Is Their Fever Too High?

I always get asked as a Canton pediatrician “What temperature is too high?” and “When should I worry about the fever, Dr. Syed?” My answer always usually runs the same, “Don’t worry about the height of the fever as much as how your kid looks. If they’re playful with a 104F, I wouldn’t worry. However, if your child has a temp of 100.4F and looks miserable or lethargic, it’s likely time to get evaluated.”

This season post-COVID, I’ve been seeing long-lasting fevers in kids in the Canton community and surrounding areas. I’m talking about six-seven-eight-nine days of continuous at-least-once-a-day fever of more than 100.4F. What’s going on? The presumption is that everyone’s immune system took a long hiatus during the pandemic (with mask-wearing and virtual school on and off) for the past two years. This now leaves kids to try fighting off one virus after another after another. In certain cases, bacterial infections can also develop superimposed on a virus. That’s when I hope parents do come to me as a pediatrician and ask for my medical recommendations. There are conditions like Kawasaki Disease and MIS-C (Multi-inflammatory Syndrome in Children related to COVID-19) that I have to keep in mind in any child with recorded temps of more than 100.4F for more than five consecutive days. Usually these kids look toxic, and need hospitalization based on clinical exam and labs.

What can parents do with their febrile kids?

1. If your child is less than 3 months of age, contact your pediatrician right away. Do not give medications to reduce fever without seeking care first.

2. For those older than 3 months of age, Tylenol can be given.

3. Try to keep Tylenol and Ibuprofen alternating every 6 hours (for the same med or 3 hours between the two meds) if fever is reaching a temp of 101F or more.

4. Tylenol dosing is 10 mg/kg/dose every 6 hours while Ibuprofen is 10 mg/kg/dose every 6 hours.

5. For temps less than 101F, I’d recommend a cool towel or lightening up layers first.

6. If your child already gets febrile seizures, make sure even more so to keep them hydrated.

7. If the fever is more than 103F for more than 3 days, or your child is looking lethargic and not eating or acting appropriately, it’s likely time to see your pediatrician.
   

And remember- fever is the body’s way of responding to an “enemy.” It’s not necessarily a bad thing as it means your child is putting up the fight they should!

Until next time,

Dr. Sana Syed