A fever occurs when your child’s body temperature is elevated. Pediatricians diagnose a fever when the temperature is above 100.4 degrees Fahrenheit. A fever is a symptom, not a disease. It is the body's normal response when fighting an illness or an infection. Most fevers are caused by a viral illness, such as the common cold. Some are caused by bacterial illnesses, such as strep throat or an ear infection. Fevers are generally harmless. They are considered a good sign that your child’s immune system is working and the body is trying to heal itself.
Normal body temperature varies with age, activity level, and the time of day. Children’s temperature is highest between late afternoon and early evening, and lowest between midnight and early morning. When children have a fever, they may feel warm, breathe faster than usual, shiver, appear flushed or sweat more than usual. They may also be more thirsty than normal. Some children feel fine when they have a fever and continue to be active and playful.
A fever cannot always be detected by feeling your child’s forehead. Use a thermometer to take the temperature.
Digital thermometers are recommended to check your child’s temperature. The American Academy of Pediatrics encourages parents to remove mercury thermometers from their homes to prevent accidental exposure and poisoning.
While other methods for taking your child’s temperature are available, such as pacifier thermometers or fever strips, they are not recommended at this time.
Digital multiuse thermometer: This thermometer reads body temperature when the sensor located on the tip of the thermometer touches the part of the body. This type can be used rectally, orally or axillary (under the arm) and may be used at any age, including newborns. Rectal temperature is considered to be the gold standard and most accurate method of taking a baby’s temperature from birth through 3 months of age.
Temporal artery: This thermometer reads the infrared heat waves released by the temporal artery, which runs across the forehead just below the skin. The reading is obtained by swiping the thermometer across the forehead. New research shows this type of thermometer may be reliable in all ages, including newborns.
Tympanic: This thermometer reads the infrared heat waves released by the eardrum. This type is most reliable in babies over 6 months of age. It must be placed correctly in your child’s ear canal to give an accurate reading. Too much earwax can cause the reading to be incorrect.
While a fever is never pleasant for a child, there are steps you can take to help your child during their illness.
Extra fluids. Encourage your child to drink extra fluids as children lose fluids from their body when sweating and breathing rapidly during a fever.
Clothing. Clothing should be kept to a minimum because most heat is lost through the skin. When your child is shivering from chills, use a light blanket.
Medicine. Remember that a fever is helping your child fight an infection. Medicine is used to help reduce the fever and the discomfort associated with it.
Acetaminophen (Tylenol): If your child is younger than 2 years of age, ask your doctor for dosing instructions. Acetaminophen may be given to your child every 4-6 hours.
Ibuprofen (Motrin, Advil): If your child is younger than 2 years of age, ask your doctor for dosing instructions. Ibuprofen may be given to your child every 6-8 hours.
- Aspirin is not advised for children of any age.
When to Treat Your Baby's Fever
So if your baby is under 3 months of age we'd really rather not treat fevers at that age, just because we don't want to mask a fever.
Those babies under 3 months of age are a little bit unpredictable. They don't have a super mature immune system. And if you think they're a little fussy or have a fever and you start giving lots of Tylenol or acetaminophen you might be masking something bigger. So we want to make sure.
Give us a call first, and we'll check the baby over and let you know. Yep. It's safe to give Tylenol now.
When to Call the Doctor
Most fevers may be easily treated at home. However, Boys Town Pediatrics recommends calling your doctor if:
- Your infant is 3 months old or younger and has a temperature of over 100.4 F.
- Your older child’s fever lasts longer than 72 hours.
- Your child is lethargic, unresponsive, refuses to eat, has a rash or is having difficulty breathing.
- Your child has signs of dehydration, such as a dry mouth, sunken soft spot or significantly fewer wet diapers.
When to Call the Doctor for Your Baby's Fever
Fever is actually a good thing. It's a way to show you that your child's immune system is functioning properly.
Our basic definition of a fever, for kids in general or for people, is 100.4 degrees Fahrenheit.
So, if your baby is 3 months and younger we take it pretty seriously. We say call right away if your baby has a fever over 100.4 or higher if they're under 3 months of age. We want to look at your baby, maybe do some labs. Especially under a month, we always do the labs.
6 months and above it's not as big of a deal. They can have a fever 101, 102. The first day of a cold we kind of let it go. You know, if they get to that third day of fever we always want to see babies. The basic virus can cause a fever for two to three days.
So if it goes longer than three days we say we want to see you and make sure there's no bacterial super infection on top of that virus.
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