When Your Child Has Swollen Lymph Nodes

Lymph nodes help the body’s immune system fight infection. These nodes are found all over the body. Lymph nodes can swell due to illness or infection. They can also swell for unknown reasons. In most cases, swollen lymph nodes (also called swollen glands) aren’t a serious problem. They often go back to their original size with no treatment or when the illness or infection has passed. 

Lymph nodes are located throughout the body. Some lymph nodes can be felt from outside the body (shaded areas).

What causes swollen lymph nodes?

Swollen lymph nodes can be caused by:

• Common illnesses, such as a cold or an ear infection.

• Bacterial infections, such as strep throat.

• Viral infections, such as mononucleosis.

• Certain rare illnesses that affect the immune system.

• Lymphadenitis, which means that a lymph node itself becomes infected.

• Cancer, in rare cases.

How is the cause of swollen lymph nodes diagnosed?

• The doctor asks about your child’s symptoms and past health.

• A physical exam is done on your child. The doctor will check the nodes in the neck, behind the ears, under the arms, and in the groin. These nodes can often be felt from outside the body when they are swollen. If the doctor thinks your child may have an infection, your child may have more tests.

How are swollen lymph nodes treated?

• Treatment for swollen lymph nodes depends on the cause. In most cases, no treatment is needed.

• The doctor may prescribe medicine to treat an infection. Your child should take all of the medicine, even if they start to feel better.

• If lymph nodes are painful or tender, do the following at home to ease your child’s symptoms: 

  • Give your child over-the-counter medicine, such as ibuprofen or acetaminophen, to treat pain and fever. Don't give ibuprofen to an infant age 6 months or younger. Don't give aspirin to children or teens unless your child’s doctor says it is safe. Aspirin can put your child at risk for Reye syndrome, a rare but serious condition.

  • Put a warm, wet cloth (compress) on any painful or sore lymph nodes.

Call the doctor

Contact the doctor if your child has:

• A fever (see "Fever and children" below).

• A seizure caused by a fever.

• Painful or sore swollen lymph nodes. 

• Lymph nodes that keep growing or that last more than 2 weeks.

• A large lymph node that is very hard or that doesn't seem to move under your fingers.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it, and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child’s fever, tell them which type you used.

Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

When to call a doctor about your child’s fever

For a baby under 3 months old:

• First, ask your child’s doctor how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the doctor

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the doctor

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the doctor