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Burning up
What to Do When Your Child Gets a Fever
by Julia Rosien
Do you worry when your child has a fever? You may find some solace in learning that in fact fever is not harmful and seldom indicates a serious problem. A fever normally indicates the immune system is doing exactly what it was designed to do -- fight off infection. Become
informed about fever and sort the facts from the fears.
When children look unwell, most parents immediately brush hair
back off the forehead and check for fever. For parents, diagnosis
begins here, along with a lot of anxiety. Ninety-nine percent of
parents worry fever will harm a child, reports the Association
for the Care of Children's Health (ACCH).
A fever is the body's ordinary, and usually effective, response
to an infection. When we get sick, from a bacterial or viral infection, for example, the hypothalamus (in the brain) turns up the body temperature. Your body is trying to kill the infection with heat. Therefore, your first reaction to a fever shouldn't necessarily be to bring down the temperature because this might interfere with the body's natural healing response. When temperature rises, it registers on the thermometer as a fever. Skin turns
red, the heart races to pump circulation through the skin faster
as the body then tries to lower the temperature. Fevers usually
rise and fall about every six hours for the duration of the
infection.
A fever is the body's ordinary, and usually effective, response
to an infection. "Fever itself is rarely a problem," notes Dr Al Sacchetti of the American College Of Emergency Physicians. "However it is a sign that infection may be present. Therefore, when a child has a fever, the focus should be on the child, and the possible infection, and not the reading on the thermometer."
Your child may have a fever that needs to be treated if body temperature is:
- higher than 100.4 degrees F (38 degrees C) when measured rectally
- higher than 100 degrees F (37.8 degrees C) when measured orally or in the ear
- higher than 99 degrees F (37.2 degrees C) when measured under the arm
According to Dr Vinay Reddy of DrReddy.com, "Usually, we regard 99.9 as the upper limit of normal temperature; unless we suggest it, you shouldn't give anything for fever unless your child's temperature is 100.0 or higher, and possibly not unless it's higher than 101," he reports.
If medication is necessary, most caregivers recommend medications such as Tylenol (acetaminophen) or ibuprofen. Never give a child (or even a young adult) aspirin, unless your doctor specifically tells you to. Aspirin in a child with certain viral illnesses (such as chickenpox and mono) can produce a very serious liver disease called Reye's syndrome which can, in turn, cause seizures and also can be fatal.
"If your baby is less than two months old, call the doctor
immediately," says Dr Wendy Mitchell, of the University of
Southern California. An older baby with a fever above 104 degrees F (40C)
who acts ill by crying inconsolably and cannot be settled should
also see a doctor. The exact temperature that should trigger a
call to the doctor depends on the age of the child, the illness
and whether the child has other symptoms with the fever. Talk to
your child's doctor about when to call regarding a fever.
Your child is:
- is lethargic or difficult to wake
- has breathing difficulties
- has abdominal, throat or ear discomfort
- shows no sign of improvement after acetaminophen
- has had a fever for more than 72 hours
- was better but the fever returned
- cries when urinating
- has a febrile seizure
"Generally, the cause of the fever is of greater concern than the
fever itself," says Dr Mitchell. "If the baby looks well, is
able to play, eat and acts normally, there is less concern. Only
when body temperature is extremely high (42 C or about 106 F) is
it in the range where the actual temperature is of great concern,
rather than the overall health of the child or the underlying
cause of the illness."
The Mayo Foundation for Medical Education and Research notes that if an infant or child under age two has a fever and seems lethargic and unresponsive, these may be signs of meningitis. If you're worried that your baby might have meningitis, see your doctor immediately -- don't wait until morning or the weekend is over. High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of two years, says the US National Center for Infectious Diseases. These symptoms can develop over several hours, or they may take a couple days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
Your grandma probably used a glass mercury thermometer. Today you
can choose from digital electronic thermometers, high-tech ear
canal models and flexible forehead thermometers. How do you know
which one to use? Where is the best place to take your child's
temperature, and how?
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"Before you take your baby's temperature, take off her clothes
and let her lie uncovered at least three to five minutes," says Dr
Paula Elbirt, author of House Calls to Your Newborn. "Use a
rectal thermometer inserted about one half inch into the rectum for at least
one and a half minutes." Fever strips or other surface methods often give
misleading information, and a baby's ear is not large enough to
allow an ear thermometer. So, use the old-fashioned glass or
quicker digital thermometers for an accurate assessment.
For older babies and children, chose a thermometer that's easy use
and read. Both glass mercury thermometers and digital
thermometers give accurate readings, but glass thermometers can
shatter and release the harmful mercury inside, so handle them
carefully. Ear thermometers quickly and easily measure
temperature inside the ear canal. They are still fairly expensive
compared to glass and electronic models, and learning how to use
them correctly takes some training.
We've all heard the mantra, get plenty of rest and drink lots of
fluids. That sage advice works well for any person, any age.
Fluids prevent dehydration and help the body cool itself. Fluids
also allow the to body expel bacteria through urination. Rest
gives the body time and energy to win the war against germs.
Keep the room temperature at about 70F to 74F (22C-23C), and
dress your baby or child in light cotton pajamas so heat can
escape. If your child is chilled, add an extra blanket until the
chill passes. Used together, acetaminophen and a lukewarm bath
may help lower a fever according to ACCH. Give acetaminophen
before the bath. If the bath is given alone, your child may start
shivering as his or her body tries to raise its temperature
again. Don't use alcohol (it can be toxic) or cold water for
baths (they are just uncomfortable).
Although febrile seizures, commonly known as fever seizures
terrify parents, they aren't as dangerous as they appear. A
seizure, also known as a convulsion, is a brief period of
unconsciousness or altered consciousness. Falling, muscle spasms,
drooling or "frothing" at the mouth, loss of bladder or bowel
control and a temporary halt in breathing may accompany it.
A febrile seizure doesn't cause brain damage, and your child
can't swallow his or her tongue during a seizure. They usually
last just a few minutes and go away on their own. It's very
unusual for a febrile seizure to last more than 10 minutes
according to The American Academy of Family Physicians. Usually,
a child who has had a febrile seizure does not need to be
hospitalized.
The Academy recommends putting your child on his side so he
won't choke on saliva. Don't put anything in his mouth or
restrain movements during the seizure. The most important (and
hardest) thing to do is remain calm. Most seizures stop within a
few minutes, so check the clock often and call 911 immediately.
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Fevers help the body fight infections by stimulating the natural
defense mechanisms. Nevertheless, fever can make a child
uncomfortable. Since fever may point to underlying illness,
finding the cause of fever is the priority. Fortunately for
almost everyone, fevers aren't a very big problem. Once the cause
of the fever is treated or goes away on its own, body temperature
comes back down to normal.
Links, information and more for you
 Is It a Cold or the Flu?
Children's Pain Relievers
What is RSV?
Safe Antibiotic Use
Directory of health articles
Directory of all articles
About the author: Julia Rosien is a freelance writer and mother of four. She lives in Canada.
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