Fever in Children

“What goes up must come down.”

Fever itself is not a disease but is a symptom of an illness. A fever is part of the body’s natural defense mechanisms for overcoming disease. The infection fighting systems are more effective at elevated temperatures. When your child has an elevated temperature we are more concerned about what is causing the fever, the symptoms associated with the fever, and how the child looks and acts. The height of the temperature is not a reliable indicator of the seriousness of the underlying condition. Some children may have a minor illness and run high temperatures, while others may be very sick and have little or no fever.

Unlike the oral temperature of a healthy adult which remains fairly constant at 98.6° Fahrenheit, the normal body temperature of infants and young children ranges form 97.1° to 100° depending on the time of day, the child’s activity level and the site at which the temperature is measured. As a rule, rectal temperature is one degree higher and axillary temperature one degree lower than oral temperature. Any temperature 101° or higher indicates a child has a fever.

How to Take a Temperature

There are several different types of thermometers used for taking temperatures:

• Traditional glass mercury thermometers(oral & rectal styles)
• Electronic digital thermometers (more expensive)
• Liquid crystal thermometers (not as accurate)

To take an axillary temperature, place the bulb of an oral thermometer in the armpit and hold the arm against the chest for at least three minutes. To take a rectal temperature, use a rectal thermometer. Make sure that the thermometer bulb is lubricated and that the baby is lying on its stomach. Gently guide the thermometer about one inch into their rectum, but never force it. Hold the thermometer in place by gently pinching the baby’s buttocks together with one hand. When you use this method, the mercury will reach its maximum level within one to two minutes.

To take an accurate oral temperature, the child must cooperate. Place the thermometer under the tongue with the child’s lips closed. If the child’s nose is stuffy or if the child is mouth breathing, the temperature will be lower. There is the danger of biting of breaking a glass thermometer. An oral temperature can be affected by hot or cold foods taken beforehand.

Child Care for Fever

Parents frequently ask what temperature should be considered dangerous or when you should consult Pediatrix. In general, use your own instincts on how your child looks and acts when caring for a child with a fever. However, call us if you notice any of the following conditions:

1. Any infant with fever of 101° or higher between birth and 6 months.
2. Any fever of 101° or higher that lasts more than 48 hours without an obvious cause or location of infection.
3. Associated symptoms such as a stiff neck, confusion, delirium, difficulty with arousal from sleep, convulsions, whimpering, increased irritability, obvious pain, painful urination or difficulty breathing. The main reason for treatment of fever is to make your child more comfortable. Avoid overdressing or using heavy covers and keep room temperature comfortable, but not overheated. Encourage fluids. Acetaminophen can be used as directed, as well as Ibuprofen.
4. When high fever in children is present or persistent.

If giving acetaminophen, fluids and undressing the child do not result in lowering the fever, try sponging the child with lukewarm water, not alcohol.

In some children a sudden rise in a temperature may cause convulsions. There appears to be a genetic predisposition to this. While a fever-associated convulsion is frightening, remember that it is not life-threatening and is usually of short duration.