by Jeffrey Snedeker, MD
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 of infections.
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 fever?
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 fever?
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) 257-2188.