Children And Fever
What is a "fever"?
The definition of a fever is any temperature of 100.4 or higher rectally. A rectal temperature is the best way to take a temperature, especially in the first couple months of life. There are many other ways to take temperatures; there's oral, there's under the arm, there's by the ear and there are new temple artery thermometers. The ear and the forehead thermometers tend to be very inaccurate at any age. They'll tell you fever or no fever, but the numbers tend to be all over the place. I usually recommend my parents do only rectal temperatures, especially in the first two to three months of life, and after that rectal temperature again is best, but if they want to do under the arm, it's OK. This is because we really don't care if it's 100.4 or 104 in older kids, we will do the same thing, which is treat the fever. In children under two months of age, any fever needs to be called to the doctor immediately, even before treatment.
How do I know if my child has a fever?
Often a child's demeanor will change if they have a fever. Babies will start acting very fussy and maybe even start crying. You may see that they start to get a little clammy, their forehead may feel warm and they may not be eating as well. So with a fever in infants you may not actually feel them being hot. Initially the fever may just cause a change in demeanor. In older kids with a fever, it's the same thing, but on top of it they're burning up. Then you take their temperature and you'll know for sure.
How do I take my child's temperature?
The best way to take a temperature again is with the rectal thermometer. With the rectal thermometer you put a little vaseline on the tip and you put it in about a half an inch. It takes a couple of minutes, then it beeps and then you know the temperature. In older kids you can do an underarm temperature. You don't have to add or subtract a degree because again it doesn't matter if the temperature is 101 or 103, you're going to do the same thing, which is treat the fever. We also don't care as much about the height of fever. People get concerned if their child has a 101 fever versus a 105 fever, but we're going to ask you either way to treat your child's temperature. What's more important is how the temperature responds and the duration that they've had the fever. So if their temperature goes up to 104 or 105, and you treat it and it goes back down to normal, and in those interim periods your child is acting o.k., that's the most important thing. And, if the fever is there for a couple of days and then goes away for good, that's a good thing too. But if the fever isn't responding to the proper dose of Tylenol or Motrin, or the fever is prolonged, that's when we want to look into the question of 'are there other things going on that is causing this temperature?'
What is the normal temperature of a child?
Any temperature under 100.4 is normal. We used 98.6 as a person's body temperature, but actually, what we found is our body temperature fluctuates throughout the day. It's probably lowest in the morning and then highest in the afternoon to evening, so our body's temperature fluctuates. I usually say anything under 100.4 is normal temperature and if your child is acting fine, don't worry about it. There is really no reason to routinely check you child's temperature, unless they're showing you signs that they may have a fever. Like if they're fussy, or they're not eating well, or they're felling hot. Remember that a fever is a good thing. A fever is your body's response to an infection. It's how you're fighting infection and it doesn't cause brain damage. The height of the fever doesn't cause seizures, it's your body's reaction to fighting. You don't even have to treat a fever. The only reason we do it is to make your child feel better, but it is not that the fever itself that will harm your child.
How do I control my child's fever?
The best thing to do to control your child's fever is to unbundle your child. Make sure they are not in a bunch of layers of clothing. You can take off the blankets, and then give them something like Tylenol or Motrin which are anti-fever medications. That really is going to do the best for the fever. Some people do a luke-warm bath. You really don't want to do an ice-cold bath. I mean, would you want to be put in an ice-cold bath? It's not comfortable. Remember, your normal body temperature is 98 degrees to begin with, which is warm, so a warm bath will still be a lower temperature than your 101 – 102 fever. You can do that to make your child feel more comfortable. Also comfort your child and make sure they're getting enough fluids. For fevers in children, the keys to helping are: unbundeling, a luke-warm bath and Tylenol or Motrin for the fever.
When do I need to call the doctor about my child's fever?
I would call the doctor if your child has a fever in the following instances. First of all, for any child under two months of age a parent should call their doctor for any temperature of 1.4 or higher. In those first couple of months it's really imperative that any child with fever is looked at. In older children, you should call the doctor if your child has a fever that is not responding to Tylenol or Motrin or that lasts more than 72 hours, or when your child has other symptoms that concern you; they are inconsolable, they are not eating or staying hydrated. Remember, when your child has a fever, I know they're going to look bad. So when your child has a fever, everything goes out the window. Their eyes are going to be rolled behind the back of their head, they're going to be really tired and lethargic, they're not going to eat well. You can't judge at that point in time. You need to treat the fever and then see what they look like when their fever goes away. If they look better when the fever goes away, that tells you you're on the right step and you're doing everything right. When the fever isn't responding, or it's prolonged, that's when it becomes a concern.
