Child's Fever: Causes and When to Seek Help

The child started having a fever on the night of June 16th?

Hello, doctor.
My child is 1 year and 2 months old.
On the night of the 16th, around 9 PM, I noticed that my child's temperature was slightly elevated, around 38 degrees Celsius.
At 1 AM on the 17th, it measured 38.6 degrees, so I administered antipyretics.
About an hour later, the fever subsided.
However, at around 10 AM on the 17th, the temperature rose again to 39.2 degrees, and I gave more antipyretics.
After taking the medication, the fever would decrease, but a few hours later, the temperature would gradually rise again.
At 6 PM, I administered antipyretics once more, and the temperature dropped to around 37.5 degrees, where it remained for the rest of the day without further medication.

On the 18th, the temperature stayed between 37 and 37.4 degrees, and I thought everything was fine.
However, at 2 AM on the 19th, the temperature rose again to 38.2 degrees.
My child is currently teething, with four new teeth coming in, and already has eight teeth.
I am unsure if the fever is related to teething or another cause.
My child's energy levels are normal, eating habits are normal, and the urine color is normal, though there has been an increase in odor.
Bowel movements have been infrequent, with only one hard stool in the past three days, and water intake has not increased.

Currently, the only option for fever management is to visit the emergency department of a large hospital, but the emergency department at Keelung Chang Gung Hospital stated that I would have to wait outside in a tent with others and cannot go to pediatrics, which raises my concerns about risks.
The fever has been fluctuating for over three days now.
I would like to ask for your advice.
Thank you for your response, and I apologize for the lengthy message.
🙏🙏🙏

Yui, 0~9 year old female. Ask Date: 2021/06/19

Dr. Xiao Kaiwen reply Pediatrics

Teething typically does not cause a fever lasting for many days.
If a fever persists for more than three days, it is important to pay attention.
If the child is active and the highest temperature has started to decrease without continuous use of antipyretics, and if the intervals between fevers are lengthening, it may be acceptable to monitor the situation.
However, if the child shows decreased activity, if the highest fever remains high, or if the intervals between fevers are still frequent, it is advisable to seek evaluation at a major hospital.

Reply Date: 2021/06/19

More Info

When a child experiences a fever, it can be a source of concern for parents, especially when the fever persists over several days. In your case, your child is 1 year and 2 months old and has been experiencing fluctuating fevers for several days, with temperatures reaching as high as 39.2°C. It’s important to understand the potential causes of fever in young children and when to seek medical help.

Fever in children can be caused by a variety of factors, including viral infections, bacterial infections, and even non-infectious causes such as teething. Given that your child is currently teething, it is possible that this could be contributing to the fever. Teething can sometimes cause mild fevers, but it typically does not cause high fevers (above 38.5°C). Therefore, while teething might be a factor, it is essential to consider other potential causes as well.

In your situation, the fever has been persistent for several days, and although your child’s overall activity level and appetite seem normal, the fact that the fever has recurred multiple times is concerning. It is crucial to monitor the following:
1. Duration and Pattern of Fever: If the fever persists for more than three days, it is advisable to seek medical attention. Persistent fever can indicate an underlying infection that may require treatment.

2. Associated Symptoms: Keep an eye out for any additional symptoms such as irritability, lethargy, difficulty breathing, rash, vomiting, diarrhea, or changes in urination. The presence of these symptoms can help determine the severity of the situation.

3. Hydration and Nutrition: Ensure that your child remains well-hydrated and continues to eat normally. Dehydration can occur during fever, especially if the child is not drinking enough fluids.

4. Response to Antipyretics: You mentioned administering fever-reducing medication (antipyretics) such as acetaminophen or ibuprofen. It is important to follow the recommended dosages based on your child's weight and age. If the fever responds well to medication but returns shortly after, this could indicate that the underlying cause needs to be addressed.

Given that your child has had a fever for over three days and is experiencing fluctuations, it is advisable to consult a pediatrician. If you are concerned about the risk of exposure to other illnesses in the emergency department, consider calling ahead to discuss your situation with the healthcare provider. They may be able to provide guidance on whether an in-person visit is necessary or if there are alternative options for evaluation.

In summary, while teething may contribute to your child's fever, the persistence of the fever over several days warrants further investigation. Monitoring your child's symptoms closely and consulting with a healthcare professional will help ensure that any potential underlying issues are addressed promptly. If the fever persists or worsens, do not hesitate to seek medical attention. Your child's health and well-being are the top priority.

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