“When should I be worried about a fever in my child?”

If you would like to be absolutely certain that your child catches something, by all means, take her to an ER. Otherwise, stop and ask these questions: 1) what have I done about it? Did you give age/weight appropriate dose of Children's Tylenol or Advil? You would be miserable with a temp of 102F as well. Try to fix that with simple intervention of medication. Next, is the child eating/drinking like usual or close to it? If no, do need to go to ER. If yes, keep reading. Is child -- once the fever down -- his or her usual self? If they are alert, engage with family, interact like usual, it is generally OK. If a child sleeps more when sick, it is because they are smarter than we are, and do not want to be awake to 'enjoy' every minute of the illness. Sleep facilitates recovery, as long as appropriate when awake. If lethargic, sleepy, poor feeder or won't eat or drink -- time to go to the ER. Last, fever is a matter of degree -- pun intended. If generally healthy, 102 is not that bad. 104 is not great. Either should be given a dose of medicine to lower the fever and see how it is going in about 1/2 hour. If child has medical issues, seizure disorder, asthma, etc., then you should discuss this in advance with your pediatrician.

Donald W. Alves, MD, MS, FACEP

I would prefer not to use the word "worry." Instead, I would ask, "When should I think about taking my child to the doctor if there is a fever?" Any child with a documented temperature of 102 should go see a doctor. Children with a fever are at a higher risk of having bad outcomes if less than 2 years old. There are many causes of fever. Some are serious and may require hospitalization, and some are less serious and can be treated as an outpatient. "Serious" = meningitis, septic shock, or influenza, as examples. Less serious are an ear infection, throat infection, etc. The take-home answer is, it takes a physician to be able to tell what is causing the fever, and separate the bad causes from the not-so-bad ones. But, a fever is always a sign of infection in a four-year-old, and they should always see a doctor ASAP. Tylenol and ibuprofen are okay and wise to give, but that doesn't change the need to go to the doctor.

Remember: children have fever for many reasons. One cannot diagnose fever in a child without actually seeing the child. So, you should have your child seen by a doctor, earlier than later. Many a times, it's a viral illness, but to be sure, your child needs to be seen by a doctor.