Fever

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With the beginning of fall, we see many children with febrile illnesses. There are some myths about fever, which frequently frightens parents more than need be. I would like to make several basic points about fever.

First, it helps to know what temperature constitutes a fever. A rectal temperature below 100.4 degrees or an oral temperature below 99.6 degrees is within the normal range. Temperatures taken through the ear are similar to rectal temperatures.

We should understand that fever is part of the body's response to infections. It helps the body fight infections and is, in that sense, a good thing. The problem with fever is that it often makes a child feel ill. However, high fever does not cause damage to the brain and is not, in and of itself, an emergency.

The height of the fever is not related to severity of an illness. Some children routinely run high fevers with minor illnesses. More important than the height of fever in assessing an ill child is how she is acting. We are more worried about a child with a temperature of 101°F who is lethargic and not drinking than we are about a child with a temperature of 104°F who is cranky, but alert, easily consolable and drinking well. Furthermore, the lack of response of fever to acetaminophen or ibuprofen usually does not mean that the child has a serious illness. If the medicine had not been given, the fever may be even higher.

When a child has a fever, giving him a fever reducer is not always necessary. The only reason to treat fever is to help the child feel better. If she is acting well despite the fever, treatment is not necessary. If you do want to bring the fever down, use acetaminophen or ibuprofen in the recommended doses and intervals. I do not recommend using both; use one or the other. Warm sponge baths can be used to bring fever down more quickly. A child with fever should be lightly clothed. It is never necessary to wake a sleeping child to give him a fever reducer no matter how hot she feels. If you are concerned about the way your child is acting or the fever is lasting more than three days, contact your pediatrician.