You can call your child’s pediatrician, no matter what time it is, even if the office is closed. After-hours calls are managed by specially trained registered nurses.

Published: September 4, 2020 | Updated: March 2, 2023

It’s 2 a.m. and your child has a high fever. The signs of the flu are there, or is it COVID-19?

At that point, a parent’s thoughts can race: “Should I call the pediatrician or go to the emergency department?”

Take an inventory of what your child looks like and how they are acting based on the list below. Depending on how your child is doing, a visit to the pediatrician’s office or an immediate care center may be appropriate. If unsure, always call your child’s pediatrician, no matter what time it is, even if the office is closed. After-hours calls are managed by specially trained registered nurses who can help you make decisions on how to manage your child’s care.

Office visit, immediate care center or emergency department?

Go to an emergency department if your child has any of these emergency warning signs of the flu or severe COVID-19:

• Lethargic (not very alert or arousable or not wanting to wake up)
• Irritability, not wanting to be held
• Fast breathing or trouble breathing (ribs pulling in with each breath or nostrils flaring)
• Bluish lips or face
• Severe muscle pain (refusing to walk)
• Chest pain or pressure in the chest
• Concerns for dehydration (no urine/wet diapers for greater than eight hours, no tears when crying, dry mouth)
• High fever — greater than 104 F — that won’t come down with a fever reducer (see reminder below)
• Fever or cough that improves but then returns or significantly worsens
• Seizures
• Unable to feed (infants)

Reminder: Never ignore any fever (100.4  F or greater) in a baby who is less than 3 months of age. Call your pediatrician or go to the emergency department immediately.

Justin M. Morgan, M.D., FAAP, is a pediatrician with Norton Children’s Medical Group – Brownsboro.