Parents learn to develop a high tolerance for dealing with sick symptoms in their children but one symptom always seems to stop even the most seasons of parents in their tracks: fever. The reality of fever, to quote my daughter’s favorite cartoon super teens Ron Stopable and Kim Possible: “no big”.
Fever is a sign that our immune systems are waging war against alien invaders, usual some sort of infection, and most commonly a virus. While most parents focus on how high the fever goes, that’s only part of the picture and not necessarily the part that’s most important. How your child looks with the fever is a much better indicator of how “sick” your child is with the illness than the height of the fever indicates and is what we use as health professionals in guiding our advice to you as to whether you need to come to the office now or wait a day or more.
Another big factor is the child’s age. So, in addition to the presence of fever, how “sick” your child looks, we take into account your child’s age. Young infants typically need to be seen during the first day of any fever but beyond that age group, most other children can wait a day or two unless they are very ill or have other symptoms occurring beyond the fever.
Some other fever tidbits to consider:
- Most fevers are caused by viruses and viruses clear with time, not antibiotics.
- All kids eventually get a fever – so load up your cabinets on fever control medication such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) so you are prepared should fever strike.
- The general rule of thumb is the higher the fever, the younger the child, the more the possibility of a serious infection and the sooner you should touch base with your physician by phone for advice.
- Serious infections don’t “hide” – they will make your kids look sick regardless of using Tylenol or Motrin.
- Know your child’s most recent weight as all medications in kids are dosed by weight and not just by age.
- Fever varies by age: 100.4 or high in infants under 4months of age and 101 or higher in older infants and children.
- Most children do not need to be evaluated the first day of a fever unless they are infants under 4 months, look very ill, or have fevers approaching 105. Your doctor’s office can help you decide what’s best for your child.
- Treat the fever as the same time you call the doctor – being so warm is uncomfortable, makes us sleepy and lethargic, and makes our appetites go away. Your child will like perk up after the fever comes down and if not call your doctor to arrange an evaluation.
- Most sick young children will refuse to open their mouths for Tylenol or Motrin so be prepared to gently force it into their mouths if needed. For picky medication takers, you can consider the suppository form of Tylenol or the “infant” drops of either medication to keep the volume of medication to a minimum.
- Keep a thermometer on hand – just feeling warm does not necessarily mean there is a fever. For babies a rectal temperature is really the best. For older kids under the arm or in the ear is ok.
- Watch for signs of serious infections and seek advice right away if any of these are present in your child: rash, stiff neck, eyes sensitive to light, severe headache, vomiting and diarrhea, no urine in the last 8-12 hours, seizure, or trouble breathing. Clearly if your child is looking very ill, having a seizure or trouble breathing, don’t hesitate to call your doctor or 911 to get help to your child as soon as possible.
Remember, fever is a sign of illness, not an illness itself. Don’t focus on the number when your child has a fever but your child. Your child’s appearance and activity level will tell you everything you need to know about how much you should worry.
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