Pediatric Essentials: Fever

When a child is running a temperature, the tendency to worry is natural, perhaps even universal among parents and caregivers.

But fever, the body’s natural response to infection or illness, should not be cause for unnecessary concern. Here are a few guidelines that will help you to recognize the signs and causes of fever, understand how to properly care for your feverish child at home, and know when it’s time to call the pediatrician.

WHAT CAUSES FEVER?

Fever in itself is not an illness but a sign of an infection or illness in your child’s body. Fever activates the body’s defenses to fight the cause of the infection. Usually, fever is caused by a viral infection, such as chicken pox, flu, ear infections or illnesses of the upper respiratory system. If your pediatrician has diagnosed an infection but your child otherwise appears well, you may not need to see the doctor if s/he spikes a fever. You can apply one or more of the Home Care tips that follow.

WHAT TEMPERATURE CONSTITUTES A FEVER?

Normal body temperature fluctuates from one person to another and even from one day to the next. So while there is no strict definition of fever, the American Academy of Pediatrics uses a baseline temperature of 100.4°F or higher to indicate a fever. Depending on the age of your child and other symptoms s/he may have, your little one may need to be evaluated—first by you, as a parent, and if necessary, by your healthcare provider.

When you take your child’s temperature, you might get slightly different temperature readings depending on how you take your child’s temperature—oral (mouth), axillary (armpit), ear, forehead, or rectal. Rectal thermometers are the most accurate, but if all you have is an instant-read forehead thermometer, go ahead and use it.

WHEN SHOULD I CALL MY CHILD’S PEDIATRICIAN?

Call your pediatrician today if your child experiences any of the following conditions:

• A baby under three months of age with a fever of 100.4°F or higher. Fever in infants can be a sign of a dangerous infection.
• A child under the age of two years with a fever of 100.4°F lasting more than 24 hours.
• A child of two or older with a fever of 100.4°F that lasts for more than three days.
• A child of any age who has frequent fevers above 104°F.
• If your baby cries continuously and can’t be soothed.
• If your child of any age has a fever of 100.4°F or higher and displays one or more of the following symptoms:*
  • Headache
  • Sore throat
  • Vomiting or diarrhea
  • Lethargy
  • Stiff neck
  • Bleeding under the skin
  • Difficulty breathing
  • Confusion or unusual drowsiness

*If you notice any of these foregoing symptoms and can’t reach your pediatrician, take your child to an emergency room or urgent care right away.

WHAT YOU CAN DO AT HOME

Fever often makes infants fussy and sleepless, so be prepared for a day or so of hands-on care. Feverish toddlers and older children may lose interest in playthings and may just want to sleep or cuddle. As long as your child doesn’t show any of the warning symptoms described above, you can help them feel better by taking the following steps:

• Give your child plenty of fluids to prevent dehydration. Water, fruit juices and popsicles are suitable for kids with fever but avoid carbonated beverages or those containing caffeine.
• Dress your child in light clothing, like PJs or a tee shirt and loose bottoms. Too many layers of clothing can trap heat and make symptoms worse.
• Encourage rest. You might find yourself holding, cuddling or rocking your feverish child, but if they cry for hours and can’t be comforted, call your pediatrician.
• You can give your child acetaminophen or ibuprofen (syrup works best with fussy babies and toddlers). Remember that such medicines can make your child more comfortable but will not address the underlying cause. Never give your child aspirin to reduce fever. Aspirin and fever in children have been linked to a serious disorder called Reye syndrome.
• Allow your child to eat lightly, but if they have no appetite, don’t force it. Remember the old adage, “feed a cold, starve a fever.”
• Apply cool wet cloths or compresses on their forehead or wrists.
• Treat your child to a lukewarm bath—never cold. Shivering can raise the child’s temperature, so if you hear chattering teeth, remove your child from the bath and pat them dry. Never leave your child unattended in the bathtub. 
• Never rub the child down with alcohol or witch hazel, which can be absorbed through the skin and cause alcohol poisoning and even coma.

WORK CITED

“Fever.” American Academy of Pediatrics, Public Website. Retrieved June 1, 2020 from https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/default.aspx

“Fever in Children.” Stanford Children’s Health | Lucille Packard Children’s Hospital Public Website, retrieved June 3, 2020 from https://www.stanfordchildrens.org/en/topic/default?id=fever-in-children-90-P02512

“Fever in Infants and Children,” by Deborah M. Consolini, M.D. Last full review/revision July 2018. Retrieved June 2, 2020 from Merck Manual Consumer Version, Public Website, https://www.merckmanuals.com/home/children-s-health-issues/symptoms-in-infants-and-children/fever-in-infants-and-children

“Fever without Fear: Information for Parents.” American Academy of Pediatrics Public Website. Last update: Last Updated April 26, 2016. Retrieved June 3, 2020, from https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-Without-Fear.aspx

“When to Call the Pediatrician.” Source: Fever and Your Child. Last update: Nov. 21, 2015.American Academy of Pediatrics public website. Retrieved June 1, 2020 from https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/When-to-Call-the-Pediatrician.aspx