It is the middle of the night, your child feels hot, and one number has your full attention. Before you decide what to do, there is another number that matters: your child's age. This episode gives you a fever plan you can remember when you are tired and worried.
Babies 3 months and younger
A rectal temperature of 100.4°F (38°C) or higher means calling your pediatrician immediately, even if your baby seems comfortable. If you cannot reach a clinician promptly, go to an emergency department. Do not wait until morning, or wait to see whether fever medicine brings the temperature down. Young babies can have a serious infection before they show the signs we expect in an older child.
Older children: look beyond the thermometer
- Fever is a sign that something is happening, often an infection. It does not tell us which infection or how serious it is.
- Watch how your child is breathing, whether they respond to you normally, whether they can drink, and whether they are passing urine.
- Perking up after fever medicine can be reassuring, but it does not prove the illness is harmless.
Call emergency services or seek emergency care for
- Severe trouble breathing, blue or gray lips, or a child who cannot be awakened
- Fever with a stiff neck or signs of severe dehydration
- A child who seems seriously ill, even if the temperature is not very high
Contact your pediatrician promptly if your child
- Is getting worse, cannot drink adequately, or is urinating much less
- Still looks very ill when the fever falls
- Has temperatures that repeatedly rise above 104°F (40°C)
- Has had fever for more than 24 hours (under age 2) or more than 3 days (age 2 and older)
Call sooner if you are concerned. Children with immune problems may need assessment sooner. Follow any individual fever plan your child's clinician has given you.
Home care
- Offer fluids often and allow rest. For babies, continue breast milk or formula.
- Keep clothing comfortable. Avoid ice baths and alcohol rubs.
- Fever medicine is mainly about comfort, not chasing a normal number. Confirm the product and dose for your child's current weight and age, check the concentration, and use the supplied measuring device.
- No ibuprofen under 6 months unless a clinician directs it. No aspirin for a child's fever. Don't invent an alternating medicine schedule.
Do this today
Save your pediatrician's after-hours number and share it with the other caregivers in your child's life. When you call, give your child's age, the temperature and how you measured it, when the fever started, what they are drinking, how they are acting, and any medicine name, dose and time.
Ask Dr. Tega is general education. It cannot examine your child, diagnose a problem through a comment, or replace urgent care. If your child is seriously unwell, seek help immediately.