When you feel your little one's fiery forehead, it's easy for panic to set in. While fevers in children are usually not serious, there are times when a fever warrants an immediate trip to the hospital. Factors such as your child's age, the level of the fever, how long it has lasted and other accompanying symptoms all play a role in whether your child needs to head to the hospital because of fever.
Fever vs. Normal
A fever is an indication that your child's body is fighting an illness. A temperature of 100.4 F constitutes a significant fever, according to the American Academy of Pediatrics. A rectal temperature -- taken in your child's bottom -- is most accurate if your little one is younger than 3. An oral or axillary temperature, taken under the arm, is easier for older children.
Age and Fever Pattern
Fevers provoke greater concern in young babies because they are more vulnerable than older children to serious infections, such as pneumonia or meningitis. If your child is younger than 12 weeks old and has a fever of 100.4 F or higher, call your doctor. If you cannot reach the doctor, take your child to the nearest emergency center for evaluation.
In a child older than 3 months but younger than 2 years old, call the doctor or visit the hospital if the fever has persisted for longer than 24 hours. For children older than 2, a fever may require immediate evaluation if it has lasted for longer than 72 hours. A fever that repeatedly rises above 104 F in a child of any age also requires an immediate call to the doctor or a trip to the hospital.
Your child's activity level and behavior are usually good indicators of whether your child's fever requires immediate evaluation at a hospital. If your child is generally feeling well and not acting "sick," the fever likely doesn't represent a serious medical problem and typically doesn't require urgent treatment. If your child is eating and drinking normally, playing, alert and has a healthy skin color, the fever generally isn't cause for serious concern.
If your child is not drinking or eating, seems subdued or listless, is uninterested in play, is unable to walk, or complains of a stiff neck, take the child to the emergency room. Severe headache, blue coloring of the lips or nails and difficulty breathing accompanied by fever also require emergency medical evaluation and treatment. Take your child to the nearest hospital emergency room.
Vaccination History and Other Illness
Your child's vaccination history is an important consideration when deciding whether a fever requires immediate medical treatment. Children who have not received all of their scheduled vaccinations are at increased risk for several potentially serious bacterial and viral infections. Because of this, a fever in a child who is not fully vaccinated may require a trip to the hospital if you cannot reach your doctor.
Children who have chronic health conditions, such as diabetes, cystic fibrosis, sickle cell disease, cancer, heart problems or HIV, are more vulnerable to serious infections. Fever is of greater concern in these children and should be evaluated at the hospital if you cannot reach your doctor.
A fever associated with exposure to high temperatures requires emergency treatment at the nearest hospital. Fever associated with a rash, stiff neck, seizures, severe pain or persistent nausea, vomiting or diarrhea is also concerning and requires immediate medical evaluation. Go to the hospital if your child seems very sick, sluggish or inattentive.
- American Academy of Family Physicians: Evaluating Fever of Unidentifiable Source in Young Children
- Nemours Foundation: Fever and Taking Your Child's Temperature
- American Academy of Pediatrics: Fever and Your Child
- American Academy of Pediatrics: AAP Issues Advice on Managing Fevers in Children
- American Academy of Pediatrics: When to Call the Pediatrician: Fever
- American Family Physician: Evaluation and Management of Infants and Young Children with Fever