Fever - A Cause for Alarm?
It’s midnight and your child wakes up crying. You go to check on him and notice he’s flushed. You feel his forehead and he’s burning up. You automatically reach for the Tylenol. But should you?
Symptom vs. Illness
Fevers are one symptom that almost every child has at some point. Parents have learned to fear fevers and to treat them whenever possible. However, a fever is just a number; it is not an illness. A fever is actually the body’s way of trying to fight off infections, and they can be beneficial.
1. How high does a temperature have to be to be considered a fever?
In general, an oral or rectal temperature higher than 100.4 is a true fever. The most accurate way to take a temperature is rectally, especially in babies, or orally after 4-5 years. If you aren’t sure how to take a temperature, check out this article, or ask your doctor. No matter how you take the temperature, do not add or subtract a degree; simply note the method you used.
Don’t rely on your hand to estimate the temperature. Studies have shown that parents are only right about half the time using the “touch method.” The cut-offs for fever do not change depending on what your child’s “normal” temperature is since that can vary throughout the day and in one study, only eight percent of people had a “normal” temperature of 98.6.
2. How high is too high?
If you have a baby two months old or younger, he or she should be seen immediately if they have a temperature higher than 100.4. (This is the one time where a fever is considered an emergency.) Older infants that have temperatures higher than 101 should also be seen, but they can wait for regular office hours.
For older children, the importance isn’t in the number but in how your child looks and acts. A child who has a temperature of 104, but is still eating and drinking, is much less worrisome than a child with a fever of 101 who doesn’t want to do anything. However, a high fever will make most of us uncomfortable, so reassess how your child is doing after the fever has come down a little.
3. Should you treat a fever with acetaminophen (Tylenol) or ibuprofen (Motrin/Advil)?
Please don’t automatically give medicine to a child who otherwise seems to be fine. A fever can actually help a child get over an illness faster. Studies have shown that children with certain diseases (chickenpox and measles) took longer to heal if they received acetaminophen. However, if your child is obviously uncomfortable, it is not necessary to make them suffer with the fever. Go ahead and give them acetaminophen if they are older than two months, or ibuprofen if they are older than six months.
Dose by weight, not age. If you are unsure of the proper dosage, call your doctor’s office or Ask-A-Nurse (800-658-3535). Do not be surprised if your child’s temperature only comes down by a degree or two. Remember, we are just trying to make him or her comfortable, not necessarily eliminate the fever.
Tips to Remember
- It is not necessary to alternate acetaminophen and ibuprofen to keep a fever “under control.” However, it is safe to alternate medicines every 3-4 hours if you need to keep your child comfortable. Because the medicines are different types, you can even give them closer together if the first medicine didn’t seem to help.
- If your child is feeling miserable, please do not withhold medicine from your child so the doctor can “see” the fever. We will believe you when you tell us what his/her temperature was at home.