Your Child Has a Fever: When to Worry, When to Wait

Here's the reframe that calms most midnight panic: fever is not the illness. It's the immune system raising the body's temperature to fight one, usually a virus. The number on the thermometer matters far less than how your child looks and behaves between spikes.

See a doctor urgently if

• Your baby is under 3 months old with any fever (100.4°F / 38°C or more), this is always an urgent visit, no exceptions.
• The child is unusually drowsy, difficult to wake, or limp even after the fever comes down.
• There's a rash that doesn't fade when you press a glass against it, a stiff neck, or severe headache.
• Breathing is fast, laboured, or you can see the chest sucking in.
• There are signs of dehydration, very few wet nappies, dry mouth, no tears, sunken eyes.
• A seizure occurs, or the fever has lasted more than three days.

What you can safely do at home

For a child over three months who is drinking, playing between spikes and generally themselves: paracetamol at the weight-appropriate dose, light clothing, plenty of fluids, and rest. Skip the cold-water sponging and alcohol rubs, they cause shivering, which raises temperature. And resist the urge to 'treat the number': a playing child with 101°F needs fluids and observation, not escalating medicines.

Why we won't always prescribe antibiotics

Most childhood fevers are viral, and antibiotics do nothing against viruses, while causing loose motions now and resistant bacteria later, when your child truly needs them to work. When the examination points to a bacterial cause, an angry eardrum, a urine infection, certain throat infections, we prescribe promptly and fully. That judgment call is precisely what the consultation is for.

Trust your instincts: you know your child's 'normal' better than any checklist. If something feels wrong, call us, we'd genuinely rather see a well child than miss a sick one.