Most parents have experienced waking in the middle of the night to find a child hot and flushed with fever. This can be pretty scary since most children with fever are usually very fussy and just look miserable. It’s helpful to realize that, in healthy children, fevers usually don’t indicate anything serious. Fever itself causes no harm and can actually be a good thing—it’s often the body’s way of fighting infection. Not all fevers need to be treated. High fevers can, however, make a child uncomfortable and worsen problems like dehydration.
So, let’s talk more about what fever is and why it happens. Fever occurs when the body’s internal “thermostat” raises the body temperature above its normal level. This thermostat is found in the hypothalamus (part of the brain). The hypothalamus is responsible for maintaining a normal body temperature. This “normal” temperature can fluctuate during the course of the day. Our body’s temperature is usually a little lower in the morning and a little higher in the evening or when we exercise.
Sometimes the hypothalamus will “reset” the body’s temperature to a higher degree in response to an infection/illness. It is believed that increasing the body’s temperature is a way of fighting the germs that cause infections. Fever is not an illness, it is usually a symptom of an underlying problem.
Fever is usually caused by infection but can also be caused by overdressing (especially in infants). Immunizations can cause fever. Fever can be caused by the environment (think of being in a hot car without AC in the summer)
When do you need to worry about fever?
This depends on the age of your child. If your child is younger than 2 months of age and has a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher you need to call your doctor or go to the emergency department immediately. This is because newborns are exposed to bacteria during the birth process. These bacteria could possibly cause problems up to 2 months later. Newborns have difficulty fighting infections and become seriously ill rather quickly. Tylenol or other fever reducers should not be given to an infant younger than 2 months.
Fever in children with chronic medical problems can also be serious and these children’s parents need to contact their doctor immediately if they have a fever. A few examples of these problems include sickle cell disease, kidney disease, cystic fibrosis and leukemia as well as many others.
So how do you know if your child’s fever is due to a serious infection? The illness is probably not serious if your child:
---is still interested in playing
---is eating and drinking well
---is alert and smiling at you
---has a normal skin color
---looks well when his/her temperature comes down
It’s also important to realize that most children with a fever don’t want to eat. Don’t worry, as long as they are drinking and urinating normally. It isn’t dangerous to eat less for a few days.
You should also know that the height of a fever has nothing to do with the severity of the illness. A simple cold or other viral infection can cause a fever up to 104 degrees F while a serious bacterial infection might not even cause a fever.
Children with fevers often breathe faster and have a faster heart rate. Unless this is extreme it is usually not a problem, just an effect of the fever.
So next time your child has a fever, don’t panic. If he/she looks uncomfortable, give them the appropriate dose of Acetaminophen (Tylenol) or Ibuprofen (Advil/Motrin---only give if over 6 months of age). Do not give your child aspirin unless instructed by a doctor. Encourage your child to drink lots of fluid and have them rest in cool quiet area. If your child appears very ill after this then call your doctor. If your child appears much better after fluids and fever treatment then continue to monitor and follow the advice given above.
Article written by Sue Gaston, M.D.