Q: My 19-month-old's fever won't drop completely and he is panting. Should we go to the ER?

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 19-month-old son (12kg) has had a fever since Friday due to a cold. Until yesterday, fever reducers brought his temperature down to normal, so I gave them every 6 hours. Now, I am cross-dosing two different fever reducers every 2 hours, but his temperature only drops from 38.9°C to 38.0°C. Should I keep giving him the medication?

He is also panting and breathing heavily, and when he coughs, it is very severe. Should we go to the emergency room? He is currently sleeping. Can I wait and take him to the doctor tomorrow morning? I have been giving him 5ml of acetaminophen and ibuprofen.

Answer:

Heavy breathing or panting in a toddler requires immediate attention. You need to observe him right now for the following signs:

• Is he wheezing (making a whistling sound) while sleeping?

• Are his nostrils flaring, or is the skin between/under his ribs pulling in when he breathes (chest retractions)?

• Are his lips or nail beds paler or more bluish than usual?

→ If you notice any of these symptoms, please take him to the emergency room immediately.

Regarding your current fever management:

1. The main goal of fever reducers is to improve the child's overall comfort, not necessarily to bring the temperature all the way down to a normal number.

2. If his temperature is dropping to and maintaining around 38.0°C, cross-dosing every 2 hours is excessive.

3. You can give 5ml (160mg) of acetaminophen every 4 to 6 hours.

4. Only add ibuprofen (every 6 hours) if it is absolutely necessary for his comfort.

⚠️ Warning signs that require an immediate ER visit:

• He is having difficulty breathing or breathing much faster than normal.

• His chest is severely retracting (sucking in) with each breath.

• He has a severe cough that causes vomiting or an inability to catch his breath.

• He refuses all fluids or has not urinated in over 8 hours.

Since he is currently sleeping, stay by his side and closely observe his breathing. If none of the severe symptoms mentioned above are present, you can wait and take him to see a pediatrician tomorrow morning. However, respiratory issues can progress quickly; if you have any doubts about his ability to breathe comfortably, do not wait and seek emergency medical care right away.

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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