In that case a baby with any temperature above 100.4 needs to be evaluated as soon as possible. For other age groups, fevers can get rather high and not be anything more than a viral process that just needs to work itself out.

There’s an old wives tale that high fevers cause brain damage. Not true. On rare occasions, a rapid increase or decrease in temperature can lead to febrile seizures (seizures induced by fever). This only occurs in a small percentage of people tend to have low seizure thresholds already and it is extremely rare for it to lead to any long term consequences.
In infants, the most accurate way to take the temperature is rectally. If you don’t feel comfortable doing this, under the arm is the next best option. As the child gets older, I like the temporal (forehead) scanners or oral thermometers. Ear thermometers do not seem to be very accurate.

Time to Worry About a Child With a Fever

    • If you cannot get the fever down or if the fever goes on for more than three to four days, or if your child has other concerning symptoms (ear pulling, complaining of a bad sore throat, trouble breathing) it is time to get them in to see their doctor.
    • If they seem lethargic or unresponsive, go to the ER or call 911.

This is meant to give you a little peace of mind so you don’t feel you need to rush in anytime your toddler or teenager gets a high fever. However, as with anything, if you’re worried it’s always worth talking with your doctor to determine if your child should be evaluated.

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