Fever in kids: What's hot and what's not

fever cartoonWinter time is germ time! Parents ask us about fever more than any other topic, so here is what every parent needs to know:

Fever is a sign of illness. Your body makes a fever in effort to heat up and kill germs without harming your body.

Here is what fever is NOT:

· Fever is NOT an illness.

· Fever does NOT cause brain damage.

· Fever does NOT cause your blood to boil.

· Unlike in the movies and popular media, fever is NOT a cause for hysteria or ice baths.

· Fever over 100 degrees F is NOT a sign of teething.

Here is what fever IS:

· Fever is a body temperature that is equal to or higher than 100.4 degrees F rectally in a newborn until the age of 8 weeks old.

· Fever is a body temperature of 101 degrees F or higher in anyone older than 8 weeks old.

· Fever is a great defense against disease, and thus is a SIGN, or symptom, of an illness.

To understand fever, you need to understand how the immune system works.

Your body encounters a germ, usually in the form of a virus or bacteria that it perceives to be harmful. Your brain sends a message to your body to HEAT UP, that is, make a fever, to kill the germs. Your body will never let the fever get high enough to harm itself or to cause brain damage. Only if your child is experiencing Heat Stroke (locked in a hot car in July, for example) can your child get hot enough to cause death. This is because the heat source is EXTERNAL (a hot car) and not generated by your child’s body.

When your body has succeeded in fighting the germ, the fever goes away. If you “treat” the fever with a fever reducing agent (Tylenol, Motrin, etc.) the fever goes away temporarily but WILL COME BACK if your body still needs to kill off more germs.

Symptoms of fever include: feeling very cold, feeling very hot, suffering from muscle aches, headaches, and/or shaking/shivering. Fever often suppresses appetite, but thirst should remain intact: drinking is very important with a fever.

Fever may be a sign of any illness. Your child may develop fever with cold viruses, the flu, stomach viruses, pneumonia, sinusitis, meningitis, appendicitis, measles, and countless other illnesses. The trick is knowing how to tell if your child is VERY ill or just having a simple illness with fever.

Here is how to tell if your child is VERY ill with fever vs not very ill:

Any temperature in an infant younger than 8 week old that is 100.4 (rectal temp) degrees or higher is a fever that needs immediate attention by a health care provider, even if the infant appears relatively well.

Any fever that is accompanied by moderate or severe pain, change in mental state (thinking), dehydration (not drinking enough, not urinating because of not drinking enough), increased work of breathing/shortness of breath, or new rash is a fever that NEEDS TO BE EVALUATED by your child’s doctor. In addition, a fever that lasts more than three to five days in a row, even if your child appears well, should prompt you to call your child’s health care provider, who most likely will want to examine your child. Recurring fevers should also be evaluated.

Should you treat fever? As we explained, fever is an important part of fighting germs. Therefore, we do NOT advocate treating fever UNLESS the side effects of the fever are causing harm. Reduce fever if it prevents your child from drinking or sleeping, or if body aches or headaches from fever are causing discomfort. If your child is drinking well, resting comfortably or playing, or sleeping soundly, then he is handling his fever just fine and does not need a fever reducing agent just for the sake of lowering the fever.

A note about febrile seizures (seizures with fever): Some unlucky children are prone to seizures with sudden temperature fluctuations. These are called febrile seizures. This tendency often runs in families and usually occurs between the ages of 6 months to 6 years. Febrile seizures last fewer than two minutes. They usually occur with the first temperature spike of an illness (before parents even realize a fever is present) and while scary to witness, do not cause brain damage. No study has shown that giving preventative fever reducer medicine decreases the risk of having a febrile seizure. As with any first time seizure, your child should be examined by a health care provider, even if you think your child had a simple febrile seizure.

Please see our “How sick is sick?” blog post for further information about how to tell when to call your child’s health care provider for illness.

Julie Kardos, MD and Naline Lai, MD

 modified from original postings of 1/11/10 and 1/15/10

©2013 Two Peds in a Pod

 

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Comments

  • 1/4/2013 11:25 PM Melisa Lai Becker MD wrote:
    Yea!
    EVERY PARENT SHOULD READ THIS POST.
    We see many children and infants with fevers in the Emergency Department and this post does an excellent job explaining why fever alone does not always mean needing antibiotics, as well as why some fevers are concerning enough to warrant testing in the Emergency Department that can be uncomfortable for a child (such as drawing blood or inserting a catheter into the bladder to obtain a urine sample).

    Bottomline is just as Drs. Kardos and Lai write: fever is a symptom. Contact your pediatrician with questions and err on the side of coming to the ED when in doubt.
    Reply to this
  • 1/7/2013 9:33 AM Sarah Park wrote:
    Fever is really in the air right now. Just before the new year, the whole family caught this along with cough and colds. I'm glad everything went well just before the new year started.
    Reply to this
  • 4/1/2013 2:29 PM diese wrote:
    Fever as same as most of our reactions from our body is necessary to maintain healthy. Though it can be avoided so easily these days. Thanks for sharing great content.
    Reply to this
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