Fevers worry parents; they scare them sometimes. I understand why. After all, a fever can be a sign of something serious — and at the beginning of one, it’s hard to know whether it’s going to turn out to be something serious.
Most of the time, it isn’t serious. Fevers are very common. They are part of how the body fights infection. The average child will get several viral infections a year — which means several fevers. The vast majority of fevers are nothing to worry about, and pass in a day or two.
Sometimes, though, parents should worry. Here are some circumstances when you should be worried about a fever and seek medical attention immediately:
–If your child is less than 3 months old. While most fevers in newborns turn out just fine, their defenses are still getting up and going and they aren’t very good at telling us what hurts.
–If the fever is accompanied by a dark rash (small or larger spots, flat or raised) that looks almost like a bruise and doesn’t get paler when you press on it. This can be a sign of a serious infection.
–If your child is extremely sleepy or extremely irritable. This always worries doctors. Kids are often sleepy and cranky when they get sick. What I’m talking about here is when that sleepiness and crankiness get severe. If you aren’t sure whether your child’s symptoms are severe, call and talk to your doctor (or the person on call).
–If your child has severe pain, or difficulty moving any part of the body (like the neck).
–If your child has trouble breathing, or is breathing more quickly or forcefully than usual. It could be a sign of a serious lung infection.
–If your child has a condition, or is taking a medication, that makes it harder for them to fight infection. It’s important to check in early with your doctor.
It’s also a good idea to call your doctor if:
–Your child has a fever greater than 102 F (or 39 C). It’s probably nothing serious, but it’s worth checking in with a doctor or nurse to go through things and see if a visit to the office or emergency room makes sense.
–Your child has a rash with the fever (not like the one described above, for that, go right to the emergency room). It’s most likely nothing to be worried about, but some viruses worry us more than others (like measles, or chicken pox) and some bacterial infections that need antibiotics (like strep throat, or cellulitis) can cause rashes.
–The fever has lasted more than two to three days. Again, probably nothing to worry about, but worth checking in to be sure.
–Your child is drinking much less than usual, especially if they are also urinating much less than usual. They may be dehydrated.
–There is something else that doesn’t seem right to you. Over the years, I’ve learned to trust a parent’s instincts. You know your child better than anyone. Call if you are worried.
If none of this applies, chances are your child has a minor illness and will be just fine. Acetaminophen and ibuprofen can be helpful for making your child more comfortable, although if your child is acting fine and drinking (eating is optional, it’s the drinking that’s key), it might be best to let the fever be and let the body do its job. Make sure your child gets plenty of rest — and TLC.
(Claire McCarthy, M.D., is a faculty editor of Harvard Health Publications.)
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