Childhood Fever: Friend or Foe?
Jeffrey Snedeker, M.D.
Fever is one
of the most common reasons parents call the doctor or take their children in
for an office visit. They are concerned about getting the fever down as quickly
as possible, especially if it seems high.
What many parents lose sight of is
that fever is not the enemy; rather, it is the underlying disease that has the
potential to cause harm. Fever is simply one of the body's defense mechanisms,
part of the natural immune response that helps the body fight off certain types
If your child is running a fever,
it's important to assess what else is going on. Is the child eating, drinking,
and active? Or, is the child vomiting, lethargic, or covered with a rash? This
is important information to gather before you call the doctor. A child with
symptoms of illness and a low fever may be much sicker than a child with a
relatively high temperature who is active and feeling fine.
What should I do if my child has a
This depends in part on the age of
the child. If a baby under six weeks of age develops a fever, you should seek
immediate medical attention. Between six weeks and six months of age, a child with a fever should be seen within 24 hours by a doctor.
To measure body temperature properly, make sure you follow the instructions
provided with your thermometer.
Beyond six months of age, parents
should look at the context of the fever. Is there a fever, rash, vomiting, or a
sore throat or sore ear? If there is, you should see a doctor. If there is a
fever, but no other symptoms, the chances are the child has a mild viral
illness. However, these children should be watched closely and if any new
symptoms appear, or if the fever does not disappear in a few days, your doctor
will want to know.
If your child is shivering, bundle
her up. If the child is hot, keep him lightly dressed. Baths are usually not
helpful, but are safe provided the water is lukewarm and not cold. If the bath is cold, the skin will cool too rapidly, the child will
stop sweating, and the internal temperature may go up instead of down.
If the child starts shivering in the bath, it's time to get out.
Should I medicate the child for
When trying to decide if the child
needs medication, you should assess his or her comfort level. If the child is
not uncomfortable, you don't have to medicate. By and large, a higher fever is
not more dangerous provided the child is drinking plenty of fluids. If the
child is uncomfortable, then you might try acetaminophen (Tylenol and other
brands) or ibuprofen (Advil, Motrin and other brands) to bring the fever down.
Do not use aspirin. Getting lots of fluid into your child is very important.
Both medications in proper doses are
very safe and effective. It is important to use the right amount: remember, the
dose varies with the child's weight. It also helps to be realistic about what
fever medications will do. They may not give your child a normal temperature,
but they will probably lower it. If the temperature goes up after taking the
medication, it doesn't necessarily mean the medication isn't working; it may
mean your child's temperature would have gone up even more without it. Some
parents have been told to switch back and forth between acetaminophen and
ibuprofen; however, it's better to stick with whichever one you prefer. And
remember that without sufficient fluid, all the medication in the world will
not bring the fever down.
Do I have to worry about brain
damage as a result of fever?
Brain damage rarely occurs as a
result of fever. A temperature of 106 degrees, which is fairly uncommon, makes
a person feel terrible, but doesn't cause brain damage. Brain damage is much
more likely to occur during heat stroke, which is not fever. You should be
concerned about heat stroke if your child plays outdoors in the hot weather and
doesn't drink sufficient fluid. Once the body temperature reaches 108 degrees
and above, which can and does happen in hot weather, brain damage can occur.
Certain children under age 5 may rarely have brief seizures with high fever,
but such seizures do not cause brain damage and are not dangerous to the body.
Dr. Snedeker is board certified in pediatric medicine and
pediatric infectious disease. He is a member of the medical staff at Cayuga
Medical Center and is in practice with Northeast Pediatrics and Adolescent
Medicine. Dr. Snedeker can be reached at (607)
Last update: August 2006