This week’s guest columnist is Dr. Shauna Bienvenu, a Family Practice resident at the University Hospital and Clinics here in Lafayette.
As a resident working in the Pediatric Emergency Department, I’ve noticed that “fever phobia” is pretty common. Many parents rush into the ER when their child has a fever. They’re afraid that fever is a sign of serious infection, and that a higher fever means it’s even more serious. They’re afraid of the fever itself, that it will hurt their kid’s brain or cause seizures. Fever can be scary for parents, but is actually harmless. Yes, it’s harmless! It feels bad, but doesn’t injure your child.
Here’s the good news: fever is an important part of the body’s defense against infection. Most infections that cause fever are minor and are “self limited,” meaning kids get over them on their own. Most fevers go away within 72 hours.
When your kid does have a fever, start by treating it at home. Have her drink plenty of fluids. If giving fruit juices, dilute with half water and half juice. Children can eat and drink milk with a fever, but don’t force them. Bland foods are better, such as breads, crackers, oatmeal, or pastas.
Use acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) to make your child feel better. Dress him or her in lightweight clothing and light blankets. You can use lukewarm baths to help your kid feel better too, though a bath may not bring down the temp. Don’t use ice baths or alcohol baths- these won’t help either, and can be dangerous.
When giving medicine for fever, use the correct dosage. A lot of parents are afraid to give too much, and end up not giving near enough to work. The correct dose is based on the child’s weight and is on the medicine’s box, or on the internet. Tylenol can be used every 4 hours and ibuprofen every 6 hours- more than that will not work any better.
A common myth is that if your child feels warm, they must have a fever! Children can feel warm for many reasons such as playing hard, crying, or hot weather. Overdressing infants can make them seem warmer too. If your child feels warm, check the temperature before calling your doctor or rushing to the Emergency Department. If the child’s temperature is less than 100, that’s not a fever, no matter how warm she feels. However, some parents are so afraid of fever that a thermometer won’t convince them- “98.6, no way! He definitely has a fever- feel him!”
Again, fevers are not bad for children. Fever is a protective mechanism, helping fight infections. If the fever does not come down or you cannot “break” the fever, this doesn’t mean it’s more serious. Height of the fever doesn’t correlate with how sick the kid is either. In other words, if a child has a temperature of 104, she isn’t necessarily sicker than a kid with a temp of 101. How your child looks is what’s important, not the height of the temperature.
So, when do you call your doctor or go to the ER? Again, it’s how your child looks. If a child has a fever, but is playful and drinking, then just treat the fever. Your child may sleep more, not eat so well, and act miserable, but this can be okay too. As long as he feels better after fever medicine (at a decent dose!), is drinking, and is breathing comfortably, then things are fine.
Talk to your child’s doctor or go the ER if your child is not alert after the fever is treated. If your child is not drinking and urinating as much, this can be worrisome too. If your child has trouble walking, cannot be easily awakened, seems confused, has difficulty breathing, has a bad headache, or has new rashes with bruising, get seen. Infants under 3 months old with fever need to see the doctor too, as do kids with certain conditions like sickle cell disease.
Yes, fevers are scary to parents, but they are usually not an emergency. Of course, if you are worried call your doctor. He or she can help you sort through your child’s symptoms and nip ”fever phobia” in the bud.