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Fever: Facts &...

Fever: Facts & Fiction

Fever is a body temperature that is higher than normal. Although your child’s normal temperature varies slightly with time of day (lower in the morning, higher between late afternoon and early evening), ambient temperature, activity level, and how much clothing is being worn, most consider any thermometer reading ≥100.4° F (38° C) to be “fever.”


Taking your Child’s Temperature.

While you can suspect your child has a fever by faster heart and breathing rates, facial flushing, as well as feeling warmth of the forehead, only a thermometer can tell exactly what the temperature is. This number may be important to convey to your pediatrician.   Another part of the puzzle is that most kids will have symptoms of the illness that is causing the fever, such as an earache, sore throat, rash, or stomachache.


Types of Thermometers.

Due to the poisonous nature of mercury, mercury thermometers should not be in your home! Here are some alternatives.

  • Rectal:  If your child is under three years of age, taking her temperature with a [lubricated] rectal digital thermometer is most reliable. Insert the thermometer 1/2–1 inch into the anal opening, hold in place for about one minute, and remove and read the number after you hear the “beep.”
  • Oral: Once your child is four or five, you may prefer taking his temperature with an oral digital thermometer. After waiting at least fifteen minutes after your child has had a hot or cold drink, place the thermometer under his tongue, hold it for about one minute, remove, and read the number after you hear the “beep.”


  • Ear (“tympanic”) thermometers may be used for older babies and children; however, due to the need for proper ear canal placement and the possibility that too much ear wax may affect a reading, they are not considered as reliable as the rectal and oral thermometers.
  • Underarm (axillary) recordings are also not as accurate as rectal or oral readings, but may be used with children older than three months. Using either an oral or rectal thermometer, place the sensor end in your child’s armpit for about a minute; remove, and read the number after the “beep.”


Fever Myths & Realities.

Myth: All fevers are bad for children.

Reality: Fever is actually one of the body’s protective mechanisms. It is involved in turning on the immune system; therefore, it can be considered a good sign that your child is trying and able to rid herself of an infection.


Myth: All fevers need to be treated.

Reality: Since fevers are generally (aside from the newborn period—see below under “emergencies”) harmless, they only have to be treated if they cause discomfort. This usually occurs only when temperatures exceed 102° F (39° C).


Myth: Teething causes fever.

Reality: Although many parents and care providers believe teething may cause a child to run a fever, teething does NOT cause a fever. If your child has a fever during the time she is teething, it should be regarded as a separate medical concern.


What to Do?

1. Keep your child cool and comfortable.

  • Keep her room comfortably cool
  • Make sure that she is dressed in light clothing
  • Encourage her to drink plenty of water or diluted fruit juices (or a commercially prepared oral electrolyte solution for children)
  • Encourage her to rest
  • In certain situations (e.g. temperature above 104° F/40° C, prior history of a febrile seizure), your pediatrician may recommend (besides medications, see below) sponging your child in a tub of lukewarm water. Usually five to ten minutes (sooner, if she is shivering) is enough time. DO NOT use cold water or alcohol!


2. Medications.

  • Acetaminophen and ibuprofen (to be used only with children older than six months of age), are safe and effective if used properly. Besides reading the label on [any] medication, talk to your pediatrician before giving your child new medication if he is younger than two years of age. Aspirin is NOT to be used, since it has been linked with intestinal bleeding and a neurological disorder called Reye syndrome.
  • If your child is vomiting and unable to take medication by mouth, your pediatrician may recommend a rectal (acetaminophen) suppository.


Emergency Situations.

While most fevers do not require emergency action, there are certain circumstances that may be more serious. Call your pediatrician immediately if your child has a fever and:

  • Is two months of age or younger
  • Looks very ill, is unusually drowsy or fussy
  • Additional symptoms such as a stiff neck, severe headache, severe sore throat, drooling, difficulty breathing, repeated and progressive vomiting, or diarrhea
  • Has been in an extremely hot place, such as an overheated car
  • Has had a seizure
  • Has a condition that suppresses immune responses, such as sickle-cell disease or cancer, or is taking steroids


In addition, call your pediatrician if:

  • Your child still looks “sick” even after the fever is brought down
  • A fever lasts more than twenty-four hours in a child younger than two years of age, or more than three days in a child two years of age or older.


Related Story: Family Health: Ask Dr. Rubin


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