Fever in a child strikes fear in the hearts of many parents. If a fever seems high, they may wonder if their child will have a seizure or the temperature will "cook" their child's brain and cause permanent damage. Fever is perhaps the most misunderstood sign in all of medicine. But you should know the proper way to treat your child's fever and when you should call your doctor.
Fever is the body's normal response to infection. Everyone has an internal thermostat that controls body temperature. When an infection is present, certain chemicals are released in the body that, in effect, reset the thermostat to a higher setting.
This helps to explain the chills your child may experience when his temperature is going up. He feels cold because his body wants to be at a higher temperature. Once his fever breaks, he is hot because his body wants to be at a lower temperature. The breaking of the fever means his internal thermostat has been turned down to normal.
Understanding how a fever occurs helps you know how to treat the chills and sweats that often accompany an illness. When your child has the chills, add some blankets until he feels comfortable. Similarly, when he begins to sweat and feels warm, you should take off clothes or blankets. Bundling him up when he feels warm defeats what his body is trying to accomplish.
Taking a Temperature
A normal oral temperature is 98.6 degrees Fahrenheit. A normal rectal temperature is one degree higher; an axillary (armpit) temperature is one degree lower. "Normal" means average -- some people run a slightly higher or lower temperature, and that is normal for them. Temperature also varies throughout the day; a person's temperature is usually a little higher in the afternoon and evening. It's a good idea to know your child's normal temperature in case it is slightly above or below average.
The most accurate way to take the temperature of a young child is rectally. Any thermometer will do, although one designed for rectal use is shaped a little differently so it goes in more easily. If your child can't keep a thermometer under her tongue and can't keep her mouth closed for three minutes, use a rectal thermometer.
Inexpensive electronic thermometers (for oral or rectal use) are more accurate, quicker and easier to read, and safer than glass thermometers, which can break. They signal you when they have reached their final reading by sounding a tone. If you use an electronic thermometer, however, keep fresh batteries on hand.
To take your child's temperature with a rectal thermometer, lay your child on her stomach. (If you are using a glass thermometer, shake down the thermometer to 96 degrees or lower and lubricate it with some petroleum jelly first.) After separating her buttocks with the thumb and first finger of one hand, gently insert the thermometer to a depth of about one inch. Then pinch her buttocks closed. Hold a glass thermometer in place for three minutes to be sure you get an accurate reading or wait for the tone to sound in an electronic thermometer before withdrawing it.
Be sure to shake down a glass thermometer before each use. Separate the baby's buttocks and gently insert the thermometer. Thoroughly wash (with cool water) and dry the thermometer after each use.
Put the thermometer under her tongue (if you use a glass thermometer, be sure to shake it down first). She should close her mouth around the thermometer (without biting down) and keep her mouth shut for three minutes or until the tone sounds. Be sure she hasn't drunk anything cold or hot within the 15 to 30 minutes before you take her temperature (if she has, the reading will be artificially low or high, respectively).
Axillary temperatures are not very accurate. The same applies to temperatures taken with strips held against a child's forehead.
How Important Is a Fever?
Many childhood illnesses cause a fever; most of these illnesses are caused by viruses. Unfortunately, viruses don't respond to antibiotics. There's nothing medicine has to offer to treat the vast majority of viral illnesses except symptomatic relief (known as supportive therapy).
Young children are smarter than adults in many ways. One is the way they respond to illness. When they are sick, they look and act sick. They don't try to hide their illness. The way your child looks and acts is a much more accurate reflection of the seriousness of his illness than his temperature.
Don't panic just because your child has a fever -- watch how he acts. You should call the doctor if a child younger than six months old has a temperature over 101 degrees. For an older child, call the doctor if the temperature is over 103 degrees or if he has a temperature of 101 degrees or greater for 48 hours. Remember that a fever is a sign the body is fighting off the illness.
Treating a Fever
If your child's temperature is high enough, or if the fever makes him very uncomfortable, you should go ahead and treat it. Acetaminophen is the drug to use. Do not give a child aspirin. The use of aspirin in a child with a viral disease has been associated with a very serious illness called Reye syndrome.
Acetaminophen is available under many different names. Acetaminophen products designed for use in children also come in different forms -- liquid, syrup, and chewable tablets. Most drug doses, including acetaminophen, are calculated according to the weight of the child. Read the package directions carefully, and be sure you understand them before giving your child a dose. Check with your doctor or a pharmacist if you have any questions about the correct dose.
Parents wonder whether they should bathe their child to bring down his temperature. Many doctors now believe this treatment is never needed. Others may advise sponge baths if your child's fever is very high. Check with your child's doctor. If you do sponge bathe your child, be sure to use tepid water (about 96 degrees Fahrenheit). Bathe him for no longer than 15 to 20 minutes and no more frequently than every two hours. Stop bathing him if he shivers or gets goosebumps.
Cooling by bathing lasts only for a short time. If you do not give acetaminophen in conjunction with bathing, your child's temperature bounces right back up once he dries off. Do not use rubbing alcohol -- inhaled fumes may cause some damage. Never use ice water to bathe your child.
A sick or feverish child is worrisome to a parent. Knowing what to do to relieve your child's suffering and treat the illness will alleviate much of your worry. Similarly, you don't want to become the kind of hysterical parent that is constantly calling the doctor. Following the tips and suggestions in this article should help you stay calm the next time your child is sick.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.
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ABOUT THE AUTHORS
Alvin Eden, M.D. serves as a Clinical Professor of Pediatrics at the Weil Medical College of Cornell University in New York, New York. He is Chairman of the Department of Pediatrics at the Wyckoff Heights Medical Center in Brooklyn. Dr. Eden is also the author of a number of child care book, including Positive Parenting and Growing Up Thin.
Dr. Elizabeth Eden, M.D. is a practicing obstetrician with her own private practice in New York City. She serves as an attending physician at the Tisch Hospital of the New York University Medical Center, as well as a Clinical Assistant Professor at the New York University School of Medicine.