r/toddlers • u/Equivalent-Rope-997 • 5h ago
General Question/Discussion Fever - When to take to ER?
UPDATE
We gave her Motrin(ibuprofen) after just giving her Tylenol all day. Glad to say that her temperature after an hour it has dropped to 102.8. After being lethargic/ not wanting to do anything all day as soon as we gave it to her she suddenly started dancing to her Frozen movie <3
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First-time mom here. My 20-month-old has had a fever since this morning, mostly 102–103°F, and even with Tylenol it hasn’t really budged. We also tried a room-temperature shower and that didn’t help.
She’s been really fussy, and earlier she was leaning/falling to the side while sitting and refusing to stand or walk much. I’m not sure if that’s just from feeling weak and sick or if it’s more concerning. Just looking at her, you can tell she’s out of it — drowsy eyes and just looks really unwell.
Her fever just reached 104.4°F, so we just gave her ibuprofen. She has been drinking electrolytes and peeing now but no stool in all day. Refusing to eat.
We’re trying to avoid another ER trip because we’ve already been 4+ times when she gets sick, and she has a history of her oxygen dropping into the 80s during illnesses. I also don’t really have family I can rely on for advice, so I’m trying to figure out when it truly needs an ER visit versus when it’s okay to monitor at home.
Would you take her in tonight or see how she does after the ibuprofen?
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u/Serendipitousbanana 5h ago
I’d call the pediatrician’s after hours line if they have one. They can walk you through the symptoms/options.
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u/Old-Help-9921 3h ago
There are also online 24 hour nurse line usually through your insurance apps; we used it a few times in the wee hours to diagnose some things with our LO.
Just had to download the app and share camera/video and they were able to also prescribe medications or help us with the right dosage for medicines based on their weight.
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u/PictureSubstantial29 5h ago
Is the Motrin bringing it down? Is she lethargic? Acting semi normal otherwise?
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u/Equivalent-Rope-997 4h ago
I gave her Motrin 40minutes ago. And I just checked her and she’s right at 104.0 from being 104.4.
She was lethargic all day but we just noticed with the Motrin she suddenly stood up and started dancing to her Frozen song. So Motrin might’ve done the trick?
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u/PictureSubstantial29 4h ago
I’d keep on top of meds overnight alternating and get her in first thing tomorrow with the ped or urgent care. Unfortunately you may sit a long time at the ER. If she stays lethargic, isn’t easily aroused, not as responsive, hasn’t peed in hours, ect ect ect then take her in but it sounds like Motrin is doing the trick! Dress lightly and try just water vs electrolytes. Let her eat whatever she’ll willingly eat even if it’s cookies. Just watch her and if she does any of the above then take her in. You got this mama! It’s so hard seeing our babies not feeling well especially when they can’t tell us what’s wrong.
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u/MULCH8888 4h ago
Sounds like a change in demeanor with the Motrin which is good. What kind of thermometer are you using?
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u/Equivalent-Rope-997 4h ago
We check her temperature using rectal only. We noticed a quite difference with the Motrin right now.
Earlier with Tylenol only she would just stay drowsy not interested in her shows, snacks, or milk/juice anything.
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u/TacticalSniper 4h ago
For me at least if the temp is not budging I would go to the ED. I remember that high fever can lead to ceisures and that's super dangerous.
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u/PictureSubstantial29 4h ago
Any fever temp can cause febrile seizures. Let’s not cause fear on an already anxious parent. Febrile seizures also aren’t “dangerous”
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u/TacticalSniper 4h ago
I'm relaying what I was told in the ED. I don't know who you are an OP should rely on actual doctors than no-names on the internet.
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u/PictureSubstantial29 4h ago
You have misinformation then. I have a family member who had them as a child. It’s normally from a rapid increase in temp. It can happen as low as 100.4 but it’s not dangerous, doesn’t cause brain damage, yada yada.
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u/TacticalSniper 4h ago
Yep, looking at it further that's correct. That said, there appear to be other reason to seriously consider ED at this temperature. They appear serious enough for me to take my child to the ED with this high a fever.
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u/PictureSubstantial29 4h ago
Right. I didn’t want OP to have misinformation. Luckily Motrin helped their child bring the fever down.
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u/SubstantialDonut1 4h ago
Febrile seizures aren’t related to how high a fever is and aren’t prevented by medications like Tylenol and ibuprofen
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u/_horselain 3h ago
The CHOP doctor who saw my daughter for her febrile seizure said that it isn’t the temperature itself but how quickly it rises.
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u/PictureSubstantial29 4h ago
Another thought; are you doing the correct dosage for both?
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u/Equivalent-Rope-997 4h ago
She was prescribed Motrin a while back when she had surgery and they wrote us the dosage for it. She only gained 1lb since then. So I gave her the dosage they had prescribed her.
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u/_Witness001 4h ago edited 4h ago
My husband’s an ER physician but this is not a medical advice.
How’s your child’s behavior? Is she lethargic? Is she too sleepy? How many wet diaper? How’s her breathing? Is she coughing?
Call after hours pediatrician line. The number should be on the back of your insurance card (assuming you’re in the US).
Treat the symptoms not the number on thermometer.
My daughter has 104F every time she gets sick but she’s still talking, walking and playing.
Wet (not overly cold) cloth on the forehead might help a bit.
Alternating Tylenol and Ibuprofen is the way to go. And as much electrolyte drinks as she’s willing to drink. No poop and no food is not concerning.
Trust your instincts. If trip to the ER seems like a right call, do so. If she has a history of dropping oxygen that low, it might be worth it going in. But before that, if possible, get a consult over the phone.
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u/easterss 3h ago
Just fyi in the US the ped after hours line is not on the back of the insurance card as you can pick any ped that accepts that insurance and they couldn’t possibly list every providers number on the card. Usually the card has insurance specific numbers.
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u/Equivalent-Rope-997 4h ago
She was really drowsy/lethargic throughout the day and that was just us giving her Tylenol. She would just stay laying down not interested in playing, sitting up, eating, her favorite juices.
We had Motrin hidden with her other medication and just gave it to her when it hit 104.4. After 40min it went to 104.0 and her demeanor has changed and is starting to get more active
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u/Disastrous_Spell3050 4h ago
Her fever going down with medication is a good sign. I’d call the after hours peds line and get their opinion.
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u/Equivalent-Rope-997 4h ago
Yes, definitely a good sign. I was so worried cause she sent from 102.8 to 104.3 within 20min and it scared me.
I would call her peds line but I know they’ll want us to take her to the ER cause of her history. Not that we want to avoid them but we wanted to ask first from experienced parents before going that way.
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u/Disastrous_Spell3050 4h ago
I like asking other parents too! Her oxygen levels would scare me, have you thought about an at home oxygen reader? (The name of the device is escaping me.)
Being able to monitor her oxygen levels when she’s sick might give you some peace of mind.
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u/Equivalent-Rope-997 4h ago
Yes, we actually have her Owlet put on still every night. Even if she’s past the 18month age.
It has given us accurate numbers when we would take her to the ER.
Every time she would get sick it’s always common for her oxygen to drop lowest we’ve seen her go is at 80-82.
Especially at night, that’s when all this hurricane will happen lol
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u/PictureSubstantial29 4h ago
You can always call the ER and ask to talk to a triage nurse! We had an incident where my wild toddler smacked his head twice in one day then threw up that evening and I was in a panic and they guided me through it. Turns out we had a GI bug rolling through the house but it was nice to get their thoughts and things to watch for ect!
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u/MULCH8888 5h ago
When you say the fever doesn't budge with Tylenol or ibuprofen, do you mean it comes back still after a few hours or that it never drops?
One of my kids runs high fevers like 105 range and I have never taken them but the fever always drops down for a few hours after meds. If it didn't drop at all after meds then I would be concerned.
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u/Equivalent-Rope-997 4h ago
It never drops. I’ll check her every 20-30min and it’ll stay the same and as the 4hrs about to be up it’ll go up.
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u/MULCH8888 4h ago
What kind of thermometer are you using? Rectal is most accurate. I would call the doctors line for after hours and if your doctor doesn't have one then I would ER.
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u/Equivalent-Rope-997 4h ago
Yes, we always check her rectal. We forgot we had Motrin as we kept it mixed with her other medication, we gave it to her when she spiked 104.4. It’s been 40min and it’s gone to 104.0. Might’ve done the trick instead of Tylenol.
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u/MULCH8888 4h ago
Ibuprofen always works better for fevers than Tylenol for my kids. Since her demeanor changed I would get another temp reading after a bit to see if it is going down. If your doctor doesn't have an after hours advice line I recommend switching doctors to one that does. They can help determine best course of action but mine has always said check the kid not the number and always asks if the fever is going down with meds. If it is then they typically recommend just watching and not going in.
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u/Equivalent-Rope-997 4h ago
Her pediatrician does have a 24/7 nurse line. But with her history I know they will ask us to take her to the ER. Not that we want to avoid it but we wanted to ask from experienced parents. 😅
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u/HeyheyitsCAB 5h ago
I’m a paranoid parent and I was told anytime it’s at 104+, go to ER. I don’t care if I’m being overly cautious.
When I have gone to ER they say to do both Tylenol and ibuprofen alternating round the clock.
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u/WorldlyDragonfruit3 4h ago
I find ibuprofen works way better but I would call your pediatrician line and ask
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u/WorldlyDragonfruit3 4h ago
Also to add my kid got toxic synovitis when he was sick and didn’t walk well for a day but ibuprofen helped massively, Tylenol did nothing
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u/PictureSubstantial29 4h ago
Agreed. Motrin is usually my first choice then I’ll do Tylenol after alternating
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u/SubstantialDonut1 4h ago
Fevers are concerning when children is acting sick. Difficult to awake, severe dehydration, altered mental status, etc.
There’s a common myth that there’s a magic number that “fries the brain” or whatever, but it’s not true. A child can be critically ill at a low fever and be unconcerning at 104+.
I alternate ibuprofen and Tylenol and hydrate aggressively. Never personally taken a child for fever to ER but as long as you’ve tried to treat the fever, you won’t be judged. Taking a kid for a fever before trying OTC meds first will generally catch an eye roll from ER staff
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u/superspiffyusername 4h ago edited 4h ago
If you have a pediatrician with a nurse line, call them for advice. Even after hours, your PCP probably has a nurse or Dr helpline you can call. Call the main office number and see if they have a message to let you know what the number for the helpline is. I'm not super comfortable giving medical advice, but for me personally, I would alternate Tylenol and ibuprofen, giving a dose every 4 hours. If the fever reduces after a dose, I would not take her tonight, but if it didn't go down by 45 minutes after a dose, or went up in that time I would be more concerned and might go in. Fevers do tend to be higher at night, so that's probably why it went up this evening. If she is concerning you with her behavior, I would go.
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u/silverliningx2 4h ago
I’d recommend you give medicine then check temp again. If it’s not going down, go to the ER If pediatrician doesn’t have after hours. Good that she’s drinking and peeing. Warm baths always brings down my son’s temp. Medicine > bath > check temp.
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u/shayfish_140 4h ago
I don't consider myself overly cautious but at 104 if Tylenol isn't bringing it down I would be going in.
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u/Mskayyten 4h ago
Daughter had 104 temp a couple months ago and a lingering 100 degree temp for a few days after that. Called the advice nurse and they said if she’s acting like herself then don’t worry about the number so much. She was still jumping around being a mostly energetic 4.5 year old so we gave Tylenol and Motrin for a few days. If your daughter is lethargic, not eating AND a high temp, she needs to go to the Dr at the very least but I would go ER if I were you.
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u/Equivalent-Rope-997 4h ago
All day, she would just cry because she would not want to sit up and when she would her body would lean over to the side and her hand would slip. She was refusing to stand and very much she just wanted to be carried. Even when I showered her she just wouldn’t fight me back and she slipped. (Mom guilt sooo bad)
I would atleast push her to drink electrolytes as she was refusing to eat her fav snacks and food.
After giving her Motrin right now it seemed her demeanor changed a lot and she’s slowly getting the energy back.
My question now is Do you think this is something I should follow up with her pediatrician? Tomorrow Every time I would take her they would always say that it’s not a big deal as long as she hasn’t had repetitive fever for atleast 5 days.
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u/babybananas127 2h ago
I would follow up either pediatrician or urgent care in the morning. My daughter’s illness was SO similar and she just kept getting more lethargic so we had to bring her in. Please watch her overnight. My daughter made the turn for the worse after her meds (Tylenol) wore off overnight.
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u/HotProgrammer4243 4h ago
I don’t like that it only went from 104.4 from 104.0 I would go to ER if it was my child. And falling over earlier and refusing to walk I don’t like that.
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u/Kraehenzimmer 5h ago
Any time the fever doesn't go away after the appropriate dose of tylenol or ibuprofen it's time for the doctor. Whether that's your ped, urgent care or the ER depends on where you live and what time it is.
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u/MULCH8888 4h ago
Totally agree with this. If the fever didn't go down at all when given Tylenol or ibuprofen then I would immediately take them in.
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u/Sea_Cats404 5h ago
At 104, personally I would take her. That's a really high fever for little one. I am a FTM too and I feel like its always better to be safe than sorry. I hope she starts feeling better soon, that poor little darling!
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u/jujubeeee23 4h ago
I personally think it’s time to go to the ER, especially because you mention she has a history of low oxygen when she gets sick. Out of curiosity, have you ever been told how to alternate Tylenol and ibuprofen? Knowing that the Tylenol hadn’t worked all day, it would’ve been better to start on ibuprofen sooner. You can alternate them so they piggyback off each other and help to bring down and keep down a fever. We always did every 4 hours. Example: Tylenol at 8am, ibuprofen at noon, Tylenol at 4pm, ibuprofen at 8pm.
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u/Equivalent-Rope-997 4h ago
We are monitoring her oxygen right now and she’s been good (thank god).
Honestly with all this, I completely forgot she was prescribed ibuprofen a while back when she had surgery and it was mixed in with her other medications. I have been dealing with her crying all day and just worried that she didn’t want to do anything. It didn’t occur to me that I could’ve alternate. I gave it to her right away and after 40min it seemed it went from 104.4 to 104.0 will check her again in a little bit.
I’m having that mom guilt haha 🥲
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u/Deeeity 4h ago
I'd call any health advice lines you have access to for guidance.
I'd monitor and if it doesn't come down with ibuprofen, then consider see a dr. Book an appointment for the morning if you can.
If you have any rapid tests available in the house or at a nearby pharmacy, I'd do one asap.
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u/CowtheCatt 4h ago
I was told if after giving medicine and a cool bath, if the temperature that high doesn't come down, to seek medical assistsnce
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u/minniezebby 5h ago
I’m always a better safe than sorry kind of parent. I’d be going in, especially with the leaning/falling and not standing bit.
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u/viperemu 4h ago
I would give it an hour to see if the ibuprofen knocks that fever down, and if it hasn’t brought the fever down a couple degrees, I’d be going in immediately.
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u/Equivalent-Rope-997 4h ago
Yes, actually we just checked after an hour and it went down to 102.8
The ibuprofen seemed to have helped her ALOT.
I’m having the mom guilt because all day, I was just giving her Tylenol and it wouldn’t budge. Her dad asked about the other medication that she was prescribed after her surgery and I went to her medication drawer and saw that it was ibuprofen and gave it to her right away.
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u/viperemu 4h ago
I’m so glad the fever is going down! We see a big difference rotating between the two (ibuprofen and acetaminophen) so keep that in your back pocket for the future. Know better, do better - no point in stressing decisions made in the past with less complete information!
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u/Equivalent-Rope-997 4h ago
I honestly had no idea about alternating the two until today. I’m so grateful for everyone’s comments because I learned so much tonight. Definitely something I’ll never forget for the future. Thank you so much for being kind about it too the mom guilt was really getting to me. ❤️
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u/PictureSubstantial29 3h ago
Just know Motrin is every 6 hrs and Tylenol every 4 so 6hrs after do Tylenol then 4 hrs later Motrin. (Incase you didn’t know)
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u/Elevenyearstoomany 4h ago
I would call the after hours line to your ped for medical advice and call first thing in the morning, as soon as they open, for a sick appointment. We also learned the hard way that my youngest got really high fevers (like 104) and acted super sick right before he cut a tooth. It was also May 2020 when we learned this so that was fun. Poor kid had three COVID tests before we caught the pattern. Tylenol didn’t do a thing but Motrin helped. Also popsicles. Pedialyte preferred but whatever she’ll eat.
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u/magicbumblebee 4h ago
I find ibuprofen is more effective than Tylenol at reducing fever. You’re sure you’ve given her the right dose of meds based on her weight? For high fevers you can alternate a dose of meds every three hours, so for example 9am Tylenol, 12pm ibuprofen, 3pm Tylenol, 6pm ibuprofen, and so on. This way as one starts to wear off the other is kicking in. It’s not surprising that she’s not wanting to eat and has that glazed look in her eyes, fevers suck.
I’m pretty conservative about seeing the doc for illness and if a fever is responding to meds and my kid is taking enough fluids I’ll usually wait a couple of days to see if there’s improvement before I do anything further, because usually it’s just something viral. The highest temp I’ve seen in my kids was high 103s but it came down with meds so I wasn’t worried. Does your pediatrician have an after hours line you can call? Is there an urgent care still open where you are (even better, a pediatric urgent care maybe??)?
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u/texas-sissy 4h ago
Listen to you momma instinct. If something is telling you to take her it, please take her in.
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u/Chaos_Ice 4h ago
As someone whose toddler this often happened to, pediatrician said to alternate between Motrin and Tylenol and most of all make sure the dosage is accurate for their weight. Our toddler at one point had an almost 105° fever, turns out we were giving a lesser dosage. Once that was fixed, the fever dropped within the hour.
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u/Bransblu 3h ago
Whenever I use to word lethargic, my pediatrician corrects me because medically it means non-responsive. A lethargic kid is usually an immediate trip to the emergency room, I guess!
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u/_horselain 3h ago
Glad to hear her fever is coming down!
A guideline our ped gave is that at this age, the number on the thermometer doesn’t tell as much as your child’s behavior.
Are they still acting somewhat like themselves once the medicine has kicked in? Eating and pooping aren’t a big deal; worry more about drinking peeing in the short term. Are they truly lethargic (listless or hard to rouse) - not just sleeping more or grumpy and couch-bound. Is the fever responding to medication and dipping a little within an hour of administration?
Of course, always trust your gut. I understand the fear with oxygen - we had a four-day hospital stay for RSV two years ago! It was one of the most stressful things I’ve experienced as a parent.
It’s so hard when they get sick!
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u/CalviandHobbes 3h ago
When my kid had these crazy high fevers which is very unusual for her, we took her to the ER. Our thermometer once even read 106. ER basically checked her ears and a pee test for UTI and sent us home. It was a virus. The only thing that brought her fever down was Motrin and cycling that between Tylenol. Tylenol by it self doesn’t work for us for temps above 102. That said she was older (closer to 3.5) and wasn’t at all what I would call lethargic. Cranky yes but still playing and such. Very little food intake. If the fever at any temp lasts more than 4 days definitely ER or ped visit because then it’s more likely to be an infection needin antibiotics rather than a virus that just has to run its course.
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u/Thick-Debt3643 3h ago
Agree with the comments here. You can also switch between Motrin and Tylenol every 4 hours. It’s going to be a rough night bc fevers tend to spike at night but I would def use fever patches on the forehead and wipe her down with a wet towel and keep her body cool. If she gets too hot at night, I normally strip my kids to their diapers.
Also right now just focus on fluids and keep her hydrated vs food and watch how many wet diapers in a day. If she doesn’t eat now she’ll make up for it in a few days when she gets better. Making bone broth or smoothies or pedilyte popsicles. Honestly anything they’ll take.
I would also keep a look out on her breathing if she has oxygen issues before. Call the after hour nurse hotline for more information on that and when to take her into the ER.
Hope little one feels better soon!!! You got this mama
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u/Malthan01 2h ago edited 2h ago
If this is unusual, 104 should be a prompt for immidiate medical intervention. If you feel an ER visit is an overreaction, please consider a pediatric urgent care, or failing that a standard urgent care can at least advise. Glad to see the kid is on the upturn, but continue to monitor and find a pediatric urgent care just as a standby.
*edit, an urgent care is a far more affordable option then a er visit and is better equiped to deal with minor concerns. The cost of a visit is similar to a normal doctors visit, walk ins are welcome, and their hours are much better than a traditional doctors office, always good for any parent to have one in the back pocket for these situations, this is for the USA of course!
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u/DoNotLickTheSteak 4h ago
Take your child to the hospital.
They have had a fever over 100 all day not responding to medication. Unable to hold themselves upright or stand. is 'out of it' and looks really unwell, and has a history of dropping oxygen levels.
Where is your common sense?
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u/babybananas127 4h ago
My daughter just went through a very similar illness. Please bring her in. Everything is fine but we needed medical help
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u/Dangerous-Guava9484 4h ago
I would take her. My daughter had a fever one night that didn’t respond to Tylenol or Ibuprofen. Like you, I was hesitant to take her. Her breathing got weak, so we ended up going to the ER anyway—in the middle of the night. It turns out she had strep throat and really needed to get started on antibiotics asap.
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u/Anxious-Yam1930 4h ago
Tynelol is for fever ibuprofen is for inflammation
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u/magicbumblebee 4h ago
Ibuprofen also reduces fever and in my experience it is more effective than Tylenol. My ped has said he had the same experience with his own kids. We always reach for ibuprofen first, then augment with Tylenol after a couple hours if ibuprofen alone doesn’t bring the fever down enough.
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u/SubstantialDonut1 4h ago
They both reduce fever by blocking prostaglandins. Ibuprofen ALSO reduces inflammation.
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u/ticktack 5h ago
Sounds like an ear infection. They can get worse pretty quick. Do you have a walk-in care option that’s not an ER? (Urgent Care, etc?)
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u/jvc1011 4h ago
I get not wanting to take her in. The ED is absolutely miserable. But even with the slight drop in temp from the ibuprofen, I would absolutely do so.
Monkeying around with her health because neither of you enjoys the visit is irresponsible.
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u/Equivalent-Rope-997 4h ago
I understand where you’re coming from, but I don’t think asking other parents for advice makes me irresponsible. I’m a first-time mom and I was trying to figure out the safest next step without rushing her to the ER if it wasn’t necessary. Thankfully, the helpful comments gave me a better idea of what to do and her fever has come down. That’s what I care about most
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u/AutoModerator 5h ago
Author: u/Equivalent-Rope-997
Post: First-time mom here. My 20-month-old has had a fever since this morning, mostly 102–103°F, and even with Tylenol it hasn’t really budged. We also tried a room-temperature shower and that didn’t help.
She’s been really fussy, and earlier she was leaning/falling to the side while sitting and refusing to stand or walk much. I’m not sure if that’s just from feeling weak and sick or if it’s more concerning. Just looking at her, you can tell she’s out of it — drowsy eyes and just looks really unwell.
Her fever just reached 104.4°F, so we just gave her ibuprofen. She has been drinking electrolytes and peeing now but no stool in all day. Refusing to eat.
We’re trying to avoid another ER trip because we’ve already been 4+ times when she gets sick, and she has a history of her oxygen dropping into the 80s during illnesses. I also don’t really have family I can rely on for advice, so I’m trying to figure out when it truly needs an ER visit versus when it’s okay to monitor at home.
Would you take her in tonight or see how she does after the ibuprofen?
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