Advice by Pediatric Conditions: Fever

What Is Fever?

Fever is a significantly elevated body temperature. Unfortunately, because different people have differing “normal” body temperatures (and everyone’s body temperature varies through the day) there is no universally agreed upon definition of fever.

For now let’s say a child has a fever when the axillary (armpit) temperature is over 99 F (37.2 C), oral temperature is over l00 F (37.8 C), or rectal temperature is over l0l F (38 C).

Is Fever Dangerous?

Fever itself is not dangerous until the temperature exceeds 107 F (rectally) and remains at that extreme level for at least a few hours. Even fever as high as 106 does not cause any brain damage. In fact, fever may actually help to fight an infection. Increased temperature is our “natural” defense and enhances our ability to fight infection. Nevertheless, fever is important. If fever is present it usually is a sign of illness. The higher the fever the more serious the illness may be, so it is often necessary for us to see a child with fever. Guidelines to help you know when we should see your child are listed below under “When Should a Parent Call”.

How Long Should A Fever Last?

Most fevers in children are caused by viral illnesses. Usually with these illnesses the temperature rises quickly at the beginning and starts to drop after 72 hours. Sometimes, however, the fever will persist for the entire illness. Treating with fever reducers like Tylenol usually lowers the temperature, but does not normalize it.

What About Your Child’s Appetite?

Children (and adults) have little or no appetite when they have a fever. However, while it is normal to refuse solid foods when feeling sick, your child should be able to drink liquids. In fact, a child with fever can benefit from extra fluids, so encourage your child to drink. A child may lose weight when ill, but will regain it once the illness resolves and the appetite returns.

What About Convulsions From Fever?

Some children may have a seizure or convulsion that is caused by fever. These seizures are called febrile seizures. They are frightening to parents and create much concern. A febrile seizure lasting less than l5 minutes causes no harm or damage. Remember, most children never have a seizure and febrile seizures are harmless. Nevertheless, you should call us if your child has a seizure. We need to check that it is a harmless febrile seizure.

How Should You Measure Your Child’s Temperature?

The safest way to take a temperature is to measure the axillary (or armpit) temperature:

• Place the tip of thermometer in dry armpit.
• Close armpit by holding elbow against the side of the chest for 4 minutes.

For older children (usually 5 years and older), you can also measure the oral temperature:

• Be sure your child has not had a very hot or cold beverage within l5 minutes prior to inserting the thermometer.
• Place the thermometer tip beside the tongue or inside the cheek.
• Have your child hold the thermometer in place with lips and fingers (not teeth).
• Have your child breath through his nose with his mouth closed.
• Leave thermometer in place for 3 minutes, and then remove.

Why Treat A Fever?

Treating the fever will not treat the illness and so does not shorten the duration of the illness. The only reason for treating a fever is to increase your child’s comfort and appetite. If your child is active, playful, and drinking plenty of fluids, you especially do not need to treat the fever. However, if your feverish child is cranky, it is helpful to lower the temperature.

How Do You Treat A Fever?

The following suggestions will make your child with fever (that is not complaining of feeling cold and is not shivering) more comfortable:

• Offer frequent liquids.
• Dress your child lightly to promote heat loss.
• A cool compress to the forehead may bring some relief to your child’s discomfort. It is not necessary to place your child in a tub of water to lower the temperature, but it does work (for a short time). Do not use cold baths or rubbing alcohol.
• Tylenol, Tempra or Panadol every 4 hours or Motrin or Advil every 6 hours. These medications can be safely taken with any other medication (that contains no fever reducer) your child is taking. They can be mixed in any liquid drink or given without mixing.
  • Use the recommended doses for child age and weight on the packages or call the office for advice on dosing