When should I worry about baby's fever? Baby's Health & Wellness

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baby getting temperature taken.
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When baby's body temperature is higher than normal, parents can start to worry. Here, a doctor explains how to know when a fever is worth a call to the doctor or visit to the ER -- and moms give tips on what to do when baby has a fever.

It Depends on Age & How She's Acting

"It is very age dependant. In the first 28 days of baby's life, any temperature above 100.4 degrees Fahrenheit indicates a need for immediate emergent medical evaluation. Those babies will be admitted to the hospital and will get a blood test, urine test, and spinal tap. The reason is that brand new babies don't have the immune response to fight off a bacterial infection, so we're very cautious to look for signs of those. We immediately put babies on antibiotics for those just in case. On...

"It is very age dependant. In the first 28 days of baby's life, any temperature above 100.4 degrees Fahrenheit indicates a need for immediate emergent medical evaluation. Those babies will be admitted to the hospital and will get a blood test, urine test, and spinal tap. The reason is that brand new babies don't have the immune response to fight off a bacterial infection, so we're very cautious to look for signs of those. We immediately put babies on antibiotics for those just in case. On those rare times their cultures for bacterial infection turn positive, we've saved those babies.

"For babies older than 6 months, who are fully immunized, it's less about the number and more about how the child is acting. I've seen kids with a 103 degree temperature, who are hydrating well. And kids with 101 degree temperatures, who are going on eight days of having a fever and are very dehydrated.

"In between 28 days and 6 months, the evidence is open to interpretation. Once the temperature is over 101 degrees, that it is worth a phone call or check-in with your doctor. Check in if your child's feeding or diaper status changes or if she's acting lethargic or irritable and crying constantly. Any time the temperature over 105, there should be at least an evaluation, so at the very least, make a phone call to the pediatrician. The child may or may not have some lab testing to find the cause. 

"Generally, don't use ibuprofen if the baby is under 6 months old, and don't use acetaminophen in a baby younger than 3 months. Over 6 months, you can have both of those at home. A big question for parents is how much fever medication to give a child. Read the label closely. You can also ask the pharmacist, or talk to the pediatrician, but remember it's really dependent on how much the child weighs.

"Any time there is a fever with a rapidly spreading rash, especially a purplish rash, that should be seen right away because they are signs of meningitis. It's a serious bacterial infection that rapidly spreads. A parent's biggest things to look for are behavior and hydration. Our fluid losses increase when we have fever, so extra hydration is really crucial in fever." -- Christina Johns, MD, MEd, FAAP, senior medical advisor, PM Pediatrics, Lake Success, NY

Keep Track of Medication

"To help bring a fever down, I recommend using a cool damp cloth and infant acetaminophen. Be sure to keep a log of how many doses and times you've given it to her, so you don't lose track while worrying. If the fever is high, go to the pediatrician as soon as they can get you in. Are you breastfeeding still? If so, keep it up. If not, try snuggling skin to skin if she wakes up crying through the night and has trouble getting back to sleep. Other than that there really isn't anything else...

"To help bring a fever down, I recommend using a cool damp cloth and infant acetaminophen. Be sure to keep a log of how many doses and times you've given it to her, so you don't lose track while worrying. If the fever is high, go to the pediatrician as soon as they can get you in. Are you breastfeeding still? If so, keep it up. If not, try snuggling skin to skin if she wakes up crying through the night and has trouble getting back to sleep. Other than that there really isn't anything else you can do for her. Stay calm and hold her as much as she needs it. Baby will feed off your emotions so keep your cool."

Keep Baby Hydrated

"Offer her plenty of breast milk or formula to help hydrate. If you mother's intuition tells you to go to the ER, then listen. The worst case is they will send you home and you will rest easier. But if you stay home, keep a log and don't be afraid to call the nurse with questions or any changes in symptoms or temp. Best of luck and hang in there!"

Two Days for a Low Fever

"For a low-grade fever, I suggest baby acetaminophen. Keep track of how long the fever goes on; if it continues for more than 48 hours, I would call the good old doc!"

Watch Baby Closely

"When my baby has a fever, I do this: Remove any hot clothes, put him in a cool bath. Give a dose of infants' acetaminophen, going by weight not age. Wait for about an hour. Take his temperature again. If it has not gone down, then I call the pediatrician. If it has gone down, I keep an eye on it. I give him lots of water or milk to keep him hydrated since fevers cause excess fluid loss. I keep him dressed cool, covered with a light sheet or thin blanket."

Call Right Away for a Newborn

"If the baby is very young, call the doctor! Small babies are not supposed to have fevers. My daughter did, and she had to be hospitalized for a severe UTI. It was dangerous. Call!"

The advice on CafeMom aims to educate, inform, and provide a range of solutions to the issues moms care about. It is not a substitute for consultation with a medical professional or treatment for a specific condition. You should not use this information to diagnose or treat a health problem without consulting a qualified professional. Please contact your health-care provider with questions and concerns.