• Posted December 16, 2023

Your Child Has a Fever: When Is It Time to See a Doctor?

It's that time of year when your kids come home with sniffles and sore throats, but when should you worry if they have a fever?

To a certain extent, fevers are the body's natural way of fighting infection, one expert says.

“Fever helps the immune system,” explained Dr. Christopher Tolcher, a pediatrician with Agoura-West Valley Pediatrics, part of the Chidlren's Hospital of Los Angeles network. “It slows down the spread of viruses and bacteria. It helps the body make more antibodies and chemicals that fight the infection, and it helps the immune system's cells move around better in the body.”

“Fevers are almost never dangerous...,” he said in a hospital news release. “A fever has to reach 107 to cause damage to tissues. That's extremely rare.”

That said, if your child's fever reaches 105 degrees, call your doctor. “It doesn't mean the child is in danger, but the child should be checked by the doctor that day to see what's going on,” Tolcher said.

A normal body temperature for a child ranges from 97 to 100 degrees, with an average of around 98.6. When a person's temperature reaches 100.4 or above, it's considered a fever.

But when is a fever considered a medical emergency?

Call your child's doctor right away for:

• A fever that lasts more than four to five days

• A fever (over 100.4) in a newborn younger than 2 months old

• A fever of 105 or higher in a child of any age, including teens

• A fever in an infant (under 1 year old) over 102 for more than two days

If your child has a fever and any of these other following signs, call your doctor right away or go to the emergency department:

• Widespread, red or purple rash

• Stiff neck and bad headache

• Severe pain, including bad abdominal pain

• Shortness of breath

• Extreme weakness or altered mental state

• Dehydration (diapers are dry, child is not peeing much and urine is dark)

• Seizures

Children under 5 can sometimes have a seizure during a fever. “Seizures are scary as heck to watch, but most of the time, you don't need to go to the ER,” Tolcher said.

If your child has a seizure that lasts less than two minutes, call your doctor. If a seizure lasts more than four to five minutes, call 911.

Now, if your child has a fever that can be treated at home, how can you best make your child comfortable while they recover?

“Focus on how the child is doing, not the number on the thermometer,” Tolcher said. “If the fever is 100.5, but the child is crying from a headache or earache, give a pain reliever. But if they have a 104 [temperature] and aren't that bad, just give them fluids and keep them comfortable.”

Too many layers of clothing and heavy blankets will raise the fever higher, so lightweight pajamas and light blankets are fine.

Give plenty of fluids. “The body burns through water a lot faster when it has a fever, which is why extra fluids are important,” Tolcher explained. “You don't want your child to get dehydrated.”

How to know when your child might be dehydrated? If your child's urine is dark, or your child is not peeing as often as normal, give more fluids. Give them whatever they will drink, including water, clear soups, electrolyte solution or popsicles.

“If a child has a 104 [temperature] and a lot of body aches, giving one medicine will bring it down two or three degrees. That's enough. You just want to make the child more comfortable," Tolcher noted.

In fact, “if you aggressively try to keep it down to 98.6, you slow the immune response to the infection,” he added.

Even if your child is miserable and you want them to feel better as quickly as possible, be careful not to overdose on the cold meds. Follow the directions on the label carefully.

The best medicines for fever are acetaminophen (Tylenol) or ibuprofen (Advil). Never give aspirin.

Most importantly, don't panic.

“We all need to rest when we're sick,” Tolcher said. “That's one of the benefits of fever. It slows you down and gets you to take a break.”

More information

Visit Nemours Kids Health for more on fevers in kids.

SOURCE: Children's Hospital, Los Angeles, news release, Dec. 2023

What This Means for You:

Fevers in kids can be frightening. Here, an expert offers advice on when to head to the doctor or ER.