Fort Worth, Texas,
12:32 PM

Fever In Newborns Should Never Be Ignored

Pediatrician explains the importance of a rectal temperature

I’ve written a lot about fevers in hopes of calming parents’ fears.

But when it comes to newborns, forget everything I’ve always taught you about fever. If an infant has a fever, it is a sign something is wrong and a serious cause for concern

In older children, fever is almost never an emergency, the exact degree of the temperature doesn't really concern me and unless there are other reasons to do so, a workup isn't indicated.

In babies up to 3 months of age, the opposites are true.

Fever in a newborn is an emergency. When a newborn has a fever, parents should have a sense of urgency.

An accurate temperature really matters for newborns. You don't need to go around checking your baby for fever randomly. But if they feel warm, are not eating well or you're otherwise worried, we recommend taking a rectal temperature. Rectal temperature is important because it's the most accurate way to determine the temperature and the studies that tell us what to do with your baby are based on rectal temperatures.

5 Steps to Take a Rectal Temperature



Once you have an accurate temperature, I recommend that you call your doctor with any temperature over 100 degrees. Technically fever is anything over 100.4, but it's good to let us know so we can coach you on what you should be looking for. It also helps us decide what should prompt a visit to the emergency room if it rises overnight.

Fever is such an emergency in babies because they can be an early sign of serious, even life threatening infections and babies can't tell us if something hurts. Babies can have blood stream infections, meningitis or urinary tract infections with little other symptoms. They also can get all the other things that older kids get too like stomach bugs, flu and other viruses but we would rather be safe than sorry.

Because of these risks, babies with fever will typically receive some type of lab work to determine if infection is present. This can include blood work, urine test and possibly a spinal tap to rule out meningitis.

While it's scary and no one wants to think of your baby needing this work-up, the fear of missing one of these serious infections or leaving them untreated, even for a short period, is even scarier.

Most babies with fever will be started on antibiotics while we wait in results from the test. This prevents babies from getting worse while we wait for results to come back.

So, as you can see, fever in newborns is a LOT different.

But, the important thing to remember is to call your doctor if the fever is over 100 and we'll help you keep your baby safe from there.

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Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.


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My 6 week old had a fever of 39.6c and no other symptoms.we took her to hospital and she had developed meningitis from a UTI which had spread into her bloodstream. She would have died in perhaps a day or so. I am so glad we bought a thermometer !