FEVER

If your child feels warm, you immediately suspect that your child has a fever, but you may be unsure of what to do next. Even if your child does have a fever, it’s not usually a serious situation. Although frightening, a fever causes no harm and can actually be a good thing. It is often the body's way of fighting off infections. Not all fevers need to be treated. A high fever, however, can make your child uncomfortable. There are steps you can take to correctly take your child's temperature and make your child comfortable.

A fever occurs when the body's internal "thermostat" raises the body temperature above its normal level. The brain knows what temperature your body should be and will send messages to your body to keep it that way. Most people's body temperatures even change a little bit during the course of the day: It's usually a little lower in the morning and a little higher in the evening and can fluctuate as kids run around, play, and exercise.

Sometimes the brain needs to "reset" the body to a higher temperature in response to an infection, illness, or some other cause. Turning up the heat is the body's way of fighting the germs that cause infections and making the body a less comfortable place for them.

Children whose temperatures are lower than 102 degrees usually don't require medication, unless they're uncomfortable. There's one important exception to this rule: If you have an infant 3 months or younger with a rectal temperature of 100.4 degrees or higher, call our office. Even a slight fever can be a sign of a potentially serious infection in very young infants.

For older children, take their activity level into account. By watching how your child behaves, you can get a pretty good idea as to whether he or she has an illness. Don't worry too much about a child with a fever who doesn't want to eat. This is very common with infections that cause fever.

There are many ways to take a temperature including axillary (under the arm), tympanic (ear), and the newest temporal artery method. However, we recommend to parents that they use the rectal temperature in infants and toddlers and the oral method in older children. No matter how you take the temperature, when you call, please tell us how you did it and the result without adding or subtracting degrees.

Taking a rectal temperature is a simple process:

• Lubricate the tip of the thermometer with a water-soluble lubricating K-Y jelly.
• Place your child face down across your lap while supporting the head, or lay the child down on a firm, flat surface, such as a changing table.
• Place one hand firmly on your child's lower back to hold him or her still.
• With your other hand, insert the lubricated thermometer through the anal opening, about half an inch to 1 inch into the rectum.
• Stop if you feel any resistance.
• Steady the thermometer between your second and third fingers as you cup your hand against your baby's bottom.
• Soothe your child and speak quietly as you hold the thermometer in place.
• Wait until you hear the appropriate number of beeps or other signal that the temperature is ready to be read.

Taking an oral temperature is easy in an older, cooperative child:

• Wait 20 to 30 minutes after your child finishes eating or drinking to take an oral temperature, and make sure there's no gum or candy in your child's mouth.
• Place the tip of the thermometer under the tongue and ask your child to close his or her lips around it. Remind your child not to bite down or talk and ask him or her to relax and breathe normally through the nose.
• Wait until you hear the appropriate number of beeps or other signal that the temperature is ready to be read.

Here are some things you can do to alleviate the symptoms that often accompany a fever:

• If your child is fussy or appears uncomfortable, you can give acetaminophen or ibuprofen based on the package recommendations for age or weight. If you don't know the recommended dose or your child is younger than 2 years, please call our office to find out how much you should give * Never give aspirin to a child unless recommended by your physician.
• Give your child a sponge bath to make him or her more comfortable and help bring the fever down. Use only lukewarm water; cool water may cause shivering, which actually raises body temperature. Never use rubbing alcohol or ice packs/cold baths.
• Dress your child in lightweight clothing and cover him or her with a light sheet or blanket. Over dressing and over bundling can prevent body heat from escaping and can cause a temperature to rise. Make sure your child's room is a comfortable temperature - not too hot or too cold.
• Offer your child plenty of fluids to avoid dehydration. A fever will cause a child to lose fluids more rapidly. Water, soup, ice pops, and flavored gelatin are all good choices. Avoid drinks containing caffeine, including colas and tea, because they can cause your child to urinate more and become hyperactive.
• If your baby or child also has vomiting and/or diarrhea, call the office for advice on electrolyte re-hydration made especially for children. You can find these solutions at pharmacies and supermarkets. Don't offer sports drinks - they're not designed for younger children, and the added sugars may make diarrhea worse. Also, limit your child's intake of fruits and apple juice.
• In general, let your child eat what he or she wants but don't force eating if your child doesn't feel like it.
• Make sure your child gets plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.
• It's best to keep your child home from school or child care if he or she has a fever. Most doctors feel that it's safe to return when temperature has been normal for 24 hours.

The exact temperature that should trigger a call to our office depends on the age of the child, the illness, and whether the child has other symptoms with the fever. Call our office if you have an:

• An infant younger than 3 months with a temperature greater than 100.4 degrees.
• An older child with a temperature of higher than 105 degrees.

If an older child has a fever of less than 104 degrees, call the doctor if the child also:

Refuses fluids or seems too ill to drink adequately
Has persistent diarrhea or repeated vomiting
Has any signs of dehydration has a specific complaint
Still has a fever after 24 hours in a child younger than 2 years or 72 hours in a child 2 years or older
Has recurrent fevers, even if they only last a few hours each night

Seek emergency care if your child shows any of the following signs along with a fever:

• Inconsolable crying for several hours
• Extreme irritability
• Lethargy and difficulty waking
• Rash or purple spots that look like bruises on the skin
• Blue lips, tongue, and nails
• Infant's soft spot on the head seems to be bulging outward
• Stiff neck
• Severe headache
• Limpness and refusal to move
• Difficulty breathing that doesn't get better when the nose is cleared
• Leaning forward and drooling
• Seizures

Acetaminophen is typically our first choice for treatment of fever. Please do not alternate medications without speaking to a member of our staff.

Acetaminophen dosage examples:

Ibuprofen dosage: 1 tsp. (100 mg.) per 22 lbs. Over 88 lbs., 2-3 tabs (200 mg each) every 4-6 hours with food or milk.