Important: This post is for informational and educational purposes only and should not be taken as medical advice. You should always consult your physician before making any medical decisions for your child.
Contrary to popular belief, the answer to the question: “Is it good to let a fever run its course?” is often yes, even in children. Unless your child is younger than 2 months old, has an underlying condition, or you’ve been advised otherwise by your pediatrician, your best course of action is to “let it ride.”
In fact, Dr. Elliston often tells parents at our pediatric practice: “I want you to have Tylenol and Motrin in the cabinet, and I want it to expire before you ever open it.”
Of course, this won’t always happen, but it conveys our stance that these medicines shouldn’t be the default course of action when your child has a fever.
At which temperature should you go to the ER?
For infants younger than 2 months, you should seek immediate support or emergency medical care for a fever of 100.4°F (38°C). Fevers can be a sign of serious infections for babies at this age. The fever itself is not the emergency, but the infection causing the fever can be.
For babies between 3 and 6 months, the advice will vary from child to child, but with a temperature of up to 100.4°F (38°C), it’s best to consult your pediatrician to evaluate your child’s level of hydration and other symptoms. It may still be advisable to visit the ER, but your pediatrician will help you decide.
If your child is older than 6 months, you may choose to contact your pediatrician if they have a temperature higher than 100.4°F (38°C) for more than a day. That said, fevers last for an average of 3-5 days and often don’t require a trip to the ER or urgent attention. It’s typically okay to let it run its course unless there are other worrisome symptoms, like a sore throat or painful urination.
Understanding fevers in children
A fever is a natural immune response that happens when your child’s body temperature exceeds 100.4°F (38°C). A fever is a sign that your child’s immune system is working to ward off an infection.
The brain’s natural response to illness is to raise the body’s core temperature. As a result of this process, your child’s body starts to produce infection-fighting white blood cells that help prevent viruses and bacteria from growing.
Your child’s body is working hard to create the fever on purpose because it improves their immune system function to fight off the infection and recover sooner. This takes a lot of energy, so at the same time they are usually more tired and not as hungry as normal, and that’s okay.
In other words, your child’s fever is likely helping them eliminate an infection, despite how uncomfortable it might feel. That said, prolonged and high fevers can be a stress on the body, and may signal that it needs help fighting the infection. It’s worth trusting your instincts as a parent and reaching out for medical attention if you’re concerned about a fever and accompanying symptoms.
Should you use Tylenol and Motrin for fevers?
Many parents reach for common pain medications when their child has a fever, but they are considered optional and are not harmless themselves. Children under 6 months should never take Motrin, Ibuprofen, or Advil, and children under 18 years should never take aspirin unless specifically instructed to do so by a doctor.
It’s completely normal if your child’s fever is not breaking with Motrin or Tylenol. While these medicines can help with discomfort, they do nothing to treat the infection itself.
If these medicines do lower a fever, it hinders the immune system’s ability to fight infection. These common pain medications are not antivirals, and they are not antibiotics.
Consult your pediatrician before giving Tylenol or Motrin. Here’s why.
At Elliston Pediatrics, we don’t give kids Tylenol and Motrin to treat fevers. We do it when they are too uncomfortable, can’t sleep, or won’t drink enough to stay hydrated due to their illness.
To illustrate our reasoning behind that approach, here are a couple of reasons why it’s a good idea to reach out to your pediatrician before using these medications to treat a fever:
1) These medications make your child feel better, and this isn’t wholly a good thing. If your child starts feeling better because the medications are just hiding the symptoms, this could potentially prolong the recovery process or even allow the infection to worsen.
When these medications improve how your child feels, they’ll use their energy to run around and play instead of resting and recovering, which is actually not what you want. It may feel good to see your child playing again, but it’s likely better for them to continue resting while their body fights off the underlying illness.
2) Tylenol and Motrin won’t prevent seizures. Many parents fear that a high fever can lead to events like seizures or brain damage. It’s a myth that fevers can cause brain damage.
Tylenol or Motrin likely won’t prevent febrile seizures, which are uncommon. That said, it’s worth noting that while simple “febrile” seizures can be scary, they do not cause lasting damage and are not precursors to conditions like epilepsy.
While these pain medications can alleviate some fever symptoms and short-term discomfort, they’re not always the best course of action depending on the situation.
Should you ever let your child’s fever run its course?
Please note that you should always consult your pediatrician first.
Contrary to popular belief, the answer to the question: “Is it good to let a fever run its course?” is often yes, even in children. Unless your child is younger than 2 months old, has an underlying condition, or you’ve been advised otherwise by your pediatrician, your best course of action is to “let it ride.”
In fact, Dr. Elliston often tells parents at our pediatric practice: “I want you to have Tylenol and Motrin in the cabinet, and I want it to expire before you ever open it.”
Of course, this won’t always happen, but it conveys our stance that these medicines shouldn’t be the default course of action when your child has a fever.
While it might seem frustrating to you, and uncomfortable for your child, letting the fever work itself out of the body can be the quickest way to overcome the underlying issue. When your child is over 2 months old, the most important treatment is:
- Sleep
- Hydration
- And a healthy dose of patience.
The only instance where using pain medication to treat a fever can be useful is when your child is having a hard time taking fluids on board. In situations like these, use the recommended dosage per child weight for acetaminophen (Tylenol) for children over the age of 2 months, or for Ibuprofen (Motrin) for children under 6 months old.
Fever-related symptoms that signal an emergency
There are several fever-related symptoms or situations that signal a trip to the emergency room may be necessary. These include:
- Seizures
- A new rash
- Taking steroids
- Repeated vomiting or diarrhea
- Excessive or prolonged drowsiness or fussiness
- Stiff neck, severe headache, sore throat, or throbbing ear pain
- Signs of dehydration like dry mouth or significantly fewer wet diapers
It’s important to note: While it’s easy to think of a fever as your child ”overheating,” it’s not the same as overheating from an external source like sitting in a hot car. These are 2 completely different situations. Unlike fevers, overheating from an external source like being in a hot car is where high temperatures can cause serious damage.
You may also want to contact your pediatrician if you notice certain behaviors after a fever lifts. For example, reach out to your child’s doctor if they still seem sick or their symptoms get worse. You should also contact your pediatrician if the fever lasts for more than 24 hours in a child younger than 2 years old, or more than 3 days in a child over 2 years old.
“Should I let my child’s fever run its course?”
If you catch yourself wondering what to do when your child gets a fever, stay calm and follow the steps outlined in this blog post according to their age.
Remember, if they’re otherwise healthy and have no underlying conditions, it can be good to let a fever run its course. Always consult your pediatrician, but when it comes to bringing a fever down, hydration, sleep, and patience are often the best treatment.
If you want to be able to ask your pediatrician questions like this whenever they come up, consider joining our concierge pediatric membership in NYC. You get direct messaging with your child’s doctor, home visits, and advanced telehealth support. We’re here to give you 24/7 peace of mind that your child’s health is in good hands.
