Don't Fear Children's Fevers; They May Help Kids Heal

For children, fever is a normal response to illness. But for parents,  it is a major cause of anxiety and visits to the pediatrician.  

Fever is a physiological mechanism that helps fight infection. In and of itself, fever is not known to endanger a generally healthy child and actually may benefit kids during acute illness.

Let's start by defining fever. It's a body temperature of greater than 100.4 degrees F (38 degrees C).  

Is fever dangerous?

High temperatures do not always correlate with the severity of illness.  In addition, there is no evidence that fever worsens the course of an illness or that it causes long-term neurological complications.

Although many parents administer medications such as acetaminophen and ibuprofen to a child with minimal or no fever, the primary goal of treating the febrile child should be improvement of the child's overall comfort rather than simply bringing down the temperature.  

How can parents decide whether to give medication to a feverish child? Consider the child's general well-being, his or her activity level, and the appropriate intake of fluids to maintain hydration. Don't wake children up to administer a medication for fever.

The only exception to these rules are children with chronic health conditions such as congenital heart disease or immunologic disorders or infants under two months. In these cases, call your child's doctor if the child has any temperature above 100.4 degrees F.

Giving medications

Administering a safe dosage of ibuprofen and acetaminophen is critical.  Up to half of parents administer an incorrect dose of these medications to their child, with as many as 15 percent exceeding the recommended dose.  Parents need to be aware that the correct dosage is based on the child's weight, and that an accurate measuring device, such as a medication syringe, should be used to measure the dose. 

Acetaminophen and ibuprofen, when used in appropriate doses, generally are regarded as safe and effective agents.   However, as with all drugs, they should be used judiciously to minimize the risk of adverse drug effects and toxicity.

Taking a temperature

Parents frequently ask the best way to take a temperature in their child.  For young children (birth through three-six months) a rectal temperature is always most accurate.  Children six months through five years can have axillary (under the arm) readings, and children greater than five years can have oral readings.

 When you communicate the temperature with your pediatrician, let them know what the temperature is and how you took the temperature rather than "adding a degree."  Temperature readings from ear thermometers can be accurate in older children if there is a good seal and minimal wax in the ear.

For more information on managing fever in your child, talk to your doctor, or visit the American Academy of Pediatrics parent website at www.healthychildren.org.

Frank Belmonte, D.O., is at Advocate Medical Group, Yacktman Pediatrics, Advocate Lutheran General Hospital.