# Fever, Colds and Ear Infections: When to Call the Doctor (AAP)

> Colds, fever and ear infections after 3 months: what helps at home, and when to call — including a fever of 101°F or higher at 3 to 6 months.

Stage: baby - Topic: Health - Page: https://www.askcladle.com/guides/baby/colds-fevers-and-ear-infections

Grounded in: AAP HealthyChildren guidance on fever, colds, coughs, ear infections and dehydration, and FDA guidance on cough and cold medicines for children. For babies under 3 months, see the newborn red flags guide: any fever then needs a call right away.

**Call now:** Struggling to breathe, blue lips, very hard to wake, a seizure, a stiff neck or a rash that doesn't fade when pressed: call 911. Fever of 101°F+ at 3 to 6 months, or a fever lasting over 24 hours under age 2: call the doctor.

## TLDR

- Colds last 7-10 days and antibiotics don't help them. Saline, suction, fluids and rest do.
- Fever medicine is for comfort: acetaminophen from 2 months with the doctor's OK, ibuprofen from 6 months. Never aspirin.
- Call for 101°F+ at 3-6 months or fever over 24 hours under age 2. Struggling to breathe, very hard to wake, stiff neck or a non-fading rash means 911.

## Colds are common

- Babies and toddlers often get 8 or more colds a year, more in their first year of group care.
- A cold usually lasts 7 to 10 days. The cough can hang on for 2 to 3 weeks.
- Colds are caused by viruses, so antibiotics don't help them.

## Easing a cold

- Saline drops and gentle suction for a stuffy nose, especially before feeds and sleep.
- A cool-mist humidifier in the room.
- Plenty of fluids: extra breast milk or formula for babies, water for older children.
- Honey can soothe a cough from age 1. Never give honey under 12 months (botulism risk).
- Don't give over-the-counter cough and cold medicines under age 4 unless the doctor says to; they
  don't work well in young children and can be harmful.

## Fever

- A fever is a temperature of 100.4°F (38°C) or higher. It's the body fighting infection, and the
  number on its own matters less than how your child looks and acts.
- Fever medicine is for comfort, not to hit a number. Acetaminophen from 2 months with the doctor's
  OK and ibuprofen from 6 months, dosed by weight. Never give aspirin to children.
- Call the doctor for a fever of 101°F (38.3°C) or higher at 3 to 6 months, a fever that lasts more
  than 24 hours in a child under 2, or more than 3 days in a child 2 or older, or a fever that keeps
  going above 104°F (40°C).

## Ear infections

- They often follow a cold. Signs: fussiness, trouble sleeping, fever, pulling at the ear, or fluid
  from the ear. Ear tugging on its own, without other signs, is often just teething or habit.
- The doctor needs to look in the ear to know. Many mild ear infections in older babies and
  toddlers clear on their own, so the doctor may suggest watching for a day or two before
  antibiotics.
- Pain relief helps either way.

## Vomiting and diarrhea

- The main risk is dehydration. Offer small, frequent sips: breast milk or formula for babies, or an
  oral rehydration solution. Skip juice and sports drinks.
- Signs of dehydration: far fewer wet diapers (none in about 8 hours), no tears, dry mouth, sunken
  soft spot, or unusual sleepiness.

## Call 911 or go to the ER

- Struggling to breathe: ribs pulling in with each breath, flaring nostrils, grunting, or blue or
  gray lips.
- Very hard to wake, floppy, or not responding normally.
- A seizure, a stiff neck, or a rash of small purple-red spots that don't fade when you press them.
- A high-pitched, noisy breath (stridor) when calm, often with a barky cough (croup).
- Signs of dehydration that aren't improving.
- If you're worried and can't reach the doctor, trust that worry and get your child seen.