Fever

What is Fever?

  • Fever is usually, but not always, an indication of some infection in the body
  • Everyone has own internal “thermostat” that regulates body temperature
  • A normal body temperature is around 98.6o Fahrenheit (37.5o Celsius)
  • When the body detects an infection or other illness, the brain responds by raising the body temperature to help fight the condition
  • Fever itself doesn’t necessarily warrant a call to the doctor. It depends on the age of the child and his other symptoms
  • Your child has a fever if:
    • Rectal, Ear or Forehead temperature – 100.4° F (38.0° C) or higher
    • Oral or Mouth temperature – 100° F (37.8° C) or higher
    • Under the arm (Armpit) temperature – 99° F (37.2° C) or higher

How to Take a Rectal Temperature?

  • Rectal temperature is the most accurate way to measure a young child’s true body temperature
  • The American Academy of Pediatrics encourages parents to remove mercury thermometers from their homes to prevent accidental exposure and poisoning
  • Use following steps to take rectal temperature
    • Use a rectal thermometer (preferably digital) that has a round bulb at the end
    • Clean the tip of the thermometer with rubbing alcohol or soap and water
    • Lubricate the tip with a water-soluble lubricant
    • Place your baby on his stomach across a firm surface or your lap. Or, if your child is more comfortable on her back, gently lift her legs and proceed to step 6
    • Stabilize your child by placing one hand on his lower back just above the buttocks. If your child is wiggling, ask someone to help you restrain him.
    • Slowly insert the lubricated thermometer into the anal opening about one-half inch, stopping if you feel any resistance. Never force the thermometer
    • Gently hold the thermometer in place between your index and forefinger while keeping your hand against your baby’s bottom
    • Wait until your thermometer beeps or signals that it’s done. A reading of 100.4 degrees Fahrenheit or more is generally considered to be a fever

Common Causes of Fever

  • Viral Infections: Colds, flu and other viral infections are the most common cause fever may be the only symptom for the first 24 hours. Other viral symptoms such as runny nose, cough, loose stools is often delayed
  • Bacterial Infections: Such as Urinary tract infection, strep infection, sinus infection
  • Newborn Fever (Serious): Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment
  • Meningitis (Very Serious): A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can’t be consoled. If not treated early, can suffer brain damage
  • Teething: Teething does not cause fevers

Treatment

  • Extra Fluids and Less Clothing – Good hydration replaces sweat. It also improves heat loss from the skin. Do not wrap in too many blankets. This may make the fever higher.
  • For fevers 100°-102° F (37.8° – 39°C), fever meds are rarely needed fevers of this level don’t cause discomfort. They do help the body fight the infection
  • Fever and Antipyretic – Fevers only need to be treated with medicine if your child is uncomfortable with fever and usually >102 F for fevers above 102° F (39° C), give an acetaminophen (such as Tylenol) or ibuprofen (such as Advil). Don’t use acetaminophen and ibuprofen together. Do not use aspirin. It increases the risk of Reye syndrome (serious brain disease). More often, antipyretics lowers the fever by 2° to 3° F (1 – 1.5° C). Not to normal level.
  • Sponging With Lukewarm Water – Sponging is an option for high fever, when Fever is above 104° F (40° C) AND doesn’t come down with fever meds. Always give the fever med first. Sponge for 20-30 minutes. If your child shivers or becomes cold, stop sponging

Outcome

  • Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C)
  • They may last for 2 or 3 days
  • They are usually not harmful

Call Your Pediatrician If:

  • Fever goes above 104° F (40° C)
  • Any fever occurs if less than 3 months old child
  • Fever without a cause lasts more than 24 hours (if age <2 yr)
  • Fever lasts more than 3 days (72 hours)
  • Your child is lethargic, unresponsive, refuses to eat, has a rash, or is having difficulty breathing
  • You observe signs of dehydration, such as a dry mouth, a sunken soft spot, or significantly fewer wet diapers
  • Your child experiences a seizure
  • You think your child needs to be seen
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