Fever: Watch the Child, Not the Number

Fevers are a part of childhood, but they can still be scary for a parent to manage. Your little one is hot and may be cranky, tired and clingy. It’s easy for your mind to race right to all kinds of possibilities… ”What could be wrong?” “Is it serious?” “Am I missing something?” “Should I call the doctor?”

So for this week’s blog, we talked with Dr. Sarah and triage nurse Nanci about all things fever – when to ride it out, when to come in, when to get urgent help, and how to make your little guy feel better.

When is it OK to take care of things at home?

When deciding if a fever is mild or serious, Dr. Sarah says, “Your child is more important than the number. A child who is interacting and having playful moments is much less worrying than a child who is groggy and just not themselves, no matter what the thermometer says.”

So if you child is over three months of age, has no other major symptoms (like repeated vomiting, trouble breathing, or a bad cough) and is acting ok, then it’s fine to treat a fever at home.

Keep them comfy and make sure they’re still eating and drinking. You know your child is drinking enough if they have 3 or more wet diapers in a day; or if they’re older, if they visit the toilet at least twice a day. Their appetite might be down a bit, but they should still show interest in some good comfort foods: soup, crackers, popsicles, etc. Babies will often nurse less or take less out of a bottle, but you should still see three or more wet diapers in a day. Also, a low grade fever may make them want an extra nap, but they should still have playful and alert times.

Dress your child lightly to let their body heat escape. Two piece outfits are better than one piece pj’s because they let the heat “vent” at the waist. You can try a tepid bath, but avoid cold baths or wiping them down with alcohol swabs. Both can bring on the chills.

Tylenol is also fine for all ages. Motrin is also an option for kids over 6 months of age.

Of course, you can call us at any time. Even if your child meets all the conditions to treat a fever at home, we are more than happy to talk it through with you. We are always here to help.

When should I really call the office?

If you child is under three months old, call us with any fever over 100.4. Fever, even a low one, in a newborn can be sign of something serious and we’d want to check everything out.

If your older child just isn’t acting right – they’re difficult to wake, not interacting like normal (this may just be making eye contact and cooing in a baby, or having a conversation with a child), not eating or drinking much at all, not wetting diapers or visiting the toilet, etc…then give us a call. Remember, behavior is often your biggest indication of how sick your child really is.

If your child has a fever AND symptoms like a headache, sore throat, vomiting or diarrhea, give us a call to talk it over. Some things like strep throat may only bring on a low fever, but still are better caught early and need an office visit. Also, just give us a call if your child has a fever that lasts more than 3 days, even if there are no other symptoms.

When should I get urgent help?

Visit the closest emergency room for any of the following.

If your child is under 3 months old and has a fever above 100.4, you may want to give us a call, but you may also want to visit the ER if your baby seems very warm or very floppy.

If your child has a febrile seizure. These types of seizures are often not serious, but should still be checked out.

If you child is having trouble breathing – breathing very rapidly, struggling to breathe so much that their nose flares or their stomach sucks in under the bottom of their ribs, or they have any bluish color around their lips.

If you cannot wake your child or they wake but are very disoriented for more than a few minutes after waking.

Remember, we’re here to help you no matter what. So if you just want to talk things through, if you need advice on treating at home, or if you have had an urgent situation, you can call us at any time.

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