In the times of COVID-19, it’s easy to forget that fevers are a normal part of childhood. A fever is your child’s way of fighting an infection and is defined as a temperature of 100.4 degrees Fahrenheit or higher. Most commonly caused by a virus, a fever often makes your child feel hot and look flushed and can cause headaches, body aches, sweating or shivering.
If your child spikes a fever, it can be scary. Should you call their doctor? For healthy children older than three months of age, these words can to help you assess your child’s condition and determine when to seek medical care: LOOK, LISTEN, ASK, HYDRATE. In addition, all fevers lasting five consecutive days should be evaluated by a physician in the office.
LOOK: Does Your Child Appear Stressed When Breathing?
Is your child having trouble breathing? All kids will breathe a little bit faster than their typical baseline when they have a high fever. You want to see how much effort they are putting into breathing.
Comfortable, slightly faster breathing is OK and your child can be observed at home. Very rapid (over 50 breaths per minute that persists) breathing, or persistent expanding of their chest or belly in an exaggerated way for more than a minute or two, is concerning. It’s about how stressed your child looks while breathing.
LISTEN To Your Child’s Breathing
Is your child making any consistent noises or gasping sounds when they inhale or exhale? Is their cry nice and strong, or weaker and more hoarse than usual? Noisy breathing, or a change in their cry, is concerning in the context of increased breathing effort. Persisting respiratory distress is a reason to call your physician.
ASK a Question to Gauge Lethargy
Ask older kids a question. If they can answer it appropriately, they are alert. In younger, pre-verbal kids, try to have them engage in a toy or book that they like. If they respond appropriately, they are alert.
They may appear fatigued and have low energy, but are not at a concerning level of true lethargy until they struggle to wake up and cannot maintain any coherent conversation or response because they are falling back to sleep. True lethargy is a reason to call your physician right away.
HYDRATE: The Most Important Way to Get Through Illness with Fever
Giving your child water is the most important way to help them through an illness with fever. Your child will feel better overall if well hydrated. Babies younger than six months should be hydrated only with formula or breastmilk, never with pure water. Not being able to stay hydrated and a decrease in urine output are reasons to contact your doctor for evaluation.
A fever does not need to be treated with medication. Remember: fever fights infection. Your doctor may recommend medication to make your child feel a bit better and more willing to drink water and stay hydrated. The aim during a fever is hydration and comfort for your child.
Fevers in Young Babies
If your child is younger than two months and has a rectal temperature greater than 100.4 degrees Fahrenheit, go to an emergency department immediately.
If your child is between two and three months old and their temperature (taken any way) is greater than 100.4 degrees Fahrenheit, call your baby’s primary care provider immediately.
Bottom line: If you’re child has a fever, don’t panic. And don’t worry too much about the temperature. Focus on the symptoms.
Check out this video on Fever in Kids from our affiliate, Children’s Hospital of Philadelphia.