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When Your Child Has a Fever

A fever is defined as a temperature above the normal body temperature of 98.6 degrees. Most health care professionals agree that a fever by itself is not an illness, but a symptom of an underlying problem.

Fevers can be a positive sign that the body is fighting an infection because fever stimulates certain defenses, such as white blood cells, which attack and destroy invading bacteria. A fever, however, can cause discomfort for a child, increase his need for fluids and make his heart rate and breathing faster.

Fevers can be a sign of a serious problem, such as a respiratory illness, pneumonia, ear infections, flu, and severe colds. It's important to be attuned to other symptoms the child is experiencing such as changes in eating habits, vomiting or diarrhea, difficulty breathing, tugging or complaining about ears, or changes in skin color.

Even a slight fever—or a slightly lower temperature than normal—in an infant less than 3 months old can indicate a problem. If a child younger than 3 months has a rectal temperature of 100.4 degrees F or higher, you should call the doctor immediately.

In older infants and young children, a fever is any rectal temperature of 101 degrees F or higher. A rectal temperature between 99 and 100 degrees F is a low-grade fever; it usually does not need a doctor's care.

If you think your child has a fever, take his or her temperature with a digital thermometer or with an alcohol-based glass one. (Do not use mercury thermometers, because they are potentially dangerous.) Children older than 3 years old can usually take an oral thermometer. Don't simply rely on touch.

Digital thermometers also are available that read the temperature in the ear or under the arm. These are fast and easy to use, but are also fairly inaccurate, especially in younger children. They can give only a general idea of how high a fever is.

Temporal artery thermometers also can be used. While these are easy to use even while your child is asleep, they are relatively new so their reliability has not yet been verified.

When to call a doctor

If your child does have a fever, it is recommended that you watch your child carefully for changes in behavior, and consider the child's age and health history to determine if and when to call your doctor. For any fever in a child that is a newborn to 6 weeks, call the doctor. A fever in a young infant is a major concern since their immune systems are so immature.

For any child under 2 years old, parents should call the doctor if the child's rectal temperature is 100.5 degrees F or greater. If a child this age gets a fever of over 101.4 degrees F for more than three days, then it warrants a call to the doctor. You know your child best. If your child is not acting as you would expect or you are worried that your child may have a serious illness causing his fever, always call your doctor for advice.

In extremely rare cases, fever can signal a life-threatening disease called bacterial meningitis. If your child has a fever greater than 101 degrees F and is lethargic or you can't get them to wake up normally, you should take him to the emergency room immediately. An older child may complain of a severe, sudden headache and have mental changes, neck or back stiffness, or rashes; these are also symptoms that warrant an immediate trip to the emergency room.

Taking a rectal temperature

  • Use a lubricating jelly to lubricate the tip of the thermometer. (Check the manufacturer's instructions to see whether they recommend a water-soluble jelly or petroleum jelly.)

  • Place the child across your lap, making sure to support his head. You can also lay him on the changing table or other firm surface.

  • Hold the baby still by pressing the palm of one hand on his lower back.

  • With the other hand, insert the thermometer one-half inch to one inch into the rectum. Stop immediately if the thermometer meets resistance.

  • Hold the thermometer between your second and third fingers and cup your hand around the child's rear. As you hold the thermometer in place, calm the child by speaking softly to him.

  • Keep the thermometer in place until you hear the signal or beep that it is ready. Write down the temperature, the date and time of day.

Treating a fever

  • NEVER give children aspirin to treat a fever. Aspirin has been linked to Reye's syndrome, a rare but potentially serious illness that affects the nervous system and can be debilitating or even fatal in children.

  • Acetaminophen and ibuprofen are the two medications for children that help fight fever. Children less than 6 months old should not be given ibuprofen. Read the instructions on the package or ask your doctor to be sure you give appropriate doses. Do not give more than the recommended dose of acetaminophen.

  • Bathing your child with lukewarm water will help bring down fever. Never use cold water or alcohol to bathe your child because it may cause shivering and actually increase the temperature.

  • Dress a child in light, comfortable clothing.

  • Increase fluid intake to prevent dehydration.