fever, Illness, infant, toddler

Fever: Common Questions and When to Worry

Here’s a quiz to start today’s blog.fever.jpg.size-custom-crop.1086x0

Which one of the following temperatures constitutes a fever?

  1. 100 under the arm in a 4-month-old baby
  2. 99.5 in a 3-year-old child who usually runs low
  3. a 2-year-old who feels unusually warm and has a runny nose
  4. a 6-month-old who has a temperature of 100.2 in the ear

Answer: none of these children has fever.

What counts as a fever?

The medical definition of fever is a temperature above 100.4. There is no need to add a degree when measuring temperatures in the armpit or anywhere else as long as you hold the thermometer in place long enough. Feeling warm is quite deceiving since radiating heat without an actual fever is common early on in an illness as the body’s metabolism is revving up to fight off the bug. Just because your child usually ‘runs low’ she still has to achieve a temperature of 100.4 or higher before she technically has a fever.

When should you rush to the ER?

Sick ChildNow that we’ve established what constitutes a fever, the next question is what is the fever level parents need to worry about? Believe it or not damage due to elevated temperature doesn’t occur until fever gets above 106.5! As a result, medical providers care more about whether a fever is present or absent than how high the temperature is. When we ask what you measured at home, it gives us a better idea of whether fever is present or absent and can sometimes point us in the direction of the cause of the fever depending on how high and persistent it is.

But what about seizures?

Febrile seizures (seizures in conjunction with fever) do occur of course but actually they aren’t necessarily due to how high the fever is. Febrile seizures can occur at temperatures as low as 101 and may occur even if the fever gets to 105 or higher. What determines whether a febrile seizure will happen is a little bit of a mystery but a combination of the specific virus causing the illness, how quickly the temperature rises, and the genetic mix of the child all combine into a ‘perfect storm’ for a febrile seizure to occur.

When should I give medication?

listlesschildBut her fever isn’t going down with my fever reducing medicine! Medicines like acetaminophen (Tylenol) and ibuprofen (motrin or advil) are really meant to make your child more comfortable. Usually they also reduce fever by a degree or so but sometimes if the fever is still rising, they may only prevent it from going higher. Since fever itself isn’t dangerous, using these medications for improving your child’s overall comfort and sense of wellbeing rather than reducing fever makes sense. In other words, if your child is miserable, it doesn’t matter whether the temperature is 100.2 or 102, use the medication but if your child is still playing or is sleeping soundly even if the fever is 104 there’s no need for medication.

What about cool baths or rub downs to reduce fever?

Since fever isn’t dangerous, making your child more uncomfortable by undressing them and putting them in a lukewarm bath (never a cool or cold bath) just seems mean to me! Rub downs with alcohol (an old fashioned intervention) can actually be dangerous since the alcohol can be absorbed into the blood stream and cause alcohol poisoning.

How should I dress my child who’s feverish?

Follow your child’s cues. When the fever is rising, the body thinks it’s cold even though it’s not and will be shivering. No need to have your child be uncomfortable, let them be more bundled up and get comfortable. Once the fever has peaked and is falling, you’ll see your child begin to sweat or indicate that they are uncomfortable being all bundled up so let some of those layers go.

Does drinking milk affect fever or illness?

Not at all. Your child can eat or drink whatever she feels up to while she has fever.

Can he take a bath while he has a fever? Can we wash his hair with a fever?

Yes indeed to both. Neither of these will make his illness worse. Just be sure to use warm enough water to keep him comfortable and bundle him up afterward if he’s chilly.

Here’s the bottom line:

  1. We care more about how your child is ACTING than how high their fever is.
  2. Use medication to make your child more comfortable but if an hour or so after giving ibuprofen or acetaminophen your child is still listless, we need to hear from you.
  3. Fever of 101 or higher with no other symptoms for 4 or more days warrants a visit to the office.
  4. If your baby is under 2 months of age all bets are off and we need to hear about fever right away, day or night.
  5. Fever in conjunction with other symptoms like severe cough, bad sore throat, ear pain, pain with urination, etc may indicate a need to come to the office sooner.

 

For medication dosing, which is always based on WEIGHT NOT AGE, visit our website: http://www.birminghampediatrics.com.

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