Monday, January 13, 2014

Fever

Tara Doman, MD
From the desk of Tara Doman, MD

Flu and cold season has arrived!  One of the most common symptoms of illness in children is fever.  It can also be one of the scariest symptoms for parents.  If your child is less than 3 months of age and has a fever of 100.4 or higher (under the arm or rectally), you should contact our office right away.   For children over the age of 3 months, here are a few fever facts.
  • Fever is a symptom of illness, not a disease itself.
  • The height of the fever does not correlate to the severity of the illness.  Just because a child has a higher fever, does not mean that they are more ill than a child with a lower fever.
  • Fevers do not cause brain damage.
  • There is not a certain level of fever that requires a trip to the emergency room.  When we evaluate a child with a fever, we are more concerned with how the child is doing overall.  A child who is refusing to eat or drink, is very drowsy or confused, has a rash with a fever, or has difficulty breathing should be evaluated right away.  A child who is playful, eating and drinking with a fever of 104 can be safely monitored at home.
  • Fever reducing medications, such as acetaminophen and ibuprofen, are very effective at treating a fever but may not eliminate it. 
When you measure a child’s fever, it is best to use a thermometer.   A child may feel warm to the touch without actually having a true fever.   When you do measure the temperature, simply use the number you see.  You do not need to add or subtract any numbers depending on how the temperature is taken.

Low grade fevers may help the body’s immune system work better.  However, higher fevers may make children feel achy and tired.   Children with fevers can also dehydrate more quickly.  If your child has a low grade fever, make sure they are staying hydrated by offering additional fluids such as water or Pedialyte.  Sponge bathing, using cold water or alcohol may cause more discomfort and shivering.  For higher fevers, acetaminophen (Tylenol) or ibuprofen for children over 6 months (Motrin or Advil), will help to reduce fever symptoms and will often bring the temperature down 1-2 degrees.  These medications should not be routinely alternated, as a child may get too much medication, and it is not necessary to control a fever that closely.  Ibuprofen can only be given to children over 6 months of age but will generally reduce fever for longer than acetaminophen.  Both medications should be dosed by weight, not age.  It is a good idea to have a medication syringe to properly measure the dose.

If your child has a history of seizures with fevers, you should ask your doctor the best way to manage fevers at home.   If your child has fevers for more than 3 days or has other symptoms associated with the fever, please call our office for advice.  Children who refuse to drink, do not urinate at least every six hours, have a rash with a fever, difficulty breathing or are lethargic need immediate medical attention. 

The majority of fevers can be safely treated at home.  However, when in doubt, give us a call! 

Best wishes for a healthy 2014!

 

Tara E. Doman, M.D., FAAP

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