Few things concern parents faster than a child with a high temperature. The good news is that a fever is often a sign your child’s body is fighting an infection. In many cases, fever can be monitored at home with rest, fluids, and guidance from your child’s pediatric provider.
Still, there are times when child fevers and when to really worry become a more urgent question. Your child’s age, temperature and symptoms all matter. Here is what parents should know about high fevers in kids and when to seek care right away.
What counts as a fever in kids?
A child is generally considered to have a fever when their temperature reaches 100.4°F (38°C) or higher. Digital thermometers are recommended, and for infants under 3 months, a rectal temperature gives the most accurate reading. Forehead thermometers can also be used for children of any age, while ear thermometers are generally best for children 6 months and older.
It is important to remember that the number on the thermometer is only part of the picture. A child with a lower fever who is hard to wake, dehydrated, or struggling to breathe may need more urgent attention than a child with a higher fever who is otherwise alert and drinking fluids.
When does your child’s fever call for emergency care?
Seek emergency care right away if your child has a fever and any of the following:
- trouble breathing
- blue lips, tongue or nails
- is hard to wake, confused, or not alert
- has a seizure
- has a stiff neck
- cannot walk or will not move an arm or leg normally
- shows signs of severe dehydration such as very little urine, no tears, a very dry mouth, or extreme sleepiness
For babies younger than 3 months, any fever of 100.4°F (38°C) or higher should be treated as urgent and in need of prompt medical evaluation. Pediatric guidance also advises not giving fever-reducing medicine to a baby under 12 weeks before they are seen by a clinician.
When should you call your pediatrician?
Call our care team at Plymouth Pediatric Associates promptly if your child:
- is 3 to 12 months old and has a fever of 102.2°F (39°C) or higher
- has a fever that rises above 104°F (40°C) repeatedly at any age
- still seems sick even after the fever comes down
- seems to be getting worse
- has a fever lasting more than 24 hours if under age 2
- has a fever lasting more than 3 days if age 2 or older
- has immune system problems or certain chronic medical conditions
- has a new rash, pain with urination, repeated vomiting or diarrhea, or other symptoms that concern you
High fever in kids by age: A quick guide
Newborns and infants
If your baby is under 3 months old and has a temperature of 100.4°F or higher, call a pediatrician or seek urgent medical care right away. Infants can get seriously ill quickly, even when they do not look very sick at first.
Babies 3 to 12 months
A fever of 102.2°F (39°C) or higher in this age group should prompt a call to your child’s provider. You should also call sooner if your baby is unusually sleepy, not drinking well, or showing signs of dehydration.
Toddlers and older children
Older children often tolerate fever better, so how they look and act matters a lot. If your child is drinking, resting, and acting more like themselves once the fever comes down, home care may be enough. But repeated fevers above 104°F, a fever lasting several days, or other such symptoms should still prompt a call.
Kids with a fever: What parents can do at home
If your child does not present emergency warning signs, you can usually start with supportive care at home:
- offer plenty of fluids to help prevent dehydration
- let your child rest
- do not force food if appetite is low
- use acetaminophen or ibuprofen according to your child’s weight and the package directions
- do not use ibuprofen in children younger than 6 months
- do not give aspirin to children unless specifically directed by a clinician
- avoid ice baths, alcohol rubs and other aggressive cooling methods
A fever does not always need to come all the way down to normal for your child to start feeling better. Sometimes even a small drop in temperature can improve their comfort.
Signs dehydration may be part of the problem
Fever can cause children to lose fluids faster, especially if they also have vomiting or diarrhea. Call us if your child has a dry mouth, fewer wet diapers, no tears when crying, sunken eyes, or unusual sleepiness. Seek urgent care if there is little to no urination, rapid breathing, confusion, or fainting.
The bottom line on child fever: When to worry
Most fevers in children are not emergencies, but some absolutely need fast attention. The biggest red flags are young age, breathing problems, difficulty waking up, seizure activity, a stiff neck, and dehydration. When in doubt, trust your instincts and call the care team at Plymouth Pediatric Associates
Need guidance for your child’s fever?
If your child is sick and you are not sure what to do next, we’re here to help. Call (508) 746-5900, to speak with our team, request a same-day sick visit, or ask whether your child should be seen right away.
