Fevers in Children


Fevers in children can be very scary, especially when you don’t know what’s causing the fever. As a parent, you want to do everything to keep your child healthy and safe. While fevers can be serious, not all of them are. We asked Andreea C. Cazacu, M.D., a pediatrician at Pediatric Associates of Wellesley, to share information on fevers, when parents should be worried and how to help alleviate fever symptoms.

 

 

What temperature is considered to be a fever and does this range change with age? 

A fever is a temperature of 100.4 degrees Fahrenheit or higher.

 

Should you call the doctor if your child has a fever? 

For fevers in babies 0-3 months of age, any temperature greater than 100.4 F rectally should prompt a visit to the pediatrician or the emergency room.

In addtion, call your doctor if your newborn has a lower than normal temperature — less than 97 F (36.1 C). Very young babies may not regulate body temperature well when they're ill and may become cold rather than hot. 

Parents should call the doctor for a fever of 104-105F, in any age child. 

 

Children 3-6  months should be seen in the office if:

* they have a rectal temperature greater than 102F for more than 24 hours

* crying inconsolably, difficult to awaken

* they have a stiff neck

* they have purple spots on the skin

* breathing is difficult AND does not improve after you clear the nose

* unable to swallow anything and is drooling saliva

* child looks or acts very sick (if possible, check the child's appearance one hour after he/she  has taken an appropriate dose of acetaminophen)

 

Children older than 6 months should be seen in office if:

* fever greater than 102F lasts more than 24 hours in the absence of any signs of cold (no congestion in nose or runny nose, no cough, sneezing), or fever that lasts more than three days even in the presence of cold symptoms.

* fever is accompanied by difficulty or pain associated with urination or patient has a history of urinary tract infections

* history of incomplete immunization

* crying inconsolably, difficult to awaken

* they have a stiff neck

* they have purple spots on the skin

* breathing is difficult AND does not improve after you clear the nose

* unable to swallow anything and is drooling saliva

* child looks or acts very sick (if possible, check the child's appearance one hour after he/she  has taken an appropriate dose of acetaminophen)

 

 

When does a fever require an immediate response (emergency room)?

An immediate visit to the doctor or emergency room is recommended if:

* the child is younger than 3 months

* the child is listless or irritable, vomits repeatedly, has a severe headache or stomachache, or has any other symptoms causing significant discomfort

* has a fever after being left in a hot car

* has a fever that lasts longer than three days (in children age 2 and older)

* they have a stiff neck.
* they have purple spots on the skin.
* breathing is difficult and does not improve after you clear the nose.
* unable to swallow anything and is drooling saliva.
* child looks or acts very sick (if possible, check the child's appearance one hour after he/she  has taken an appropriate dose of acetaminophen).

 

 

What's the best way to take a temperature for infants, toddlers, kids and teens?

There are many ways to measure body temperature. For young babies and toddlers under 12 months, the most accurate way to measure temperature is rectally. For older kids axillary and oral thermometers are used very frequently.

 

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If a child has a fever, what should parents do?

Home remedies are the first line of treatment for fever:

* drinking plenty of fluids, cold fluids might be more helpful

* resting

* keeping children cool

* tepid bath or cool compress on forehead

* parents can use medication (antipyretics) to bring fever down – acetaminophen or ibuprofen

 

What should parents NOT do when a child has a fever?

Some parents believe that because children have chills, they should be bundled up. This is not correct and febrile kids should be dressed lightly and allowed to cool off.

What's the best way to bring down a high fever?

Hydration and cool clothing are usually first measures taken when a child has a fever.
  

How long should parents keep children out of school?

In general children can return to school after being 24 hours fever free, unless advised differently by their pediatricians (ex. Children with streptococcal pharyngitis are contagious for 24 hours after starting medicine.)

 

Many parents send their kids to school with fevers. Why is this bad?

Children should not go to school while febrile, even if the fever comes down with antipyretics, because they are considered contagious and they expose other children to their illness.

 

What are some myths that you've heard about fevers that aren't true?

Many parents believe that fevers are bad. Fever is an immune response of the body, a sign of fight and it helps the body destroy the microbial or viral invader. It is also part of an inflammatory response, which sends all kinds of substances to the area of infection to protect the area, prevent the spreading and start the healing process.

 

When in doubt, go ahead and call your child's doctor, whether you think your child's temperature is abnormally high or abnormally low. 



Andreea C. Cazacu, M.D. is a pediatrician at Pediatric Associates of Wellesley, located in the Medfield office. 

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09 Sep 2014


By Andreea C. Cazacu, M.D.
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