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Spring 2013 - When Fevers Rise

Fevers climbing over 100°F can be alarming for parents, but Courtney Mann, MD, pediatric emergency medicine physician, wants to help debunk a few myths. "It's important for parents to realize that a fever itself is not necessarily harmful," said Dr. Mann. "A fever is the body's natural immune response to infection - it's the body's way of turning up the heat to fight the germs." A fever can mean your child's body is doing exactly what it is supposed to do.

How High is Too High?
"For normal, healthy children older than 6 months, parents should worry less about the number on the thermometer and more about other symptoms," said Dr. Mann. "The body's natural thermostat, located in the brain, simply isn't going to allow a fever to rise indefinitely unless there are extreme environmental temperatures or other health conditions of concern such as previous damage to the brain or a compromised immune system."

Cause for Concern
Dr. Mann recommends seeking medical advice or care for the following:

  • Babies younger than 6 months with a rectal temperature of 100.4°F or higher
  • Children with a fever for 2 or more days
  • Altered mental status or difficulty arousing child
  • A child with a fever of 104°F accompanied by other symptoms

Other Symptoms of Concern

  • Trouble Feeding
  • Difficulty Breathing
  • Severe Pain (abdominal, chest or head)
  • Rash-Like Bruising
  • Problems Drinking Fluids or Urinating

Treating a Fever
Typical treatments for fever are merely efforts to comfort a child.

  • Do NOT give aspirin to a child with a fever.
  • Do NOT give children aspirin-containing medications. Check all labels carefully.
  • Keep children hydrated. Give them fluids.
  • Make sure they rest and get plenty of sleep.
  • Don’t go overboard with bundling a child when his/her temperature is already high.

Although it isn’t necessary to treat a fever, Dr. Mann says taking acetaminophen or ibuprofen may comfort children. Read children’s dosage instructions carefully and call a doctor if you are unsure about the type or amount. Keep a log of anything you give them. Don’t wake a child that is sleeping to give them something for a fever. Remember, the fever itself is not the problem, and they need the rest.

Play It Safe
Most of all, trust your instincts. Although a fever alone is not necessarily cause for concern, Dr. Mann encourages families to call for help when in doubt.

Scary Seizures
A small percentage of children experience seizures with fevers. "Although they can be scary, they are typically brief and self-limited," said Dr. Mann. "They will not cause long-term brain damage." In fact, many children outgrow fever-related seizures.

If a child is having a seizure, move them to a safe location. Do NOT restrain them during a seizure. Clear the area of anything dangerous and loosen/open clothing from the waist up if possible. Do NOT administer oral medication or insert anything into a child's mouth during a fever-related seizure. If the child vomits or there is fluid (saliva) or any sign (tongue placement, etc.) of breathing difficulty, turn the child on their side or stomach.

If a seizure ends quickly (in seconds), and the child awakens, you can drive the child to the closest emergency room for evaluation. If it last minutes, it is probably best to call 911 to have an ambulance transport the child.



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