Q: My child has had a high fever for 3 days and Ibuprofen isn't bringing it down. Should I go to the ER?
- Myeongchan Kim, MD
- 4 days ago
- 3 min read
Medically reviewed by Sang Hyun Ahn, MD
Content edited by Myeongchan Kim, MD
This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Question:
My child has been running a fever for three days now. On the second day, the fever went down when I gave them a fever reducer. Yesterday, we visited the clinic, and the doctor said it seemed like a cold and prescribed some medication. However, since last night, the fever hasn't gone down at all despite consistently giving fever reducers. It's staying very high, around 38.9°C to 39.1°C (102°F - 102.4°F). Ibuprofen isn't working either. Should I take my child to the emergency room right now?
Answer:
It is completely understandable that you are very worried about your child's high fever persisting for a third day.
When to Seek Immediate Emergency Care:
If your child exhibits any of the following symptoms, you need to take them to an urgent care center or emergency room today for an immediate evaluation:
Difficulty breathing: Flaring nostrils, wheezing, or the skin pulling in under the ribs when breathing.
Dehydration: No urine output for more than 8 hours, or a very dry mouth, lips, and tongue.
Lethargy: Extreme sleepiness, difficulty waking up, poor eye contact, or a severe lack of responsiveness.
Neurological signs: A stiff neck combined with a severe headache or repeated vomiting.
Skin rash: Red spots on the skin that do not fade or disappear when you press on them.
Managing Fever When Medication Seems Ineffective:
When a fever reducer like Ibuprofen does not seem to be working, it is crucial to ensure that the dosage is correct based on the child's current weight.
Ibuprofen: Generally dosed at 5–10 mg per kg of body weight, given every 6–8 hours (maximum 4 times a day).
Acetaminophen (Tylenol): Generally dosed at 10–15 mg per kg of body weight, given every 4–6 hours (maximum 5 times a day).
While alternating medicines is not routinely recommended for mild fevers, if a high fever is completely uncontrolled by one medication, you can alternate between Acetaminophen and Ibuprofen every 2 to 3 hours. However, you must strictly track the doses to ensure you do not exceed the minimum intervals and daily maximum limits for each individual medication.
Home Care and Next Steps:
Hydration: Offer small sips of water or an electrolyte solution every 5–10 minutes.
Environment: Dress your child in light, breathable clothing and keep the room at a comfortably cool temperature.
Avoid cold baths: Do not use wet towels or tepid water baths, as this can cause shivering, which can actually raise the body's internal temperature.
Keep records: If you do go to the hospital, be sure to bring the medication packets you received yesterday and a written record of the fever reducers you have given so far.
If your child does not have any of the emergency warning signs listed above, and they are able to drink fluids, urinate, and remain alert, you should contact your current pediatrician today to request a re-evaluation of the persistent fever. However, if it is after hours, on a weekend, or if you feel uncertain about your child's condition at any point, please proceed directly to a local urgent care clinic or emergency room for an in-person assessment.
For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.
