Fevers: What Every Parent Should Know
The pediatrician's office is busy this time of year and the most common sign of illness is fever. Parents often call the physician with questions regarding the definition, measurement, prognosis, and management of an elevated body temperature. Over the years several misconceptions concerning fever have arisen and as a result have caused undue fear and hysteria in all of us who are parents. Let us address some of the fundamentals, myths and facts so that we may better take care of our children.
A person's body temperature will vary according to age, activity, and the time of day with the highest temperatures being between late afternoon and early evening. Fever is defined by pediatricians as a rectal temperature over 100.4 degrees Fahrenheit (F), oral temperature over 99.5 degrees F, and axillary (under the arm) temperature over 99.0 degrees F. Mild elevations can occur with excessive clothing, exercise, or increased room temperature.
Thermometers rather than touch by the hand should be used to follow a fever. Glass mercury thermometers are usually found in every household and are accurate, yet often times are difficult to read and must be left in place for two to three minutes. Digital thermometers are also very accurate and require less time, approximately one minute. Tympanic (ear) thermometers are convenient, yet often are more difficult to obtain an accurate reading. If the child is less than three years old, then measure the temperature rectally.
What does it mean if a fever is detected? Fevers are a flag that an infection, viral or bacterial, is in the process, but the fever is also a mechanism by which the body fights the infection. Some of the common myths related to fever are as follows:
1. Myth: Fevers are bad.Fact: Fevers turn on the immune system and temperatures of 100-104 degrees F are beneficial.
2. Myth: Fevers cause brain damage.Fact-only if over 107 degrees F.
3. Myth: All fevers need treatment.Fact: Only if causing discomfort.
4. Myth: With treatment, a high fever should return to normal.Fact: Treatment only decreases the temperature by 2-3 degrees.
5. Myth: The exact number of the temperature is important.Fact: How your child looks and feels is important.
Treatment centers on the child's comfort. Do not place the child in cold-water baths or sponge him with alcohol. Also do not remove clothing if the child is having chills. Keep the child comfortable. If the child is comfortable, yet has a fever, then do not give medical treatment. The mainstay of therapy is Acetaminophen (Tylenol) and Ibuprofen (Motrin, Advil) and should be used as directed. Remember these drugs are not benign and have toxicity to the liver, stomach, and kidneys therefore these drugs should only be used as needed and not given prophylactically around the clock.
Fever can be alarming to the concerned parent. The above information should be reassuring during times of illness, but never hesitate to call the pediatrician if you have a question regarding fever in your child.