What is fever, How to assess your child, When to call, What to do
At one time or another almost all children will probably have a fever. Fever is a symptom, not a disease, and is usually caused by infection. It is one of the ways the body naturally fights infection. Although it can be scary because kids can get irritable, whiny, and fussy with a fever, the fever itself is not harmful, and it by itself is rarely (except in infants under 3 months of age) a sign of serious illness. Most infections are viral and will get better on their own. Some, like strep throat, urinary tract infections and some pneumonias are caused by bacteria and antibiotics will be prescribed. Normal body temperature is 98.6, but can vary, especially in the evening. Under 100.4 is considered normal. Often children will have chills, or look flushed when their fever is on the rise. You can not tell if a fever is present by feeling the skin. You must use a thermometer. For infants rectal temps are most accurate. Read about the many ways to take a temperature. The degree of fever is only important in the following ages:
- Infants under 3 months with a rectal temperature of 100.4 degrees or greater. (must be seen immediately)
- Children under 6 months with a temperature of 102.2 or greater. (call our office any time if the cause has not already been determined, or if the condition has changed)
- Children between 6 and 12 months with a temperature of 103 degrees or greater. (call our office any time if the cause has not already been determined, or the condition has changed)
- As children get older the degree of fever is much less important than the other symptoms your child is having and how he or she is acting after a fever reducer, like Tylenol. Sometimes children with very serious illness run no fever and simple viruses can cause very high temperatures.
Always be ready to answer the following questions:
- What other symptoms does your child have? Runny nose, cough, sore throat, vomiting, diarrhea, rash?
- Any exposures? Anyone else at home sick?
- Is your child playing?
- Is your child eating or drinking? Any signs of dehydration?
- Is your child alert? Attempting to smile?
- Have you given Tylenol (any age) or Ibuprofen (over 6 months), and have the symptoms improved as the fever has come down?
If you’ve answered that other minor symptoms are present and the child is alert, hydrated, and the fever has responded to Tylenol– it is most likely safe to wait and continue to treat the symptoms. If the fever lasts more than 2-3 days, your child’s condition changes, a specific symptom is present and persists (like an earache), or you are worried– call us. You can speak to our nurse or schedule an appointment during regular office hours, or the doctor on call can be paged after hours, if you feel it can’t wait.
Symptomatic Relief Tips:
Remember fever is not dangerous, but it can make kids uncomfortable. It only needs to be treated to make your child more comfortable or to help asses what else is going on.
See the dosing guide for Tylenol and or Motrin. Dress in light clothing. For high temps a lukewarm sponge bath will often bring temp down. (no rubbing alcohol). Offer lots of liquids and plenty of rest. Read more about fever.