Red Flags & When to Go In Person for Fever in Infant - Triage

Audience: pediatric

Fever in infants can be a sign of many different illnesses, some mild and others more serious. It is important for parents and caregivers to recognize when a fever can be managed at home or through telemedicine, and when it requires urgent in-person medical care. Telemedicine can often help assess symptoms, provide advice, and guide next steps for infants with fever. However, certain warning signs or "red flags" indicate that the infant needs to be seen by a healthcare professional immediately. These include very young age (under 2 months), difficulty breathing, persistent vomiting, poor feeding, unusual sleepiness, or a rash. Understanding these signs helps keep infants safe and ensures timely treatment when needed. This guide explains when telemedicine is suitable for infant fever and when to seek in-person care.

Red flags — go in person / ER

• Infant younger than 2 months with any fever (≥38°C or 100.4°F) — seek emergency care immediately.
• Difficulty breathing or rapid breathing — go to emergency care without delay.
• Seizures or convulsions — call emergency services immediately.

What telemedicine can do

• Initial assessment of fever in infants older than 3 months without red flags.
• Providing advice on fever management and symptom monitoring.
• Guidance on when to seek in-person care.

What telemedicine cannot do

• Fever in infants younger than 2 months.
• Infants showing red flag symptoms such as difficulty breathing, seizures, or persistent vomiting.
• Emergency situations requiring immediate physical examination or interventions.

Understanding Fever in Infants

Fever is a common symptom in infants and often signals the body is fighting an infection. In infants younger than 3 months, even a mild fever may require prompt evaluation because their immune systems are still developing. For older infants, fever can be due to many causes, including viral infections, teething, or other illnesses. Monitoring the infant's behavior, feeding, and other symptoms is important to determine the severity.

When Telemedicine Can Help

Telemedicine visits can be useful for initial assessment of an infant with fever, especially if the infant is older than 3 months and does not have severe symptoms. Through video or phone calls, healthcare providers can ask about symptoms, observe the infant's appearance and behavior, and provide advice on fever management. Telemedicine can guide parents on how to monitor the infant and when to seek further care.

Red Flags That Require Immediate In-Person Care

Certain signs in an infant with fever require urgent evaluation in person. These include:

If any of these signs are present, seek emergency medical care immediately.

How to Prepare for a Telemedicine Visit

Before a telemedicine visit for infant fever, prepare the following:

After the Telemedicine Visit

After the telemedicine consultation, follow the healthcare provider’s instructions carefully. This may include:

When to Seek In-Person Care Beyond Red Flags

Even if red flags are not present, in-person evaluation may be needed if:

Timely in-person assessment helps identify serious infections and other conditions early.

How to prepare for your tele-visit

• Have a reliable thermometer ready to measure and report the infant’s temperature.
• Note the exact temperature reading and time taken.
• Observe and be ready to describe the infant’s behavior, feeding patterns, and other symptoms.
• Prepare a list of any medications or treatments already given to the infant.
• Ensure a quiet, well-lit area for the telemedicine visit.
• Have a caregiver available to assist with the infant during the consultation.

After your tele-visit

• Follow the healthcare provider’s instructions regarding medication and care.
• Monitor the infant’s temperature and symptoms regularly.
• Keep the infant hydrated and comfortable.
• Schedule an in-person visit if symptoms worsen or do not improve as advised.
• Seek emergency care immediately if any red flag symptoms develop after the visit.

FAQs

Can I use telemedicine to check my 1-month-old baby’s fever?

Infants younger than 2 months with any fever should be evaluated in person promptly. Telemedicine is generally not recommended for this age group with fever because they are at higher risk for serious infections.

What temperature counts as a fever in infants?

A fever is typically defined as a body temperature of 38°C (100.4°F) or higher when measured with a reliable thermometer.

When should I take my infant with fever to the emergency room?

Go to the emergency room immediately if your infant has difficulty breathing, seizures, persistent vomiting, poor feeding, excessive sleepiness, or a rash that does not fade when pressed.

Can I give my infant medicine to reduce fever before a telemedicine visit?

You may give fever-reducing medication such as acetaminophen if appropriate for the infant’s age and weight. Inform the healthcare provider during the telemedicine visit about any medications given.

How long can I monitor a fever at home before seeking in-person care?

If your infant is older than 3 months and does not have red flag symptoms, you can often monitor the fever for up to 3 days. If the fever persists beyond this or the infant’s condition worsens, seek in-person care.

Sources

1. Fever in Children — MedlinePlus, U.S. National Library of Medicine.
2. Fever in Infants and Children: When to Call the Doctor — Centers for Disease Control and Prevention (CDC).
3. Fever in Children: Causes, Symptoms, and Treatment — Mayo Clinic.
4. Managing Fever in Children — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation and care. If your infant shows any red flag symptoms or if you are concerned about their health, seek immediate in-person medical attention.