When Should You Be Worried About a Fever?

At our pediatric clinic, questions about fever account for about 90% of our after-hours phone calls. Parents are very fearful of the effects of a fever and worry about whether their child should see a doctor immediately.

The definition of a fever is a temperature over 100.4 degrees and I often tell parents that fever is just a symptom and its presence doesn’t give us any clue to the nature of the infection or how severe it will be. We don’t fully understand why our body needs to maintain a higher temperature when fighting an infection. Some experts believe that our efforts to bring the temperature down go against the body’s tendency to keep a higher temperature while the immune system is turned on. However, many parents continue to overreact when their child has a fever.

What are the common causes of fever?

A good place for parents to start understanding fever in their child is by determining what is a normal temperature for their child. For some children, a normal temperature runs from 99 degrees to 100 degrees, anything below 100.4 should not be treated with medicine. It is more important to let the body fight off the fever, as a fever is nature’s response to fighting off whatever infection your child might have.

The best thing you can do for your child if they are running a low-grade fever is to make sure the child is hydrated. When a child is hydrated his temperature will go down, we know this because if the child is not hydrated the fever will not go down. When children are sick and have a fever, they often do not want to eat and that is fine, but it is very important to keep them hydrated by offering fluids about every five minutes.

Does a high fever mean a more serious infection?

How high a fever is doesn’t always correlate to how severe the infection is. When assessing symptoms, it really doesn’t matter if the child has a fever of 102 degrees or 103 degrees, every child has a unique immune system and some will have a high fever with an illness, whereas another child might have a lower temperature with the same illness. It is important to look at the child and ask what are the symptoms? Are they eating, playing and sleeping? How are they doing with normal daily activities?

Many parents fear that a high fever will cause brain damage and that is why they go to the Emergency Room in the middle of the night, but the statistic do not support that. Some children are more likely to have a history of high temperatures with minor infections.

When should you take your child to the doctor for a fever?

While every situation is different, here are the general guidelines I recommend when your child has a fever:

• Any fever lasting more than three days.
• If a child is vomiting for more than 8 hours.
• If there is difficulty breathing.
• If a child has no urine in over 6-8 hours.