Wrenny had her first fever from a virus at 7 months. It was the worst! Her eyes were so droopy and it was the first time I actually saw her frown. What I wouldn’t give to take all that sick away and see her smiling again. Having a sick infant or child is heart-breaking and sometimes scary, because your laughing, energetic babe transforms into the opposite :(. This article will help you determine whether or not your child has a fever and decide what to do about it.
What is a fever?
So we can get on the same page, let’s start with the basics. A fever is a rise in body temperature that’s temporary, usually a response mounted by your body to fight infection.
A fever is …
- Body temperature >100.4
- An emergency in infants < 1-month-old due to their naïve immune system
- An increase in body temperature, often triggered by the immune system, as a mechanism to fight an infection
- Possibly caused by other things besides infection
How do I measure my child’s temperature?
There are a variety of thermometers available, but the most reliable in-home measurement comes from an oral or rectal thermometer. Other thermometers may be more convenient, less invasive, and provide a good ballpark, but they’re not the most accurate measure. Touching the skin is also not an accurate or objective gauge of the intensity of a fever, but it can signal that you should get a real measurement.
Here’s a great article with more details on how to check your child’s temperature.
Should I give medicine?
There are medications available to treat fever, including acetaminophen, commonly known as the brand name Tylenol, and ibuprofen, commonly known as brand name Motrin. However, if you confirm your child has a fever, you don’t have to immediately treat the fever with medication. The fever is actually doing an important job by creating a hotter than normal environment in the body to help you fight off the infection. Viruses and bacteria are less likely to survive in a hot environment. Some studies show that allowing the fever (rather than bringing the body temperature down) can actually decrease the duration of an infection.
But, we know that fevers can make your child feel really bad. They can have a rapid heartbeat, fast breathing, chills and sweats, or feel very tired or fussy. If they’re super uncomfortable, we definitely recommend treating the fever. In that moment, it’s more important for them to be comfortable and get rest than to tough out a fever.
If you decide to treat the fever, you can use acetaminophen at any age and ibuprofen after 6 months of age. Dosing is weight-based, not age-based. Check out our Fever Medication Dosing Tables as well as our Symptom Checker for more guidance!
Should I go to the emergency room?
We see fever as one piece of the puzzle. You shouldn’t go to the ER for fever alone. There’s no magic number that makes us automatically recommend going to the ER or coming into the office to see us. Instead, we want to look at all the other puzzle pieces:
- Is your child breathing ok?
- Is your child drinking/feeding well enough and keeping hydrated?
- Is your child in a lot of pain?
- Does your child have enough energy to play or engage with you?
If most of the answers above are YES, then you don’t need to seek immediate or emergent medical care, and you can probably continue supporting your child at home. Remember, as doctors, we never treat a number. We treat your whole child, and we need to keep the big picture in mind.
Remember, if you’re not sure what to do, you can phone the physician on call at our office number for advice. If you feel like your child needs urgent attention and our office is closed, we recommend Kapiolani Medical Center After Hours Clinic if they’re open, or their emergency room, due to their expertise in caring for children.
How long do fevers last?
Most fevers will take about 3-5 days to resolve, though for viral infections, other symptoms can last longer than that and sometimes linger for weeks (pesky coughs and sniffles). Fever should not linger beyond 5 days. Also,fever should also have a pretty obvious cause … like if your child has a fever as well as a cold or a tummy bug then it makes sense that they’d have a fever. But if your child is having a fever with NO other symptoms for 5 days straight, then definitely give your pediatrician a call for further investigation.