Fevers in children are common and usually not a cause for alarm. However, in some cases, a high temperature can signal a serious illness requiring emergency care. Here’s how to determine when to take your child to the ER based on their age and symptoms.
When to Worry Based on Age
- Infants under 3 months: A rectal temperature of 100.4°F (38°C) or higher is an emergency. Young babies have underdeveloped immune systems and need immediate medical evaluation.
- Babies 3-6 months: Seek medical care if the fever is above 102°F (38.9°C) or if your baby is extremely irritable, lethargic, or refusing to eat.
- Children 6 months to 5 years: A fever above 103°F (39.4°C) should be monitored closely. If the child is drinking fluids, playing, and generally alert, you can manage at home. However, seek emergency care if they experience severe lethargy, difficulty breathing, persistent vomiting, a widespread rash, or signs of dehydration (such as dry lips, no tears when crying, or reduced urination).
- Grade-school-aged children (6-12 years): In older children, the cause of the fever is often viral. However, head to the ER if the fever is above 104°F (40°C), lasts more than five days, or is accompanied by symptoms like confusion, chest pain, severe headache, difficulty waking up, or a stiff neck (which could signal meningitis).
Serious Warning Signs at Any Age
Take your child to the ER immediately if they experience:
- Seizures (febrile or otherwise)
- Difficulty breathing (rapid breathing, wheezing, or bluish lips)
- Severe pain or swelling in any part of the body
- Unresponsiveness or extreme drowsiness
- Persistent vomiting or diarrhea leading to dehydration
If you’re ever unsure, trust your instincts. Call your child’s doctor or go to the ER if they seem severely unwell. Early action can make all the difference.
Simon Downes, MD, PhD 