Many parents have been woken up in the middle of the night by a crying child. But there are times when it is a little more intense than usual. You go into your child's room, check to see what might be the problem and realize they are burning up. In these instances, it is necessary to figure out if your child has a fever and what this fever might be telling you.
Fevers are not illnesses. They are only an indication of a possible illness or medical condition and represent the body's natural response to fighting infection. A fever is when the body temperature reaches a certain point, with most body temperatures averaging 98.6 degrees Fahrenheit, plus or minus one degree. Fevers begin when someone has a temperature higher than 99 degrees orally or 100 degrees via the rectum.
The most obvious sign of a fever is if the child's forehead is warmer than usual. More signs to look for include poor sleeping, not eating, lack of interest in play, face may be red, sweating or shivering, and being more cranky or fussy than normal.
Cold, flu, strep throat, ear infections and other viral or bacterial infections are all common causes of fever in children. Your child may also get a fever after getting any immunization shots, which should go away within a day. Babies can also run a fever while they are teething. This is normal and typically lasts around 24 hours.
The American Academy of Pediatrics recommends using a digital thermometer, taken rectally for children from birth to 3 years and orally for children older than 3 years. To take a rectal temperature, lay the child on his or her stomach, put a dab of water-soluble lubricating jelly on the tip of the thermometer and insert it one-half inch into the rectum, holding it in place until it beeps. To take an oral temperature, place the tip of the thermometer under the tongue and close the mouth until the thermometer beeps. If you alternate between taking rectal and oral readings, get two thermometers and label one for each use. Temperature readings may also be taken with the armpit, although this is not the most accurate method. Position the thermometer snugly under the armpit with the arm down and wait until the thermometer beeps. Temporal and ear thermometers are also available for children older than 6 months. Mercury thermometers are no longer recommended due to the potential risk of mercury exposure. Whichever method you choose, be sure to always clean the thermometer with rubbing alcohol after each use.
- If you have an infant younger than 3 months with a rectal temperature higher than 100 degrees, the pediatrician needs to be notified immediately
- A child between 3 and 6 months old with a fever reaching up to 102 degrees can be monitored at home unless they are showing other symptoms of being sick or the fever goes beyond 102 degrees
- Children over 6 months old with a fever up to 102 degrees can be monitored at home unless it lasts longer than one day or goes beyond 102 degrees (if your child is showing symptoms such as cold, cough or diarrhea, you might call sooner)
- Call if your child has a stiff neck (child cannot touch chin to chest)
- Call if your child has a hard time breathing
- Call if your child gets some sort of skin rash
- Notify the pediatrician if your child has not had a wet diaper/urinated for more than eight hours
- If your child gets a fever after an immunization shot that lasts longer than a day, call the pediatrician
- If a low-grade fever persists or recurs for more than a week, notify the pediatrician
- Call immediately if there is any significant change in behavior, loss of consciousness, confusion, delirium, or convulsions (or go straight to the emergency room)
- For fevers over 105 degrees, go straight to the emergency room
Note: You can obviously call sooner if you feel your child might have an underlying problem. After all, pediatricians are there to be utilized. Remember that you know your child best and having peace of mind is always a good thing.
- Give your child extra fluids since they will be perspiring more than usual (try popsicles if they are old enough)
- Dress your child lightly since the more layers they have on, the warmer they will get, making the fever more intense
- Keep the child's room cool (try a fan if it's a warm day, but do not have the fan blow directly on them)
- Make sure your child is getting plenty of rest to fight off whatever the infection might be
- Check your child's temperature every four hours to make sure it is not getting worse (check more often if the child is showing other symptoms)
- Try a lukewarm bath (not a cold bath), as this will help to bring the temperature down as well as help them relax
- Give your child acetaminophen as a last resort, but check with your doctor first (use weight as opposed to age to determine the correct dosage)
- Do not give aspirin to anyone younger than 21 years, as it can make them very sick
- Do not rub children's skin with rubbing alcohol to cool them down, as it can be absorbed through their skin
Seizures are a very rare occurrence when a child has a fever. Only 2 to 4 percent of all children under the age of 5 actually have a febrile seizure. If your child starts to twitch a lot, stiffen up, or it looks like they are going to pass out, call your pediatrician immediately. Make sure to place your child on their side (so they do not choke on their own vomit). Do not put anything in their mouth. Do not try to stop arms and legs from moving. Call 911 if the seizure lasts longer than three minutes.