Ask Dr. Brinn
When should I call the doctor about my baby's temperature?
When a pediatrician gets a call from an anxious parent after midnight, nine times out of 10, it's about fever. Fever is part of the body's response to fight infection.
The most common cause of sudden-onset fever is a viral infection, an illness that will run three to five days. The child may experience off-and-on lethargy, decreased appetite, headache, and perhaps respiratory or gastro-intestinal symptoms.
When Should You Worry About Fever?
I tell my moms and dads: NEVER worry ONLY about ANY fever number caused by illness alone. With any infection, a child's fever may run between 101 and 105 – or more – degrees. However, the thermometer reading is not an accurate measure of how sick your child is.
Instead, focus on what is important. How your child looks and acts matters far more than body temperature.
- Consider how long the child has had fever. If it's three days, that child – of any age – should see a doctor. It's very unusual that a child over 2 months of age would have a serious illness with only hours of fever.
- If the child is under 2 months of age, call the doctor for any rectal temperature of 100.4 or higher.
- Monitor your child's behavior. A fever may not be cause for worry if the child is responsive even for 10 or 15 minutes before becoming lethargic again, or is able to play or take fluids.
- Watch for other symptoms. If your baby is unresponsive or sick-looking, that may signal a more serious problem.
Febrile Seizure
Parents may fear the possibility of a "febrile seizure," or a seizure with fever.
Only anticonvulsant medication can prevent a seizure with fever, but that drastic measure is uncalled for in most cases. If your child has had a seizure with fever in the past, discuss the pros and cons of preventive therapy with your doctor.
A high fever does not, in itself, cause a seizure. The seizure results from a rapid rise in temperature, say from 100 to 104 in a matter of seconds. If your child has a 105 degree fever, and has not seized, chances are a seizure won't happen with that spike of fever. A brief seizure warrants a call to your child's doctor. But if it lasts three minutes, call 911.
Managing Fever
You may offer the correct dose of ibuprofen OR acetaminophen to help lower the fever. Do not alternate these two medicines; it will not control fever spikes or prevent seizures. And never offer aspirin. Light clothing and a cool room may also make your child more comfortable.
Never keep sponging your baby with fever once shivering begins. You should stop immediately as shivering increases body heat and can lead to a seizure.
If you are concerned about your child's temperature, certainly call your doctor or bring the child to the office to be examined.
Steven Brinn, MD, is a local pediatrician with Liberty Sharonville Pediatrics, serving as an editorial consultant for Young and Healthy.
