Fevers In Babies & Children
You have probably found yourself waking to the sounds of your child tossing in bed to find them flushed, hot and shivering. You go to kiss them on the forehead to settle them, and they feel as if they are on fire. Immediately your mind begins racing, is it a fever, what do they have, should I call the doctor, take them to the emergency room? What do I do?!
Here is what you need to know
Fevers are a normal response of the body to fend off germs, bacteria, viruses, and disease. In healthy children, a fever isn’t cause for much concern. I know, it is tough to look at your little one suffering from a fever and ignore your first thought to dose them with Tylenol or Motrin to bring it down and help them feel better.
What if I told you, it’s unnecessary at first? A fever is in fact, your bodies way of defeating whatever is brewing in their system. When an outsider, like a virus, or bacteria enter the body, the first reaction of your body is to go to war. White blood cells build up and race out to find and destroy the stranger that has somehow made it inside. While this is happening, it is believed that the temperature rises both because of the extra work your body is taking on and to make your body an uncomfortable place for this little culprit and drive them out.
Now, yes, a fever can be dangerous, even deadly. Though, letting it ride its first go around for a short period of time can be beneficial. That being said, never ignore a higher fever, A temperature of 102 degrees F or higher is usually when it calls for medicine to take it down. Though, if your child is three months of age or younger you should call your doctor at the first sign of a fever, with their temperature reading 100.4 degrees F or higher.
Serious complications such as, but not limited to seizures, heat stroke, brain damage, or death usually occur at much higher temperatures, approximately between 105 and 108 degrees. A febrile seizure occurs when there is a sudden spike in your bodies temperature, not just by reaching a higher temperature. For brain damage to occur your body temperature would have to reach 107.6 degrees F.
The important thing to know is a fever itself is your bodies way of telling you something’s not quite right. It may be the common cold, the flu, the stomach bug, strep, or any number of things. In babies, low-grade temperatures are even associated with teething, the point is, it means something. Pay attention and be on the lookout for other symptoms. We will get on how to treat a fever shortly.
Also referred to as Pyrexia or febrile response which are just fancy medical terms for fever. A fever is essentially any rise in temperature above the bodies normal or baseline temperature. Generally speaking, a normal body temperature is 98.6 degrees F.
First, we need to understand what body temperature means. Your bodies ability to regulate temperature is an automatic process and is the ability to make and get rid of heat.
When your body begins to get too cold
Your blood vessels will narrow (tighten). With your blood vessels now more narrow in size the blood flow to your skin will be reduced to save heat.
Notice how you shiver when you are cold? That action actually produces heat in an effort to raise your body temperature; there is a reason for everything your body does.
On the other hand, if your body gets too hot
your blood vessels will widen to increase blood flow toward your skin, and you will sweat. Sweating is the bodies natural cooling system. As your sweat begins to evaporate you will cool down.
It is important to know that 98.6 degrees F is regarded as the normal temperature because it is the average norm in studies. Though, what is normal for some is not always normal for others. Everyone is highly individual, and their “baseline” or normal for them temperature can be slightly lower or higher. As a rule of thumb, 98.6 is normal, but you are not considered feverish until your temperature hits 100.4 degrees F.
Your temperature readings will also vary depending on the instrument you use and where you take the measurement. The gold standard for children under the age of 2 is to take a rectal temperature. Getting an oral temperature is often difficult in littles ones and tends to be less accurate.
When your child is older than the age of 2 years, the mouth or ear are the next best places to measure for an accurate temperature. I cannot stress enough how inaccurate and unreliable axillary (arm pit) readings are. If you call your child’s pediatrician with an axillary reading they will direct you to re-take the child’s temperature and call back.
Readings that indicate Fever
Oral (in the mouth): 100 degrees F or above
Rectally (in the bottom): 100.4 degrees F or above
Axillary (under the arm): 99 degrees F or above
Tympanic (Ear): 100.4 degrees or above
Temporal Artery (side of forehead): 100.4 degrees or above
How to take your child’s temperature
Orally (by mouth): Turn on the digital thermometer. Place the tip of the thermometer under your child’s tongue toward the back of the mouth and ask your child to close their mouth and keep it under their tongue.
*Important: If your child has had anything to drink or eat in the past 20 minutes wait until twenty minutes have passed before taking an oral temperature. The mouth is very sensitive to hot and cold, and this will give you an inaccurate reading.
Rectally (bottom): Lubricate the tip of the digital thermometer with petroleum jelly. Place your child on his or her back, lift their legs as you would for a diaper change, and insert only ½ to 1 inch into the rectum. Never try to force the thermometer past any resistance. Hold in place.
Axillary (underarm): Turn on digital thermometer and place under your child’s arm making sure it is only touching skin and not clothing. Have your child tightly hold his or her arm down to their side, so his or her underarm surrounds the thermometer. Add 1 degree to your reading.
Tympanic (Ear): Hold your child’s head still and remind them not to move. Gently pull the child’s ear straight back, turn on thermometer and place carefully in the ear canal. These readings can be thrown off by ear wax.
Temporal Artery (Forehead): Place thermometer to center of the forehead and hold the button down, slide across the forehead from the center (between eyebrows) across the hairline to the side of the outer eye (temple) all while keeping the button held. Be sure not to lose contact during the sweeping motion. The accuracy of these readings varies due to improper use because they are a bit tricky to operate. I would suggest sticking with rectal or oral temperatures.
Do not fall prey
To the cutesy pacifier or plastic strip thermometers, though convenient; they are terribly inaccurate. I get it; no one is excited to take a rectal temperature, but it is the most accurate way for children under the age of two. These companies prey on the simple notion that no one likes doing it, and we fall, victim because it’s less stressful and more convenient. Bottom line is, they don’t work.
Treating A Fever
Sponging: This is not the same as a “cool bath” with this method you are going to be mimicking the bodies normal cooling response via sweat, using water instead. First, fill the bath only 1 to 2 inches with tepid water, 85 to 90 degrees F. If you do not have a bath thermometer, use the back of your hand, the water should feel lukewarm. Now, sit your child in the tub and begin squeezing your sponge or washcloth over their body, letting the water coat them. Pause between each coating of water, the point is to let the water evaporate in the same fashion that we discussed earlier on how the body normally regulates temperature through sweat and evaporation. This technique can reduce a fever by 1-2 degrees within 30-45 minutes.
Cool Washcloth: Wet a washcloth with cool water and pat around your child’s forehead and face. You can also do this to their arms, legs, etc.
Cold Pack: It is important to know I am not referring to ice, ice packs are an emergency treatment that needs to be done by medical professionals in a certain way to prevent shock. Use a cold pack designed for children to be used in the same fashion as a cool washcloth. They make very cute animal covered ones that may help with your child swatting away the cool washcloth.
When to give Medicine:
Acetaminophen (Tylenol) and Ibuprofen (Motrin) are the standards for fever reduction. While your child shouldn’t need these unless the fever has reached 102 degrees F, you may choose to give it sooner due to aches, pains, or general discomfort and fussiness. Make sure you follow the dosing instructions carefully and take note of the time you give the medicine to your child.
Acetaminophen overdosing can cause fatal complications such as, but not limited to, liver damage. Ibuprofen can lead to Reye’s syndrome, a rare but serious condition that causes swelling in the liver and brain. It is very dangerous to over-do it with medicine, especially in children.
Always consult your child’s Pediatrician before moving forward with medicinal relief, while these are OTC (over the counter) medications, that is to make them more easily accessible in time of need, this does not make them any less dangerous than other medications.
Breaking a stubborn fever
(This should not be carried out unless advised by your child’s Pediatrician)
For a high and stubborn fever that won’t seem to break, most Pediatrician’s will advise you to alternate fever-reducing medications. In this instance, you would give Acetaminophen, and If the temperature remains high at the 3-hour mark, you will give Ibuprofen. Every 3 hours you would switch which medication you are giving.
Dosing would look something like this;
4pm- Motrin (and so on)
Important to know: This is only for very stubborn fevers, and only if your Pediatrician has told you to do so.
When to call the Doctor
Three months or younger: A temperature of 100.4 degrees F or higher
Four months and older: A temperature of 102 degrees or higher
Pay attention to the symptoms your child is experiencing besides the fever, to give your child’s doctor a better picture as to what may be going on. If the fever has lasted more than three days, you should call the doctor as this is a sign your body is having trouble fighting off the infection.
Also, if your child is complaining of neck pain and/or stiffness you should seek medical attention immediately.
Did You Know?!
The shivering stage of a fever can actually make the fever worse. The act of shivering causes your body temperature to rise similar to that of jogging in place to warm up when you’re cold.
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