Fever is one of the most common ailments for which parents seek medical advice.
What is a Fever?
Fever is generally defined as a temperature inside the body of 100.4 or more. Normal childhood temperatures range from 97 – 100 F and 98.6 F is considered the average.
Fever happens when the body’s internal “thermostat” raises the body temperature above its normal level. This thermostat is found in a part of the brain called the hypothalamus. The hypothalamus knows what temperature your body should be (usually around 98.6°F/37°C) and will send messages to your body to keep it that way.
The impression that your child has a fever because he feels hot is probably more accurate than we used to think but if you’re going to call the doctor, please use a thermometer. The most accurate methods for measuring are oral, rectal, or ear thermometers (used in the appropriate places!). Axillary (armpit) or forehead thermometers are OK but can be misleading so we discourage your using them if you’re truly concerned about a fever.
Is it a Fever?
A gentle kiss on the forehead or a hand placed lightly on the skin is often enough to give you a hint that your child has a fever. However, this method of taking a temperature (called tactile temperature) won’t give an accurate measurement.
Use a reliable digital thermometer to confirm a fever. It’s a fever when a child’s temperature is at or above one of these levels:
• measured orally (in the mouth): 100°F (37.8°C)
• measured rectally (in the bottom): 100.4°F (38°C)
• measured in an axillary position (under the arm): 99°F (37.2°C)
What causes a fever?
It’s important to remember that fever by itself is not an illness — it’s usually a symptom of another problem.
Fevers can be caused by a few things, including:
Infection: Most fevers are caused by infection or other illness. A fever helps the body fight infections by stimulating natural defense mechanisms.
Overdressing: Infants, especially new-borns, may get fevers if they’re over bundled or in a hot environment because they don’t regulate their body temperature as well as older kids. But because fevers in new-borns can indicate a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.
Immunizations: Babies and kids sometimes get a low-grade fever after getting vaccinated.
Although teething may cause a slight rise in body temperature, it’s probably not the cause if a child’s temperature is higher than 100°F (37.8°C).
When Is a Fever a Sign of Something Serious?
Doctors decide on whether to treat a fever by considering both the temperature and a child’s overall condition.
Kids whose temperatures are lower than 102°F (38.9°C) often don’t need medicine unless they’re uncomfortable. There’s one important exception: If an infant 3 months or younger has a rectal temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department immediately. Even a slight fever can be a sign of a potentially serious infection in very young babies.
If your child is between 3 months and 3 years old and has a fever of 102.2°F (39°C) or higher, call to see if your doctor needs to see your child. For older kids, take behaviour and activity level into account. Watching how your child behaves will give you a pretty good idea of whether a minor illness is the cause or if your child should be seen by a doctor.
The illness is probably not serious if your child:
• is still interested in playing
• is eating and drinking well
• is alert and smiling at you
• has a normal skin colour
• looks well when his or her temperature comes down
And 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. For kids who still drink and urinate normally, not eating as much as usual is OK.
Because fevers can rise and fall, a child might have chills as the body’s temperature begins to rise. The child may sweat to release extra heat as the temperature starts to drop.
Sometimes kids with a fever breathe faster than usual and may have a faster heart rate. Call the doctor if your child has trouble breathing, is breathing faster than normal, or is still breathing fast after the fever comes down.
How should I treat my child?
Remember that fever is not the enemy and helps fight the infection. If your child is obviously uncomfortable, consider the following options:
1. Remove excess clothing to only t-shirt and diaper or underwear.
2. Offer cold liquids, ice chips or popsicles.
3. Give acetaminophen /paracetamol to children 3 months and older or ibuprofen for children 6 months of age or older.
Sponging is an option if high fever persists. Of course, remove all clothing first and use warm (skin temperature) water, as cool water can cause shivering which defeats the purpose of the bath. Do not give fever medication to children 2 months of age or younger unless you have consulted your physician first.
Infants younger than 2 months old should not be given any medicine for fever without being checked by a doctor. If your child has any medical problems, check with the doctor to see which medicine is best to use. Remember that fever medicine can temporarily bring a temperature down, but usually won’t return it to normal — and it won’t treat the underlying reason for the fever.
Food and Drinks
Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids more rapidly than usual.
Taking it Easy
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 a child with a fever home from school or childcare. Most doctors feel that it’s safe to return when the temperature has been normal for 24 hours.
When should I call the doctor?
• Your child is 2 months of age or younger
• Your child’s fever is over 104 F
• Your child has a seizure
• Your child looks or acts very sick.
Not immediately, but within 24 hours or so, if:
• Your child is 3 – 6 months of age
• Your child is under 2 years of age with fever lasting longer than 24 hours without apparent cause or symptoms
• Your child’s fever went away for 24 hours or more then returned
• You have other concerns or questions.