From the Guidelines
Viral fevers in toddlers typically last between 3 to 5 days, though some may persist for up to a week, with treatment with oseltamivir reducing the median duration of illness by 36 hours in children with laboratory-confirmed influenza, as shown in a Cochrane review of 6 RCTs involving 2356 children 1. The fever often peaks in the first 2-3 days before gradually subsiding as the child's immune system fights off the infection.
- During this time, it's essential to manage symptoms with age-appropriate doses of acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) as recommended by your pediatrician, typically every 4-6 hours as needed for fever or discomfort.
- Keep your child well-hydrated by offering frequent small amounts of fluids to prevent dehydration, which can complicate recovery.
- Rest is essential for healing, so allow your toddler plenty of downtime. Some key points to consider:
- The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend the use of oseltamivir to treat influenza in both term and preterm infants from birth because benefits of therapy of neonatal influenza outweigh the risks 1.
- Treatment with oseltamivir for children with serious, complicated, or progressive disease presumptively or definitively caused by influenza is recommended by the AAP, CDC, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society, with earlier treatment providing better clinical responses 1. While most viral fevers resolve on their own without specific treatment, you should seek medical attention if:
- The fever exceeds 102.2°F (39°C)
- Persists beyond 5 days
- Is accompanied by severe symptoms like difficulty breathing or extreme lethargy
- Or if your child appears significantly ill. The duration varies because different viruses affect the body differently, and each child's immune response is unique, with younger children sometimes taking longer to recover due to their developing immune systems.
From the Research
Duration of Viral Fever in Toddlers
- The duration of viral fever in toddlers can vary depending on the type of virus and the child's overall health 2.
- According to a study on the course of fever following influenza virus infection in children, the period until normalization of temperature was longer in type B than in type A/H3N2 disease, and was negatively associated with age, and positively with maximal body temperature 2.
- Another study found that the effectiveness of oseltamivir on body temperature in type B disease was less apparent in certain seasons, irrespective of age 2.
- However, there is no substantial evidence to suggest a specific duration for viral fever in toddlers, as most studies focus on the management of fever rather than its duration 3, 4, 5, 6.
- It is essential to note that fever is a physiologic mechanism that has beneficial effects in fighting infection, and the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature 3, 5.