Fever Management

What is Fever?

Fever is a normal response of the body to infection or inflammation. With the appropriate stimulus, the body raises its internal thermostat and thus its temperature above normal.

A normal temperature is 98.6 degrees Fahrenheit or 37.6 degrees Celsius, taken rectally. Temperatures are most accurately taken rectally in infants, and orally in older, cooperative children. Axillary temperatures (temperatures taken under the arm), are somewhat unreliable. New ear thermometers are reliable in children older than nine months if a small probe cover is used.

When reporting a fever to a doctor or nurse, it is important to give the temperature and how it was taken. Do not try to convert the temperature by adding or subtracting a degree or two, or assume the child has a temperature because he feels hot.

Fevers by themselves are not dangerous to children. Among the greatest myths of medicine is that a high fever can cause brain damage in any child, or possibly infertility in boys. This is simply not true.

Fevers are usually symptoms of something else. They may be due to a viral illness such as roseola, influenza, mononucleosis, or many others that require primarily supportive care. Fevers may also indicate a bacterial infection that may need antibiotics such as an ear infection, strep throat, or a urinary tract infection.

What to Do for Fever

The most important thing to determine isn’t the height of the fever, but whether or not the child needs to be seen by a doctor immediately.

You should contact the doctor immediately for any infant less than two months of age with a rectal temperature greater than 100.4 degrees. Also, regardless of age or degree of fever, if your child appears very ill, listless, floppy, irritable beyond consoling, has any difficulty breathing, or is acting disoriented or confused, he should be seen immediately.

If your child has a fever but is acting mostly well, then you have time to determine if or when the child should be seen. Any child with a specific complaint such as an earache, cough, or pain with urination, should be seen at the earliest convenient time. A child who is acting well, with no complaints, but with a fever can be managed at home.

Once you have determined that you will initially manage your child’s illness at home, then you can address the fever for your child’s comfort.

Steps to Take for Fever

Do:

  1. Dress child lightly to let the heat leave his body.
  2. Refer to our “Fever Medications” handout for our medication usage recommendations.
  3. Increase the fluid intake since fevers make our bodies use up more fluid.
  4. For very high fevers you may want to give your child a warm bath. As the water cools, the body will cool also.

Don’t:

  1. Don’t panic. Regardless of how high the fever is, unless a child has other symptoms that worry you, there is no need to rush the child anywhere.
  2. Don’t bundle the child. This only makes him conserve heat.
  3. Don’t give alcohol baths or rub‚Äźdowns. This only dries the skin.
  4. Don’t wake the child in the middle of the night to check the temperature. If he is sleeping, then he is comfortable enough.
  5. Don’t assume a fever of greater than 101 degrees is due to teething.

The worst possible complication of the fever itself is a febrile convulsion. As scary as these events may be, they are rare and are not dangerous to children. Millions of children have had febrile convulsions and there has been no documented long lasting brain damage. If your child were to have a convulsion, make sure he/she is not in a place where he can get hurt by falling or banging himself against anything. There is no need to put anything in his mouth. He cannot swallow his tongue. The child should be taken to the nearest emergency room for evaluation, to make sure there is no other reason for the convulsion.For the most part, however, no additional reason will be found and the child will be discharged to home.

If at any time you have doubts or concerns about your child, or about whether or not you need to take him to the emergency room, you should always feel free to call.

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