Q: My 22-month-old baby has a high fever up to 40.4°C but no other symptoms. What should I do?

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:

Hello, my 22-month-old baby has had a continuous high fever since Friday morning. When I give a fever reducer, the temperature drops, and my baby's overall condition is quite good—they eat, play, and sleep well.

On Friday, the fever was around 38°C, but on Saturday morning, it spiked to 40.4°C. I gave a fever reducer, and it dropped to 36.9°C. It stayed down until around 7 PM when it went back up to 38.7°C. I gave another dose and put the baby to sleep. They are sleeping well, so I haven't given any additional medicine.

There are no other symptoms like a cough or runny nose. A clinic we visited on Friday mentioned it could be early-stage pneumonia, but my baby isn't coughing at all. Bowel movements are normal, and they are drinking water and juice well. When the fever was at 40°C, my baby seemed a bit lethargic and wanted to be held, but completely bounced back after the medicine kicked in. What should I do in this situation?

Answer:

It is understandable that you are worried about your 22-month-old having a high fever since Friday. Fortunately, it is a very reassuring sign that the fever responds well to medication and that your child is still eating, playing, and sleeping normally.

Current Status Assessment:

• 3rd day of high fever (peaking at 40.4°C)

• Good response to fever reducers

• Good overall condition and vitality (eating, playing, sleeping)

• No visible respiratory symptoms

Things to Monitor closely at Home:

Please keep an eye on the following over the next few days:

1. Ensure urine output remains normal (monitor the weight and frequency of wet diapers).

2. Check the skin for any new rashes or red spots.

3. Observe if the child shows signs of pain when their neck or ears are touched.

Home Management Guidelines:

• Fever reducers: Administer only when the child is visibly uncomfortable or in pain (maintain 4-6 hour intervals).

• Hydration: Offer small, frequent amounts of fluids (water, juice, or broth).

• Environment: Dress the child in light, breathable clothing and keep the room temperature comfortable (around 24-26°C).

• Observation: Check their body temperature and activity levels every 4 hours.

When to Seek Medical Attention:

If the fever persists into Monday, you must visit your pediatrician for a follow-up evaluation. A high fever without a clear cause that lasts for 3 days or more often requires further diagnostic testing (such as a urine or blood test) to determine the exact source of the infection.

Go to the Emergency Room immediately if your child develops any of the following:

• Convulsions or seizures

• Decreased consciousness, extreme lethargy, or inability to wake up

• No urine output for 8 hours or more

• A new skin rash, especially if accompanied by joint pain

Since you are carefully observing your child and their general condition remains strong, try not to panic. Continue your excellent home care, but be sure to get an in-person medical evaluation if the fever continues or if any warning signs appear.

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

fevercoach.us

Apple App Store

Google Play

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