 Caring
for fever isn’t always a burning issue
By Gwenn Schurgin O’Keeffe, MD, FAAP
Your Kid’s
Health, The
Salem News
May
3, 2004 If
there is one thing this past fast and furious
flu season reminded me of it’s how even
the most experienced parents crumble when
their kids are sick. What’s interesting
is parents stay calm for almost all symptoms
except one – fever. The reality of fever,
to quote my daughter’s favorite superteens
- 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 the height
of the fever is important, it is only part
of the picture. How your child looks with
the fever and the age of your child helps
guide us health care professionals to advice
you of when to either come to the doctor now,
in the morning or even visit your local emergency
room. The old adage “take 2 aspirin
and call me in the morning” comes out
of the fact that most illnesses are viral
and most patients do not need to be seen in
the first day of illness – that motto
is still valid today except we never use aspirin
in kids anymore for fever. Also, keep in mind
that even if your child needs an antibiotic,
it takes 2-3 days for an antibiotic to really
make an impact on an illness so delaying by
a few hours to get into see your own doctor
will not prolong your child’s illness
considerably.
Some other fever tidbits to consider:
- All kids eventually
get a fever – so load up your cabinets
on acetaminophen (Tylenol) or ibuprofen
(Motrin or Advil) and be prepared.
- The general rule
of thumb is the higher the fever, the younger
the child, the more the possibility of a
serious infection.
- 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.
Keep this list handy
for the next time your child has a fever and
I bet you’ll find that you’ll
be running to your pediatrician and local
ER a bit less than you may have otherwise.
© 2005 Pediatrics
Now.
All rights reserved. PEDIATRICS NOW is a trademark
of Pediatrics Now.
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