Fever: How High Is Too High?

Fever is an indication that your child’s body is fighting illness and infection, and that’s normally a good thing. In children, fever is usually the sign of a harmless viral infection and very rarely (about 1 in 100) indicates a serious illness.

However, there are times when a fever is not beneficial and warrants immediate medical attention. Here’s what to look for.

When to go to the ER with high fever.

  • Babies under three months old: A high fever is a forehead or rectal temperature of 100.4°F or higher.
  • Children three months to four years old: A high fever is a forehead or rectal temperature of 102.2°F or higher or armpit temperature of 99°F or higher.
  • Older children and adults: A high fever is one that is above 102°F and doesn’t respond to medication or lasts for more than three days, or one that consistently spikes to 103°F or higher.

When to seek medical care for fever with other symptoms.

Often a child’s temperature falls below high fever guidelines, but as a parent, you just know something’s wrong. Always listen to your intuition where your children are concerned. In addition to fever, if your child has any of these additional signs and symptoms, medical care may be necessary.

  • Childhood illnesses: If something’s going around at school or in the neighborhood, your child may need to be checked to see if she’s contagious or needs treatment.
  • Tummy troubles: Stomach pain accompanied by repeated vomiting and high fever should always be checked out, but so should stomach pain without fever if it is severe, lasts 24 or more hours or is localized to one particular area.
  • Breathing problems: Children who are having trouble breathing, who are making wheezing or crackling sounds, or who are coughing severely should be examined immediately.
  • Seizures: Some children experience febrile seizures when they have a fever. While this can be frightening and is certainly worthy of a trip to the ER, most fever-triggered seizures are harmless.
  • Other warning signs:
    • Lethargy, inactivity, sleepiness or unresponsiveness
    • Pale, ashy, patchy or bluish skin or a reddish rash
    • Weak or constant crying or fussiness
    • Loss of appetite
    • Muscle weakness, ear pain or stiff neck

Treating fever.

Children should be kept comfortable and get plenty of rest and fluids to prevent dehydration. Studies show that alternating ibuprofen (Advil, Motrin) with acetaminophen (Tylenol) will maximize the benefits of both and prevent the risks of taking too much of either. Always check with your pediatrician and the medication label for correct dosing.

If you are having a medical emergency, call 911.