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What should you do if your child has a fever? When should you call the doctor? And how is fever related to COVID-19 and a new, rare condition in kids called multisystem inflammatory syndrome in children (MIS-C)?
Christopher Tolcher, MD, FAAP, a pediatrician with Agoura-West Valley Pediatrics—part of the CHLA Health Network—shares the facts on fever and what parents need to know.
A normal body temperature for a child ranges from 97 to 100 degrees, with an average of around 98.6 F. When a person’s temperature reaches 100.4 or above, it’s a fever.
Fevers are common in children. And while a fever is never fun, in most cases it’s nothing to fear. It’s part of the body’s way of fighting an infection.
“Fever helps the immune system,” Dr. Tolcher explains. “It slows down the spread of viruses and bacteria. It helps the body make more antibodies and chemicals that fight the infection, and it helps the immune system’s cells move around better in the body.”
“Fevers are almost never dangerous, with the exception of ‘hyperthermia’, or a high body temperature from the body’s being unable to cool off in a very hot environment,” he says. “A fever has to reach 107 to cause damage to tissues. That’s extremely rare.”
That said, if your child’s fever reaches 105, call your doctor. “It doesn’t mean the child is in danger,” he adds, “but the child should be checked by the doctor that day to see what’s going on.”
Call your child’s doctor right away for:
If your child has a fever AND any of the following signs, call your doctor right away or go to the emergency department:
Children under 5 can sometimes have a seizure during a fever. “Seizures are scary as heck to watch, but most of the time, you don’t need to go to the ER,” Dr. Tolcher says.
Call your doctor if your child has any fever for more than four or five days. Also call your doctor if your child has a high fever AND any of the following: cracked red lips, red tongue, red eyes, swollen hands and feet, rash, abdominal pain or enlarged lymph nodes.
“I want to reassure parents that MIS-C is rare,” he adds. “We need to watch for it, but don’t freak out.”
Tip: Watch how much your child is peeing. If your child’s urine is dark, or your child is not peeing as often as normal, give more fluids. Good options: water, clear soups, electrolyte solution or popsicles.
“If you aggressively try to keep it down to 98.6, you slow the immune response to the infection,” he notes.
The best medicines for fever are acetaminophen (Tylenol) or ibuprofen (Advil). Never give aspirin. If COVID-19 is suspected or diagnosed, acetaminophen should be your first choice.
The bottom line? Keep your child comfortable, hydrated and at home. “We all need to rest when we’re sick,” Dr. Tolcher says. “That’s one of the benefits of fever. It slows you down and gets you to take a break.”