Dr. Greta’s “Take” on Fever

Fever – Curse or Blessing?

Fever is the body’s way of fighting infection.  At any one time, there can be several “invading” infections, trying to make us sick!  Most of the time our bodies can fight these intruders with several “weapons”.  One of the most important is fever.  The brain, which controls our body temperature, can “turn up the thermostat”, or make us have a fever to try to “cook”, or kill the invading infection.

Therefore, fever is a good thing!  So, why is everyone so worried about a high fever? In the past, people thought that fever caused brain damage.  This is not true; certain infections, like meningitis, can cause brain damage, but these are not common.  The most important reason to fear fever is dehydration.  Young children may not drink enough fluids to maintain the loss from sweating that occurs with fever. 

There is confusion over causes of fever.  There is a big difference from having a fever due to infection (the most common cause in kids) and feeling hot from heat stroke or heat exhaustion.  Usually you will be able to tell if the child has been in a place to get over heated, such as in the summer time, or left in a car or enclosed area (which should NEVER happen!).  Heat stroke, is a true medical emergency, and the child needs to be cooled down rapidly and taken to the hospital. 

Normal body temperature by mouth is 98.6F.  Normal rectal temperature is about 99.6F.  Normal axillary (armpit) temperature is about 97.6F.  Ear thermometers can be set to read either rectal or oral temperatures. 

There are different definitions of fever.  I define it as a temperature over 101F taken rectally or by the ear thermometer on the rectal setting, or orally.  An axillary temperature of 100F is considered a fever.

When a child has a fever:   1. Find out why there is a fever and if needed, treat the cause. 

                                                2.  Keep the child well hydrated.  Give small amouns of liquid FREQUENTLY!!! 

                                                3. Have a plan for watching and evaluating the fever.

When to worry:     Infants -3 months: Call with any fever.  Infants are more susceptible to serious                                                  infections and can become seriously ill very quickly.

                                Call if any child appears ill, isn’t eating well, has decreased urination, has a stiff  neck,                                                       or isn’t moving much, seems very uncomfortable or in pain.

                                If you are worried.

If a child is eating, smiling, playing, urinating normally, eating/drinking normally and does not appear ill, you can allow the child to have a fever without calling for:

                                 3 months – 1 year: up to 12 hours 

                                1 year -2 years: up to 24 hours

                                2 years and above: up to 48 hours

Treating Fever – If the child is drinking well, and isn’t fussy, don’t treat!  He’ll get better faster due to the fever!  If the child is fussy, or you are worried about dehydration, you can use Tylenol (acetaminophen).  After 6 months of age you can use or Advil or Motrin (ibuprofen).  It is no longer  recommended to use both, alternating every few hours.  There were too many children who were overdosed, due to giving the medications too frequently. NEVER USE ALCOHOL RUBS!!  NEVER PUT THE CHILD IN ICE WATER !!!  These will make the child shiver, and actually increase the temperature.  Lukewarm baths can be given if they don’t upset the child.