Fever is a normal body function in most situations that it occurs, and is one of the weapons your body uses to fight off infections and other body insults. Fever is a good sign that the body’s ability to fight off infections is working properly. However, many parents have trouble figuring out when to be concerned over their child’s fever and how to treat it.
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As a general rule, most pediatricians feel that any temperature, taken by any method, that is 100.4 degrees Fahrenheit or higher should be considered a fever. Below are common questions and answers regarding children and fevers:
Q: Does it matter how I take the temperature? Should I add a degree?
A: When notifying a doctor, don’t add a degree as some people recommend. Simply tell them the number and method of taking the temperature.
Q: When should a parent be concerned?
A: Parents shouldn’t be concerned for most fevers. However, any fever in a child two months or younger should be reported to a physician, because they are more susceptible to serious infections, and may need a physical exam and have laboratory samples drawn to explore the fever further. In older children, parents should be more concerned with how the child is acting than how high the fever gets. Consult a physician if the child:
l Still acts ill when the fever is brought down
l Is very drowsy or lethargic
l Has neck pain, prolonged vomiting or diarrhea, severe headache or sore throat, or a seizure
l Has other chronic diseases that affect the immune system such as cancer or sickle cell disease
l Has been in a very hot environment (such as a hot car)
Q: How can you fight a fever at home?
A: Both acetaminophen and ibuprofen are safe and effective for children. Acetaminophen can be used for any child and ibuprofen should be used only in children older than 6 months. Aspirin should never be used to treat
fever or illness in children. Sponge baths in lukewarm (not cold) water can also be used. Never use alcohol as it can be inhaled, ingested or absorbed through the skin and cause more serious problems.
Q: What’s different about a fever in an infant versus one in a toddler?
A: Fever in infants younger than 2 months may indicate a more serious infection, as these children are more susceptible to those infections (such as sepsis or meningitis).
Q: What are the most common reasons for fevers in infants and toddlers?
A: Most fevers are caused by very common infections, such as colds, flu or ear infections. A majority of these are caused by viruses and need no further treatment. Fever is not a sign that your child automatically has a more severe infection, or that he or she needs antibiotics.
Q: How can a parent tell when an infant or toddler has a fever without using a thermometer?
A: The only sure way to diagnose a fever is using a thermometer. However, most experienced parents have a good idea by the way the child is acting and how warm they feel.
Q: Does the type of thermometer matter? Is it best to use a rectal thermometer? Is there an age limit?
A: The American Academy of Pediatrics recommends the discontinuation of use of mercury-containing thermometers. The most accurate reading can be obtained by using a digital thermometer either orally or rectally. Most pediatricians will suggest that a rectal temperature be used for children younger than 3. For older children, a digital thermometer used orally is best, followed by using it under the arm. Digital ear thermometers and forehead strips are not very accurate, and have significant limitations.
Dr. Marcus DeGraw is board-certified pediatrician at the St. John Children’s Center-Macomb Township, and medical director of Pediatric Subspecialty Services at St. John Hospital and Medical Center.
