When you should worry about a fever

When to Worry About Your Child's Fever
When to Worry About Your Child's Fever


Were you a "Little House on the Prairie" fan? Someone was always dying from a mysterious fever, and if they didn't die, they were tortured in ice water baths by Doc and all the other villagers. A fever back then was scary for two reasons. One, it hallmarked an illness there was probably no treatment for, and two, there were no effective medicines to bring down the fever itself.

A fever is a part of our immune response, and it is useful. It raises the body temperature in an attempt to kill bacteria and germs. We commonly see fever with infections, the flu, the common cold and gastroenteritis. For the most part, they are benign and treatable.

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However, high fevers can cause seizures in some people, especially children, and fevers can be a sign of something much more serious.

When to worry:

  • If your child is less than four months old and has a fever over 100.4, call your doctor.

  • If the fever persists more than one day in child less than 2 years old, or in an older child more than three days, call your doctor. The underlying condition may be easily treated.

  • If you cannot control the fever with acetaminophen (Tylenol) or NSAIDs (Motrin, Advil), call your doctor.*

  • If you have a fever without other obvious symptoms, call your doctor. More serious conditions like blood clots, autoimmune disease, hormonal abnormalities and cancer can present with fever.

  • If your child is extremely lethargic, seems very sick, has a rash, stiff neck, sore throat, headache or earache, call your doctor. If your child has a seizure, or you are otherwise very concerned, call 911.

For the most part, fever is self-limited and will clear when the immune system gets the infecting agent under control. The fever itself is very uncomfortable, and while some people advocate riding it out, I always treat my children's fevers. I hate to see them suffer when I have the fix in my medicine cabinet. It is a good idea to keep track of your child's fever – with a good thermometer, not your hand – and to track how it responds to medicine. If you need to see your doctor, this will help him or her make an accurate diagnosis.

*While aspirin is a good fever reducer, it should never be taken by children or teens because of the risk of Reye's Syndrome.

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Originally published