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23rd Oct 2014

Fever (temperature of 100.4 or higher) is often scary for parents.  Fever in infants and children indicates something is not completely normal, but learning what causes fever and how to treat it should help make you less anxious and better informed how to handle the situation.

It is only natural to be concerned when your child has a fever, especially if it is going up, but not all fevers are a cause for worry.  Some fevers don’t need treatment.  Fevers activate your child’s immune system and by doing this can actually shorten the illness.  Everyone has their own internal ‘thermostat’ that regulates body temperature.  Normal temperature is not a specific number.  It usually ranges from 97 degrees to 100.4 degrees, but can also vary according to time of day, age, and physical activity.

When your body detects an infection or inflammation, the body responds by raising the temperature to help fight the infection.  How ill someone is acting is a better indicator of the severity of illness than the height of the temperature. A child with 103 temperature who is playing and maybe just a little out of sorts is usually not as much of a concern as a child who is “out-of-it” or not very responsive regardless of the temperature.

A person usually has chills when their temperature is going up rapidly, and sweats when it is coming down. Treatment is rarely required for a child older than three months who has a mild fever and no other symptoms.  If other significant symptoms appear with the fever or if the child is younger than three months of age with a fever of 100.4 or higher, you should call our office.

You should call our office when your child has a temperature of 100.4 or higher if:

  • Your child is younger than 4 months
  • Your child is lethargic, unresponsive, refuses to drink, has a rash, is in pain, or is having difficulty breathing
  • You see signs of dehydration, such as dry mouth, significantly fewer wet diapers.
  • The fever lasts more than a few days
  • If your child experiences a seizure

(Most of these symptoms would require our attention even without a fever.)

The best way to tell if your child has a fever is to take their temperature.  A fever can’t always be detected by feeling a child’s forehead.  The best way is to use a rectal thermometer for an infant and an oral one for a child.  This way is still the most accurate.

Use a digital rectal thermometer, clean the tip with rubbing alcohol, lubricate the tip with a water-soluble lubricant, place baby on stomach or accross a firm surface, or on his/her back with legs lifted, slowly insert the thermometer into the anal opening, about 1/2 inch.  Hold the thermometer with one hand and hold baby with the other hand and then wait for the reading of the thermometer.

Althought not every fever needs to be treated, there are some things you can do to try to make your child more comfortable.  You can give acetaminophen or ibuprofen to reduce the fever.  Make sure you give the appropiate dose.  Our office does not recommend alternating acetaminophen and ibuprofen because of the risk of overdosing your child in a situation where the risks outweight the benefits.  Don’t overdress your child with a fever, and offer a lot of fluids to keep him/her from getting dehydrated.  Remember, if you have questions or are just not sure, call our office.

A quick note about febrile seizures.  A febrile seizure is a relatively common and harmless side effect of fevers in young children.  It looks like a full-body seizure where your child might be unresponsive, look strange, twitch, stiffen or roll his/her eyes.  If this happens, you should try to remain calm, move him/her to a safe place where he/she can’t hurt themselves.  Do not try to put anything in his/her mouth.  The febrile seizures usually last less than one minute (they can last as long as 15 minutes).  If the seizure lasts longer than a few minutes, you should call 911.  Follow-up with our office for all febrile seizures.