Here is how to tell if your child is VERY ill with fever vs not very ill:

Any temperature in an infant younger than 8 week old that is 100.4 (rectal temp) degrees or higher is a fever that needs immediate attention by a health care provider, even if the infant appears relatively well.

Any fever that is accompanied by moderate or severe pain, change in mental state (thinking), dehydration (not drinking enough, not urinating because of not drinking enough),  increased work of breathing/shortness of breath, or new rash is a fever that NEEDS TO BE EVALUATED by your child’s health care provider. In addition, a fever that lasts more than three to five days in a row, even if your child appears well, should prompt you to call your child’s health care provider, who most likely will want to examine your child. Reoccurring fevers should also be evaluated.

Should you treat fever? Given the information from above and from Part 1 of this fever blog post, you may have concluded that fever is an important part of fighting germs, and in fact I do NOT advocate treating fever UNLESS the side effects of the fever are causing harm. Reduce fever if it is preventing your child from drinking or sleeping. If your child is drinking well, resting comfortably or playing, or sleeping soundly, then he is handling his fever just fine and does not need a fever reducing agent just for the sake of lowering the fever.

A note about febrile seizures (seizures with fever): Some unlucky children are prone to seizures with sudden temperature fluctuations. These are called febrile seizures. This tendency often runs in families and usually occurs between the ages of 6 months to 6 years.  Febrile seizures last fewer than two minutes. They usually occur with the first temperature spike of an illness (before parents even realize a fever is present) and while scary to witness, do not cause brain damage. No study has shown that giving preventative fever reducer medicine decreases the risk of having a febrile seizure. As with any first time seizure, your child should be examined by a health care provider, even if you think your child had a simple febrile seizure.

I refer you to our “How sick is sick?” blog post for further information about how to tell when to call your child’s health care provider.

Julie Kardos, MD
©2010 Two Peds in a Pod