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Hem Fever in children – A Pediatrician’s guide

Fever in children – A Pediatrician’s guide

Children with high fever in mother's arms

This post is also available in: Svenska

Facts and advice about fever in children – information written by pediatricians. For many parents, the 40C (104F) mark is a magical limit. For a pediatrician, there are no magical temperature limits. Here you will read about what to do when the child has a fever, and how to distinguish between dangerous fever and harmless fever.

When is a fever dangerous?

Fever itself is not dangerous, even if it goes up to 41-42C (106-107F). A fever occurs when the body is responding to an acute inflammation. In other words, it’s the immune system’s way of fighting an infection. Infections in children are usually self-limiting, but may require treatment in hospitals. In isolated cases, infections in children are dangerous and require immediate treatment in the pediatric emergency room.

Read about febrile seizures or chills in children

Signs of a serious infection in children with fever

A child with a serious infection will look ill. The child may be tired and slow or relaxed in the body and should go to the pediatric emergency room for assessment. Infants are difficult to read. But an infant who has lost interest in eating, must go to the pediatric emergency room for assessment immediately. It may be a sign of a serious infection.

All children get tired during their fever peaks. But it’s the children who do not perk up between the fever peaks that we should be worried about.

The combination of headache, sensitivity to light, vomiting and fever may be signs of a meningitis; an infection that can be serious and require immediate hospitalization.

Read more about meningitis in children

Infants with fever

Babies under three months have small margins and can be difficult to assess for those who are not used to it. Don’t be shy to seek a pediatric emergency room with an infant who has a fever. The older the baby gets, the easier you can read them. A 6 month old baby with a cold, who eats and pees, does not need to be admitted to the children’s emergency room. There, the health center or local emergency room is a better option if you feel they need an assessment.

Colds are the most common cause of fever in children

The most common cause of fever in children is the common cold. If the child has a congested nose, sore throat or moderate cough, the child is likely to have a cold. As long as the child is still drinking and peeing, the wisest thing to do, is to wait at home.

Read more about sore throats and colds in children

High fever may be a urinary tract infection

Kidney infections are not entirely uncommon in children, especially in children under one. Kidney infections require antibiotic treatment, even though children may not appear particularly ill or have any symptoms from the urinary tract. So a child with a temperature over 38.5C (101F) for more than 24 hours, without cold symptoms, needs to give a urine sample for assessment. You can do this at a medical center or a local emergency hospital. For infants, the children’s emergency department is most appropriate.

Read more about urinary tract infections in children

Fever and a swollen eye may be a sign of sinusitis

Fever and a unilaterally swollen eye are often signs of an ethmoid sinusitis, a nasal infection in children. Children may not be particularly ill or affected, but antibiotic treatment (often intravenous) is required and often even an X-ray examination of the eye socket to detect possible complications.

Fever and difficulty breathing

High fever and difficulty breathing or intense coughing, may be due to intrinsic asthma, pneumonia or the flu. Seek a medical center, emergency room or child emergency depending on the severity of breathing the child has.

Read more about pneumonia in children – symptoms and treatment

When is it a fever?

Over 38.5C (101.3F) we say go to the children’s emergency room. 38.0-38.4C (100.4-101.12F) is borderline. Under 38.0C (100.4F) is not a fever. As pediatricians, we have absolute temperature limits. We do not compare this with the child’s normal temperature, although we know that children can vary in their normal temperature.

High temperatures above 39C (102.2F) during the winter months are often a flu.

When should I give anti-pyretic medications?

Fever itself is not dangerous for the child, even if it is very high. There is therefore no need to give anti-pyretic medications just because the child has a fever. Unfortunately, anti-pyretics do not protect against febrile seizures, even though it was said to have previously. I give anti-pyretic medications to my children and to the children in the pediatric emergency room in the following cases:

1. If the child is dull and uninterested in their surroundings. I give anti-pyretics to see if the child perks up, in order to distinguish between serious and less seriously ill children.

2. If the child is so tired from the high fever that they are unable to drink liquid. Often anti-pyretics help.

3. If the child is whiny or says it has a sore throat, ear or body, I also give acetaminophen or ibuprofen. It’s not to lower the temperature, but to relieve the pain.

Read more about acetaminophen and ibuprofen for children

Read more:

Coronavirus covid-19 – facts for parents and children

Febrile seizures or chills in children

Urinary tract infection (UTI) in children and babies – symptoms and treatment

Meningitis in children – fever, neck stiffness or sore neck

Flu (influenza) in children – symptoms and treatment

Acetaminophen and Ibuprofen in children – dosage for pain and fever

Pneumonia in children – symptoms and treatment

Wheezing or strained breathing – a guide to when your child has difficulty breathing

Sore throat and a cold in children

Rashes and red spots in children – a visual guide

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