What fever is too high?
I get this question all of the time. As a pediatrician I know there is no set number. As a mother I know how scary it is to see the thermometer ticking up, up, up while your little one looks miserable. With some viral illnesses like the common cold, children can have fevers over 104 degrees and they still do not require antibiotics or anything other than extra cuddles and lots of rest. Especially with our social distancing and lower exposures overall, we are seeing viral illnesses last longer, make kids sicker, occurring in seasons that they previously did not happen.
Don’t forget:
Infants under 1 years old need rectal temperatures to get their true temperature and for them a number over 100.4 degrees F is a fever.
For kiddos over 1, an underarm temperature is appropriate and a fever is over 101 degrees F.
What I watch out for: fever plus a “localizing sign” that means something that points to a serious infection.
like fever plus difficulty breathing that may point to pneumonia. Not just coughing episodes because these are common but repeated episodes where children can’t catch their breath or drink. Many times going in the bathroom with a steamy shower is enough to open the airways. I recommend this 3 or more times a day for a few days.
or fever plus ear pain and crying. These may point to an ear infection. Some ear infections are caused by a virus like with the common cold and they clear up on their own in older kids. While others are caused by bacteria and require antibiotics. In the last 4 years I have written antibiotics less than 10 times because most truly are viral and clear up on their own.
or fever plus not drinking enough so the inner mouth becomes dry (not lips alone. They are always chapped when folks get sick) or your kiddos urine gets really dark yellow or brown. These are signs more fluids are needed and this can mostly be fixed by increasing breast milk or formula for infants or coconut water or tea for older kiddos.
Make sure to check in with your pediatrician when your children get sick. Skilled pediatricians can help a ton by telephone or telemedicine and we can often save you an in person visit so your kiddos can relax at home in their PJs. We can’t promise you’ll get any work done while they are home though!