There is nothing quite like your child spiking a fever to strike fear in even the most rational of parents. Although it can make them feel crummy and it is no fun to see your child not feeling well, in most cases it is transient and no reason for alarm.

 

What is a fever?

• Believe it or not, this is not as obvious a question as it sounds. Many parents think a temperature of 99 is a fever. Although this may be higher than what you think of as your child’s usual temperature – temperatures do fluctuate throughout the day and vary from person to person. In medicine we define fever as > 100.4 degrees farenheit.

What causes a fever?

• Without getting too much into nitty gritty a fever is actually a normal physiologic response to illness and is the body’s way of resetting its internal thermostat to try to fight off infection.

Wil fever harm my child?

• In by far the majority of cases, no. Even high fevers do not cause brain damage or other frightening concerns parents often worry about. A fever would have to be close to 108 or higher to cause brain damage and temperatures this high are very rare and often involve external factors such as a very hot environment.
• However high fever (above 102) can cause dehydration which can be harmful and in some cases a high fever (>104) can be a sign of a more serious illness.

How high is TOO high of a fever?

• There is not a set temperature above which we need to worry (see above, except for extremely high; > 108.) It is more important to look at your child’s behavior and appearance to determine how much to worry. Things to consider:
• Are they eating and drinking well (emphasis on drinking and hydration, it is ok for appetite to be decreased for a few days.)
• Do they still have periods during the day when they are playful and happy?
• Do they look ok when their fever comes down or are they still listless or sleepy?
• Aside from nap or bedtimes are they relatively alert and do they interact with you?

How do I treat a fever?

• In babies 3-6 months Acetaminophen (Tylenol) is recommended.
• After 6 months Ibuprofen (Motrin or Advil) can be used.
• Do not give your child Aspirin which has been associated with a disorder called Reye syndrome that can occur in the setting of a virus with use of Aspirin.
• In addition to medications simple measures such as encouraging hydration, offering cool liquids or popsicles, avoiding overbundling, keeping the home or bedroom cool, applying a cool washcloth on the forehead can also help. It is not recommended to put the child in a cold bath as it doesn’t provide any additional benefit and can be very uncomfortable. Shivering can even raise the body temperature. A lukewarm bath can be helpful though.
• Under 3 months with fever your child needs to be evaluated by a physician.

Ibuprofen Dosing Chart

When should I call my Pediatrician?

• If your child is younger than 3 months and has a temperature of 100.4 or more
• If your child has an immune system problem or is on medications that weaken their immune system
• If your child has been in a very hot environment such as a hot car
• If your child looks very ill, is extremely sleepy or fussy and unconsolable
• If your child has signs of dehydration; lethargy, sunken eyes, no urine in > 8 hours, not making tears
• If your child has difficulty breathing that doesn’t improve with clearing nasal congestion
• If your child has severe pain; head, neck,  throat, ear or abdominal pain
• If your child has a seizure
• If your child has had a fever for more than 3 days or persistently higher than 104
• If your child doesn’t seem to be feeling or looking better when fever comes down
• If your child has severe vomiting or diarrhea

Helpful Resources:

Fever – kidshealth.org

 

Fever without Fear – healthychildren.org