Lymph Nodes - Swollen

When To Call

Call Doctor or Seek Care Now

• Node in the neck causes trouble with breathing, swallowing or drinking
• Fever higher than 104° F (40° C)
• Skin over the node is red
• Node gets much bigger over 6 hours or less
• Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• 1 or more inches (2.5 cm or more) in size by measurement
• Very tender to the touch
• Age less than 3 months old
• Node limits moving the neck, arm or leg
• Toothache with a swollen node under the jawbone
• Fever lasts more than 3 days
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• In the neck and also has a sore throat
• Large nodes at 2 or more parts of the body
• Cause of the swollen node is not clear
• Large node lasts more than 1 month
• You have other questions or concerns

Self Care at Home

• Mildly swollen lymph node

Care Advice

What You Should Know About Normal Nodes:

• If you have found a pea-sized or bean-sized node, this is normal. Normal lymph nodes are smaller than ½ inch or 12 mm.
• Don't look for lymph nodes, because you can always find some. They are easy to find in the neck and groin.

What You Should Know About Swollen Nodes from a Viral Infection:

• Viral throat infections and colds can cause lymph nodes in the neck to get bigger. They may double in size. They may also become tender.
• This reaction is normal. It means the lymph node is fighting the infection and doing a good job.
• Here is some care advice that should help.

Pain Medicine:

• To help with the pain, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.

Fever Medicine:

• For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Note: fevers less than 102° F (39° C) are important for fighting infections.
• For all fevers: keep your child well hydrated. Give lots of cold fluids.

Do Not Squeeze:

• Don't squeeze lymph nodes.
• Reason: this may keep them from shrinking back to normal size.

Return to School:

• Swollen lymph nodes alone cannot be spread to others.
• If the swollen nodes are with a viral illness, your child can return to school. Wait until after the fever is gone. Your child should feel well enough to participate in normal activities.

What to Expect:

• After the infection is gone, the nodes slowly return to normal size.
• This may take 2 to 4 weeks.
• However, they won't ever completely go away.

Call Your Doctor If:

• Node gets 1 inch (2.5 cm) or larger in size
• Big node lasts more than 1 month
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Photos

Lymph Node Swelling of Left Arm Pit

Severe swelling of lymph node(s) in left arm pit. The child had a finger infection and the lymph node(s) in the arm pit became enlarged to help fight this infection.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.