In urgent care, kids with fevers are among our most common patients. Parents often worry that a fever is dangerous, sometimes even wondering if it could cause brain damage. They may also think that a high fever must mean their child is seriously ill. But while a fever is usually a sign that something is going on, it’s rarely dangerous or even a sign of a severe illness.
What causes a fever?
A fever — usually defined as a rectal temperature at or above 100.4 degrees Fahrenheit (38 degrees Celsius) — can be the brain’s way of helping the body fight an infection, because our immune systems work better at higher temperatures. The most common cause is a viral infection, during which a fever might develop and then go away in two or three days. A fever may also be a sign of a bacterial infection, such as an ear infection or strep throat. In rare cases, a fever can be a sign of an inflammatory or other serious medical condition.
Medications like ibuprofen and acetaminophen help “trick” the brain into temporarily lowering the fever, and can help make kids feel more comfortable. Don’t be surprised, however, if the fever returns after these medications wear off.
Is a fever dangerous?
Although it’s a sign of illness, a fever itself is almost never dangerous. Fevers that occur during an infection don’t cause brain damage. (Remember, the brain is creating the fever on purpose to help the body fight infection!) A small percentage of young children (3-5 percent) could develop febrile seizures, which tend to run in families. While this may look scary, it does not cause brain damage or increase the risk of a child developing epilepsy. It is more important to watch how your child is feeling and acting than it is to worry about his or her fever.
There are a few exceptions. Dangerously high fevers (over 106 degrees Fahrenheit) can be caused by external heat exposure, such as being left in a hot car. They also can occur when a child has an underlying brain injury or tumor, causing the brain to function abnormally.
How can I help?
If your child has a fever and is happy, playful, and appears comfortable, most times it’s best not to treat the fever. Pediatricians usually recommend treating a fever only when it is causing your child to be uncomfortable.
Here are some ways to care for a child with a fever:
- Dress your child lightly, don’t over dress them.
- Give your child plenty of liquids.
- Have your child rest or play quietly.
- Give your child medicine, such as acetaminophen (Tylenol) or ibuprofen (for children over 6 months), to treat the discomfort from a fever. Make sure you know how much and when to give any medications. Check with your child’s doctor or a pharmacist if you are unsure. Most pediatricians don’t recommend alternating fever medications. Usually it’s best to choose one and stick with it.
- Do NOT give your child aspirin or use rubbing alcohol to bring down a fever.
- If your child has a seizure, place your child on the floor on his side and stay with them. Call 911 if the seizure lasts longer than five minutes, or if your child is not recovering quickly, has trouble breathing, or seems very ill. Call your child’s doctor if the seizure is less than five minutes and your child seems to be recovering well (is awake and alert and breathing comfortably).
Pediatricians usually recommend treating a fever only when it is causing children to be uncomfortable, so if your child is still happy, playful, and appears to be acting otherwise normally, it’s usually best to just let the fever run its course.
When should I call the pediatrician?
Most children with a fever for less than two or three days can be treated at home if they are otherwise feeling well. You should call your child’s pediatrician’s office if you have any questions or concerns, or if your child:
- Is younger than three 3 months old with a rectal temperature of 100.4 degrees Fahrenheit or higher (Very young babies have a higher risk of more serious infections than older babies and children.)
- Has a fever for more than two to three days
- Seems very sick or is in pain
- Has other symptoms with the fever that worry you (such as trouble breathing, irritability, ear pain, headache, stiff neck, a rash, or pain with urination)
- Has a seizure
- Has special health care needs or medical problems that make fevers more concerning, such as sickle cell disease, cancer, or immune problems
- Isn’t drinking enough or has signs of dehydration (decreased urination, dry mouth, lack of tears, or decreased activity)
If you are unsure of what to do or worried about your child, call your pediatrician’s office. They will give you advice on home treatment and let you know if or when your child should be seen. If your doctor’s office is closed, you may be directed to urgent care, or even the emergency department. Those of us at urgent care are always happy to help make sure your child is well and give plenty of advice on how to keep your child comfortable.
