How to Treat Your Child’s Fever
I have been a pediatric nurse for eleven years. I have learned in that time that nothing scares most parents worse than when their little one has a fever. Believe me, I’ve been there.
When I first started out as a pediatric nurse my one year old developed a fever of 104.7. I was on the phone with my nurse manager in tears, “But this is MY baby. His fever is too high!” She talked me down and helped me care for him at home. Everything turned out just fine. I appreciated her empathy and patience so much that day.
Odds are, if you found this post, you are looking for how to treat your child’s fever. I am here to help you know when to treat a fever, when to leave it alone, and when to call the doctor.
First, this post focuses on an infant or older child with a fever, but no other symptoms. Or for those times when you already have a diagnosis (strep throat, hand foot mouth), and are in the trenches dealing with the symptoms.
HUGE DISCLAIMER HERE: IF YOUR BABY IS LESS THAN 12 WEEKS OLD AND HAS A FEVER. STOP READING AND CALL A DOCTOR.
What is the Purpose of a Fever?
The most important thing to know about a fever is that while scary, it means your child’s body is working exactly like it is supposed to. The fever is their body’s way of fighting infection, whether viral or bacterial. The fever may make your child uncomfortable, but it will not hurt them.
“But I’ve Heard a High Fever Can Cause Brain Damage?”
Brain damage from high fevers are a common concern for parents, but you can rest at ease. The brain’s thermostat prevents fevers caused by illness to go above 105 or rarely, 106 (God is good!). In nine years of working with sick children I have only seen a fever of 106 one time. Surprisingly, that child was still happy and playful.
Why do I keep saying, “fevers caused by illness”? I say this because a child’s core temperature can go up to dangerous levels (108 degrees) if left in a car or other dangerous situation. So it is possible for a child to sustain brain injury from a high temperature, it just does not happen with infections.
But what about Febrile Seizures?
“If my child’s temperature gets too high won’t he have a seizure?” Yes and no. Some children have febrile seizures, but it is not related to how high the temperature is. It is thought that some viruses are more prone to causing febrile seizures.
We also know that children who have had a febrile seizure before are more likely to experience them again. If you have a family history of febrile seizures your child will be more likely to experience a febrile seizure.
The good news about febrile seizures is that most febrile seizures do not cause any harm and are over quickly. Sometimes however, a seizure can be dangerous to a child if it lasts longer than a few minutes or if your child becomes pale or blue. If this happens, call 911 immediately.
If your child has a seizure of any kind, even if it is very brief and associated with a fever, you should call their physician to get them checked out.
Does a High Fever Mean Your Child is Really Sick?
Nope. A child with a common cold can have a fever of 104, while a child with strep throat or other bacterial infection will run a low grade fever. You cannot judge how sick your child is based on their temperature. As a matter of fact, the children I see with the highest temperatures are the children with simple fever viruses. Give those children a little fever reducer and they are running around playing again in an hour.
What is a Fever?
Rectal, ear, temporal artery: 100.4F or higher
Oral or paci: 100F or higher
Axillary (underarm): 99F or higher
*You really want a rectal temperature in a baby less than three months. Rectal is the most accurate method for checking a temperature. However, the temporal artery thermometer is considered the next best thing according to a study by The American Academy of Pediatrics on the Exergen temporal artery thermometer.
Parents often want to know which thermometer is the most accurate. Here is a guide to choosing the best thermometer for your family.
When do I treat my child’s fever?
When we treat a child’s fever it is important to remember that we are treating the child more so than the fever. We want your child to be happy and comfortable, so if he is running around playing with a temperature of 101, then leave it alone. If he is lying on the couch shivering at 100.5 treat it.
Typically, your child will feel okay until their temperature reaches around 102. That is the point when they most often begin to feel yucky allover.
How to treat your child’s fever
Now to the “how” part of treating fevers.
- Keep your child hydrated. Their body will use more fluids when they have a fever, so offer cold fluids in unlimited amounts during times of illness. This is a good time to let them have popsicles, slushes, smoothies, and their favorite drinks.
- Give your child a lukewarm bath. A lukewarm bath is 100 degrees, which is cooler than your child’s core temperature when they have a fever. It should be a pleasant experience because your goal is to make your child more comfortable. If they are crying or shivering, take them out and wrap them up right away.
- Give fever reducers. Here is an excellent info sheet on Tylenol (acetaminophen)and here is one for ibuprofen . It is important to note that we do not use ibuprofen in children under six months old. Also, if you are giving any multi-dose medications such as Tylenol cold, be sure you are not duplicating ingredients.
- Keep your child dressed lightly. Children will often want to bundle up when they have a fever, and parents often want to have the child undressed to keep them cooler. Remember that we want your child to be comfortable, and shivering raises the core temperature, so go for the middle ground. Light clothing with one light blanket is perfect.
When to Seek Medical Attention
- Fevers of 104 or higher that don’t come down to 101 or 102 with the treatment measures above.
- Irritability this means more than just fussiness. A truly irritable child will cry for hours with minimal verbal interaction and is almost impossible to console.
- Meningitis symptoms are high fever, stiff neck or pain in the back of the neck, vomiting, headache, bright light hurts the eyes.
- Lethargy this means more than your child just isn’t acting right or laying quietly in your arms. Lethargy actually refers to your child being limp, lifeless, unresponsive or won’t make eye contact.
- Less than 12 weeks old I know I have said it about a hundred times, but if your young infant has a fever, contact the pediatrician right away.
- If you suspect strep, ear infection, or if your child has any difficulty breathing Often, cleaning your little one’s nose with saline and suction (I love the NoseFrida!) will relieve difficulty breathing. If it doesn’t call your doctor right away. You also want to call if you suspect flu or a bacterial illness.
Never Feel Bad for Calling Your Pediatrician
I once had a brain surgeon call me because his toddler bumped his head on a table. Why? Because when it is YOUR child all the knowledge in the world doesn’t matter. Sometimes you just need to talk to someone else about it. Parents often apologize for bothering me, but I know they are just being good parents. Besides, if they didn’t call I wouldn’t be able to work from home and take care of my kiddos when they are sick.
Good parents try to take the very best care of their children and that often creates anxiety when they are sick. That is what we nurses and doctors are here for. If your pediatrician makes you feel bad, then it is time to find a new one.
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