I'm on call, and I've just discussed fevers for the third time tonight with a worried parent. I can definitely confirm that fevers are hands down the number one reason pediatricians get called during the night. But, what many parents don't realize is that fevers are their child's friend. Children definitely are unhappy and fussy with fevers, but fevers are the body's way to protect itself.
Here are some basic fever facts:
1. A fever is safe
A fever is the body's way of controlling its immune response. Your child's body is controlling the temperature, and the temperature is going to fluctuate no matter what you do. You cannot control a fever with pain relievers. A fever has to run its course, and you cannot do anything to alter the temperature.
Fevers definitely make children look and act more tired. Fevers force children to slow down, rest more and sleep more. Thanks to fevers, your child will recuperate more quickly. Please don't awaken children from a deep sleep to give medicine, as there is no need to do this.
2. Take oral temperatures when possible, and rectal ones when it's not
Ear thermometers, sticker thermometers, pacifier thermometers and temporal artery thermometers are not reliable. Stick to a good digital thermometer for the best accuracy. As far as how frequently a fever needs to be monitored, once a day is sufficient.
3. There is no maximum number to go to the emergency room, as long as your child is drinking, urinating, and responding well
Ask yourself: is my child drinking? Urinating? Responding normally for being sick? If your answer is that he or she is doing all of the above you are in terrific shape and can monitor him at home.
I often wish that thermometers had a gauge that read either "fever" or " no fever". That would definitely help parents who get worried about a high fever. My most frequent calls involve worried parents who want to know how high a temperature is too high.
4. Make it your goal to make your child comfortable, not to reduce the fever
Since you cannot reduce a fever, making your child comfortable should be your goal. Be generous with fluids, ice chips and popsicles. Dress your child lightly. Give tepid baths to cool your child down. Avoid rubbing alcohol as this can be absorbed into the skin. Allow your child to sleep. If he or she’s sleeping don't awaken to give medicine. I guarantee you that most children will feel much better after the above measures. Give fever reducers only if your child feels uncomfortable, not solely to reduce temperatures.
5. Do not alternate Tylenol and Motrin
Alternating medications often leads to overdosing or excessive medication that your child does not need. I cannot think of any circumstances in which you need to alternate medications. If your child is that uncomfortable, he or she needs to be seen.
6. When your child needs to be seen
In some circumstances, children must be seen for fevers. Any child with a temperature of 100.4 or higher and is less than 8 weeks of age must be seen immediately. Any child who is getting chemotherapy or has a compromised immune system must be seen as well.
See the doctor if there is no clear source for the fever (no cough, no runny nose, no known pain) and it's been 2-3 days. See the doctor for a fever that lasts more than 5 days, even if your child looks terrific.