Fever

Fever is when one’s body temperature is higher than normal. Normal body temperature is 98.6 degrees Fahrenheit. 

Fever in children under 2 months of age is a medical emergency.  If your child under 2 months of age has a rectal temperature of 100.4 or greater, call our office immediately. You will be directed to take your child to an emergency room at Children’s Healthcare of Atlanta (www.choa.org). Do not give any medication to reduce the fever. 

Just feeling your child’s forehead does not give an accurate measurement of temperature. It is best to take your child’s temperature with a thermometer. Digital thermometers provide a quick, accurate way to measure body temperature. They can be used to take rectal, oral, or axillary temperatures.  Pacifier thermometers, ear thermometers, forehead thermometers, and plastic strip thermometers (small plastic strip pressed to forehead) do not give accurate readings and are not recommended. Glass mercury thermometers should not be used due to concerns about possible exposure to mercury. Make sure to read the directions that come with your thermometer. It is important to use it correctly to get the most accurate reading. 

Your child’s temperature can be taken rectally (by bottom), orally (by mouth), or axillary (in armpit). Rectal or oral temperatures are the most accurate. 

          Newborn to 15m= rectal
          16mo to 3 yrs= rectal, axillary
          4-5 yrs= rectal, oral, axillary
          Over 5 yrs= oral, axillary
 

To take an axillary temperature:  The armpit should be dry before taking the temperature. Place the tip of the thermometer high in your child’s armpit. Hold the thermometer in place by holding your child’s arm down by his side.    

To take an oral temperature: Your child should not drink cold or hot liquids 30 minutes prior to taking an oral temperature. Place the tip of the thermometer under your child’s tongue. Have your child hold the thermometer in place with his lips. If needed, he may gently hold the thermometer with his fingers. Avoid biting the thermometer.

To take a rectal temperature: Position your baby on his/her back on a changing table. Spread apart your baby’s buttocks with one hand. Use the other hand to grasp the thermometer between you middle and index finger. Gently insert the bulb of the thermometer about 1 inch (2.5cm) into the rectum or until the tip of the thermometer disappears. Keep a firm grasp on the buttocks by cupping them with the palm and fingers of the hand that is holding the thermometer.  

Your child has a fever if:

          Rectal temperature is greater than 100.4
          Oral temperature is greater than 99.5
          Axillary temperature is greater than 99

Fever itself is not an illness. Fever is a symptom. Most fevers are a symptom of infection or other illness. Although fevers can be frightening, fever itself usually does not cause harm. 

Fever helps the body fight infection by stimulating natural defense mechanisms.   So, fever can actually be a good thing as it is the body’s way to fight off infection.   

Watching your child’s behavior will help you determine whether a minor illness is the likely cause of your child’s fever or if you child needs to be seen by a physician. Your child’s illness if probably minor if he/she is still interested in playing, eating and drinking well, alert, smiling, and has normal skin color. 

Not all fevers need to be treated. If your child’s temperature is 99-100 degrees Fahrenheit and he is feeling well, do not treat with fever reducing medication. Monitor your child’s temperature closely. 

If your child’s temperature is 101 degrees Fahrenheit or greater, he/she may feel a bit cranky due to the fever. Thus, a fever reducing medication may provide some relief. Treating fever with fever reducing medications does not treat the illness causing the fever.   Lowering fever with fever reducing medications may help your child feel better.   Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) are the only fever reducing medications which should be used in children. Ibuprofen should not be used in children under 6 months of age. Never give aspirin to treat your child’s fever. It may take 60 minutes for these medications to reduce fever. Click on this link if you are unsure of the tylenol or Ibuprofen dosing.

  • Tylenol/Motrin Dosing Chart/Sheet
  • There are some other things you can do to help soothe your child with fever. A lukewarm washcloth on your child’s forehead may be helpful. Never give you child a cold bath for fever. Cool water will cause shivering which can increase body temperature. Never use rubbing alcohol to reduce fever as it can cause poisoning when absorbed thru the skin. Avoid overdressing or over bundling your child as it can prevent body heat from escaping.   Make sure your child’s room temperature is comfortable. Offer plenty of fluids when your child has a fever to avoid dehydration. 
     
    Fever may cause your child to breathe faster and have a higher heart rate. Once the fever decreases, your child should be breathing normally and heart rate will be back to normal. If not, your child needs to be seen.  
     
    Your child needs to be seen at urgently for any of the following:
     
    • Seizures related to fever
    • Child is acting ill. For instance, not easily comforted or soothed, crying a lot, or acting very sleepy.   
    • Inconsolable crying or extreme irritability
    • Severe headache
    • Stiff neck
    • Rash with fever
    • Purple spots on skin
    • Concerns of dehydration—your child is not drinking well, not keeping down fluids, decreased urine output
    • Labored breathing
    • Fever in a child with a chronic medical condition such as sickle cell anemia, heart disease,
    • No clear explanation for fever. For instance, no cold symptoms, no recent immunizations.
    • Limpness or refusal to move  
    • Persistent vomiting or diarrhea

    If you have any concerns about your child with fever, call our office and speak to our phone advice nurse.  If you are in doubt about what to do, call our office. If your child is acting ill or in a way that concerns you, even if he/she does not have fever, call our office. 

     

     

     

     


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