Fever
Fever, the fear of many parents, but it shouldn’t be. Fever is actually your friend. I swear.
First, what is a fever?
That answer can vary. We like to say that normal body temperature is 98.6F, and that technically a fever is anything over 100.4F in infants and 101F in everyone else. However, that’s mostly for convenience, as the thermometer used, where it was taken, and even variations in personal normal temperatures means that the true answer is variable. When we need one as accurate as possible, such as in a young infant, the rectal temp is used.
So should I always use a rectal thermometer, then?
No, it’s really only needed when the temperature needs to be as accurate as possible in an infant. In the clinic we generally use a temporal thermometer, which is quite accurate, but can be expensive. Oral temps are fine as long as the child is able to keep their mouth closed long enough. Axillary temps are good if you’re able to keep the arm tightly closed, but please don’t add a degree when reporting it. Ear temps can be tricky because little ears are tiny and often not straight. It’s not recommended to use the old mercury thermometers as mercury is a poison and can hurt your child if the glass breaks.
The important part of keeping track of temperature is to keep checking it with the same thermometer and method, so you know when there is a true difference. And when you report it to your pediatrician, tell them the temperature you recorded and how you took it.
You said fever was my friend, how does it help me?
First, it tells you that something is wrong with your child’s body. Sometimes that’s the only sign they will show. In infants younger than two months, and especially younger than one month their immune system is very immature so they can get sick quickly and without many symptoms.
Secondly, a fever can be part of the body’s defense against viruses and bacteria. Raising the temperature of the body these pathogens are in can cause them to not be able to work as well.
Okay, but fever makes my child feel bad.
Yes, it absolutely can. While there’s no reason to treat a fever if your child feels fine, low energy, pain, or other symptoms can definitely be a reason to treat it.
The medical treatments are variations of acetaminophen (tylenol, fever-all, etc) and ibuprofen (advil, motrin, etc). They come in various forms, such as liquid, chews, and swallow pills. Acetaminophen also comes in a rectal form. Check with your doctor to get the correct dose for your child’s weight (not age – dosing is based on weight for this).
Non medical treatments for fever are varied. Make sure the child isn’t bundled up, and is wearing cool clothing. A tepid, but not cold, bath or cool cloths may help their temperature improve. Push fluids to help replace the fluids your child loses due to the fever.
But what about febrile seizures?
Febrile seizures are a very scary thing for parents, but have never been shown to be harmful to children. They occur in a very small percentage of children less than 6 years old. They last a short amount of time for the most part, but rarely over 15 minutes.
I usually advise my patients that if they can get to the phone and the child is still seizing, then go ahead and call 9-1-1. Either way, make sure to call your pediatrician when they’re next open so you can inform them of the seizure and be seen if needed.. Often seizures are due to a virus, ear infection, strep throat, or something similar.
Medicines for fever, such as tylenol and advil, are fine to give your child if they’ve had a febrile seizure before, but have not been shown to prevent any further ones.
When else should I call the doctor?
If your child is under 2-3 months, the doctor needs to know if your child has a fever. Especially under 1 month, they need to know right away. As a child gets older pediatricians get less upset about fever. If there are other symptoms that need to be looked at – ear ache, sore throat, not breathing well – or you are concerned, then it never hurts to at least call the clinic. Remember that the fever itself won’t hurt your child, even up to 105F, the question is why does your child have a fever.
Links
Mayo clinic quick guide to treating a fever.
