| What to do when your child has a fever |
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By Tamara Walker, RN, www.momRN.com Fever in children is one of the most common parenting concerns. Fever is also the main reason children are seen in the pediatrician’s office. Parents frequently ask the following questions:
It is important to know that the body’s normal temperature can vary slightly from person to person and fluctuates naturally during the day. Although 98.6 F (37 C) is considered the “norm”, body temperature can vary from 1 to 2 degrees throughout the day. Generally, body temperature is lowest in the early morning and rises slightly throughout the day, depending on your level of activity. Fever itself is not an illness; rather it is a symptom of an underlying cause, such as illness, becoming overheated due to heat exposure, dressing too warmly, or overexertion. A fever is rarely harmful or dangerous and in fact, it can be beneficial for fighting infection. It is a natural defense response to help kill bacteria and viruses and to heal from infection. The best method for taking your child’s temperature varies depending on your child’s age. For infants, a rectal temperature is the most accurate. This can be done using a digital thermometer and petroleum or KY jelly. Hold your baby on her belly across your lap, or lay her face down on a flat surface, turn on the thermometer, clear any previous readings, insert the thermometer approximately ½” to 1” and hold until it beeps or signals that it is finished reading. For toddlers and older children, a digital thermometer can be used to take an oral temperature or an axillary temperature (under the arm). Your child must be able to hold the thermometer still under her tongue and not breathe through her mouth, and not have had anything to eat or drink within 30 minutes of taking an oral temperature in order to have an accurate reading. If this is not possible, you can use the digital thermometer under the arm, against the skin only, to take an axillary temperature. Oral temperatures are usually 1 degree lower than the rectal temperature and axillary temperatures are usually 1 ½ to 2 degrees lower than the rectal temperature.
A fever is medically defined as a body temperature of 100.4 F (taken rectally) or above. Temperatures of 101 F and below are considered low grade and do not require treatment unless your child is 3months old or younger, or if your child is very uncomfortable and fussy. If you have a newborn less than 3 months of age, it is important to have him seen by a doctor immediately for a fever of 100.4 F or higher. Infants and toddlers between 3 months and 3 years of age warrant a call to the doctor’s office if running a fever of 102 F or higher. For older infants and children, the amount of fever is less important than the other symptoms the child is having when determining whether to see a doctor. If your child is running a fever under 104 F but the fever reduces using acetaminophen or ibuprofen, and your child is not exhibiting signs of a serious illness, then it is okay to treat your child’s fever as needed and not rush to the doctor. A good general rule is to take your child to the doctor if a fever under 104 F persists for 72 hours even if she does not have other symptoms or has mild symptoms. For a fever of 104 F or higher, call or visit the doctor if it persists for more than 24 hours, or does not reduce with fever-reducing medications, or if the child has other symptoms that need to be evaluated. Fever of 105 F or higher warrants a visit to the doctor’s office or a call to the doctor’s answering service if after hours. The doctor can tell you whether to take your child to the emergency room or whether it is okay to wait and come in the next morning to the office. When treating a fever at home, your goal should be to make your child comfortable. If the fever is under 101 and your child is not extremely fussy or uncomfortable, it is not necessary to use medication. Remember, fever is the body’s way of helping fight infection, so it is counter-productive to reduce the temperature unless the child is truly uncomfortable. Ways to reduce fever:
Take your child to the doctor or emergency room if:
Generally, doctors advise keeping kids home from school and daycare until they are fever-free without the use of medication for at least 24 hours. Above all else, trust your instincts as a parent. You know your child and if you feel something is wrong and needs to be evaluated, call or take your child to see the doctor. Every child is unique and some will run a high fever with every slight illness and some may run little or no fever even with a serious illness. As a mom, I’ve had both extremes. My daughter ran very high fevers every time she had an ear infection or strep throat. My son could have a double ear infection and a throat infection at the same time with no fever at all. I learned to pick up on the other signs of illness to determine whether a trip to the pediatrician’s office was necessary.
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Tympanic (ear) thermometers can be used for children older than 3 months but may give less accurate readings than digital thermometers. Forehead strips and pacifier thermometers may be able to tell you if your child has a fever, but are usually not accurate in telling the amount of fever. The new forehead thermometers are also not as accurate as a digital one. Glass thermometers, while highly accurate, are no longer recommended due to the risk of breakage and mercury exposure. If you take your child to the doctor, let her know which method you used.
Tamara Walker, R.N. offers support, information, advice, and encouragement to parents through her alter ego, “MomRN”. Whether the issue is family, parenting, health or safety, Tamara’s got the RX! Tamara is also passionate about protecting kids. She has taught abduction prevention and child safety workshops for the past five years and has been interviewed as a child safety expert in newspapers, on radio and television. She hosts a blog radio show and also writes parenting, health and safety articles for various publications and websites. 
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