Fever is one of the most common reasons parents seek medical care for children. In most cases, a fever is a normal response to infection and does not automatically mean a child needs emergency treatment. Decisions about where and when to seek care depend on a child’s age, temperature, symptoms, and overall appearance, as supported by pediatric and emergency medicine guidance.
This guide organizes evidence-based criteria to help parents decide whether fever care can be managed at home, should involve a pediatrician, or requires urgent or emergency evaluation.
Quick Triage Summary
Emergency care is needed when a child with fever:
- Is a very young infant
- Has a very high fever
- Appears very ill or difficult to wake
- Has breathing problems, seizures, or blue discoloration
- Has fever that does not improve after fever-reducing medicine
If none of these apply, many fevers can be safely monitored with guidance from a pediatrician.
What Counts as a Fever
- A fever occurs when body temperature rises above normal.
- Pediatric guidance commonly defines fever as 100.4°F (38°C) or higher, especially when measured rectally.
- Fever is not a disease; it is a sign the body is responding to infection or inflammation.
- Normal body temperature can vary throughout the day.
How Temperature Is Measured Matters
| Child’s Age | Recommended Measurement |
| Infants and very young children | Rectal (most accurate) |
| Older children who can cooperate | Oral |
| Some age groups | Underarm (axillary), with awareness of limitations |
Measurement method and age both influence how fever thresholds are interpreted.
When Fever Can Often Be Managed at Home
Many children with fever do not need urgent or emergency care when they:
- Are alert, responsive, and consolable
- Are drinking fluids reasonably well
- Have a fever that improves
- Do not show severe or concerning symptoms
Home management involves monitoring, ensuring hydration, and following medical guidance.
When to Contact a Pediatrician
Contact a pediatrician when:
- Fever lasts longer than expected for the child’s age
- Fever returns after going away
- The child appears ill, drowsy, or uncomfortable
- Additional symptoms are present (such as ear pain, sore throat, vomiting, diarrhea, or signs of dehydration)
- The child has a chronic medical condition or is immunocompromised
A pediatrician can help determine whether further evaluation or testing is needed.
When to Go to the Emergency Room
ER Evaluation Is Recommended When a Child with Fever:
- Is an infant younger than 28 days with a temperature of 100.4°F (38°C) or higher
- Has a very high fever (around 105°F / 40.5°C), especially if it does not improve after fever-reducing medicine
- Appears very ill, lethargic, or difficult to awaken
- Has non-stop or inconsolable crying
- Shows trouble breathing or blue lips, tongue, or nails
- Has a stiff neck, severe headache, or seizure
- Develops a rash with purple or bruise-like spots
- Has fever with persistent vomiting or cannot keep fluids down
Emergency departments are equipped to evaluate and treat children with severe or high-risk symptoms.
When to Call 911 Immediately
Call emergency services right away if a child with fever has:
- Serious difficulty breathing
- Blue or gray coloring of the lips, tongue, or nails
- Extreme unresponsiveness or trouble waking
- A seizure lasting longer than five minutes
- Other life-threatening symptoms
Urgent care centers are not appropriate in these situations.
Fever-Reducing Medicines: What Evidence Supports
- Acetaminophen and ibuprofen are commonly used to reduce fever and discomfort.
- Dosing should be based on a child’s weight and age, following medical guidance.
- Infants younger than 2 months should not receive fever-reducing medicine without pediatric evaluation.
- If a fever does not decrease after medication or the child worsens, medical advice is recommended.
Common Causes of Fever in Children
causes include:
- Viral infections such as colds or influenza
- Bacterial infections (for example, ear or urinary tract infections)
- Fever following immunizations
A healthcare professional determines whether testing or treatment is necessary.
Children Who May Need Earlier Evaluation
Earlier medical advice is recommended for children who:
- Are very young infants
- Are immunocompromised
- Have underlying medical conditions
These children may need evaluation even when symptoms appear mild.
Frequently Asked Questions
What temperature is considered a fever?
A temperature of 100.4°F (38°C) or higher is commonly considered a fever, particularly when measured rectally.
When should I take my child to the ER for a fever?
Emergency care is recommended for very young infants, very high fevers, or fever with severe symptoms such as breathing problems, seizures, or significant lethargy.
When should I call 911?
Call 911 for breathing problems, blue coloration of lips or nails, prolonged seizures, or other life-threatening symptoms.
How long should a child have a fever before seeing a doctor?
Duration depends on age and symptoms. Persistent or returning fevers should be discussed with a pediatrician.
Can fever be managed at home?
Yes. Many fevers can be monitored at home when the child is alert, drinking fluids, improving, and has no high-risk symptoms.
When should I take my baby to the ER for a fever?
Infants younger than 28 days with a temperature of 100.4°F (38°C) or higher should be evaluated urgently.
What temperature is too high for a child?
Very high fevers around 105°F (40.5°C) are considered a medical emergency, especially if they do not improve with medication.
Should I go to urgent care or the ER for a fever?
Urgent care may be appropriate when symptoms are not severe and emergency signs are absent. Life-threatening symptoms require ER care or calling 911.
Does teething cause fever?
There is no high-quality evidence supporting this as a cause of significant fever requiring emergency care.
Key Takeaway
Most childhood fevers are not emergencies. Age, temperature, symptoms, and how a child looks and behaves are the most important factors in deciding when to seek care. When severe symptoms or very young age are involved, prompt medical evaluation is essential.
APA Reference List
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