Q: My 4-month-old has a middle ear infection and a 38.1°C fever. Should we go to the night clinic or wait until tomorrow?

Medically reviewed by Sang Hyun Ahn, 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 4-month-old baby has a fever. Yesterday, we went to the clinic because of a very severe, yellow runny nose and were told it's a stage 4 middle ear infection. The doctor prescribed powdered antibiotics. At dawn, my baby sounded very phlegmy and couldn't sleep due to the congestion, so we went back to the clinic today. The doctor said the breathing sounds were fine and advised us to continue the current antibiotics, but to return to switch to liquid antibiotics if a high fever developed.

This afternoon, the temperature rose to a mild 37.8°C, and it is currently 38.1°C. I am torn between giving a fever reducer and waiting to see the doctor tomorrow morning, or taking my baby to an urgent care night clinic right now.

Last week, my older child had a suspected adenovirus infection and is still on antibiotics, so I'm wondering if the baby caught that. The baby is fussy, constantly wants to be held, coughs, and has mild eye discharge, but is drinking formula well. However, the baby keeps making continuous groaning sounds.

Answer:

I understand how difficult it must be to see your 4-month-old baby struggling with a middle ear infection and cold symptoms. It must be especially worrisome with your older child being sick as well.

Current Situation Assessment:

• A temperature of 38.1°C in a 4-month-old baby requires careful attention.

• A stage 4 middle ear infection combined with fever and phlegm sounds needs to be monitored very closely.

• While drinking formula well is a positive sign, the persistent groaning sounds indicate that your baby is in discomfort.

What You Should Do Now:

1. Recheck the baby's temperature 1 hour after administering a fever reducer.

2. Turn on a humidifier and slightly elevate the baby's head.

3. Frequently clear the nasal congestion using a nasal aspirator.

4. Burp the baby thoroughly after feedings, and offer smaller amounts of formula more frequently.

→ Go to the Emergency Room Tonight If:

• The fever persists at 39°C or higher.

• The chest sinks in deeply (retractions) while breathing.

• The baby refuses formula or vomits.

• The baby becomes lethargic or shows delayed reactions.

→ You Can Wait for the Clinic Tomorrow Morning If:

• The temperature stays around 38°C and the baby drinks formula well.

• The fever is successfully controlled by the fever reducer.

• The baby is able to fall asleep.

There is indeed a possibility that the baby caught the adenovirus from the older sibling. Since 4-month-old babies have relatively weak immune systems, you must observe any symptom changes very carefully. Please check your baby's temperature and breathing status every 2 to 3 hours throughout the night.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us