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Patient education: Fever in children (Beyond the Basics)
Deputy Editor: Mary M Torchia, MD
Notes: This is our third installment on fevers. As mentioned several times fevers are a normal part of childhood. As children acclimate to the world around them they come in contact with many bacteria, germs, and viruses. A fever is the body’s way of killing off dangerous adversaries. When your baby is very young (first three months) you want to be especially careful. Contact your pediatrician if your baby develops a fever. As baby matures you will learn how to read his symptoms and understand how ill he is.
As I have previously mentioned, each of us as a unique mean body temperature. 98.6 is the average body temp., but your temperature and the temperature of your baby may differ a bit. When your baby is healthy take her temperature several times over a 24 hour period. Record, for your own knowledge what those numbers are. Keep that record with your notes. Pay attention to external influencers. At night when baby is wearing long sleeved long legged clothing her temp may be a tad higher. After bathing she may be a bit cooler.
If you purchase a new thermometer rerecord this information. It will help you know your baby’s mean temperature. Temperatures usually run in the evening. They usually dissipate in the morning. For babies under three months of age call your pediatrician. I do not recommend using medications to alleviate fevers unless your pediatrician encourages this.
Read and learn:
FEVER OVERVIEW. Fever is a normal response to a variety of conditions, the most common of which is infection. Fever occurs when the body’s temperature is elevated as a result of the body’s thermostat being reset to a higher-than-usual temperature.
Nearly every child will develop a fever at some point. The challenge for parents is to know when to be concerned. This topic review will discuss the definition of a fever, how to accurately measure a child’s temperature, how and when to treat fever, and signs and symptoms that require further evaluation.
FEVER DEFINITION Because of the normal variation in body temperature, there is no single value that is defined as fever. In general, a fever means a temperature above 100.4ºF (38ºC). You might get slightly different numbers depending on how you take your child’s temperature – oral (mouth), axillary (armpit), ear, forehead, or rectal.
Axillary, ear, and forehead temperature measurements are easier to obtain than rectal or oral temperatures, but they are less accurate and may need to be confirmed rectally or orally in certain children.
FEVER CAUSESInfection is the most common cause of fever in children. Common viral and bacterial illnesses are the most likely illnesses to cause fever. These include:
●Gastroenteritis (see “Patient education: Nausea and vomiting in infants and children (Beyond the Basics)”)
●Ear infections (see “Patient education: Ear infections (otitis media) in children (Beyond the Basics)”)
●Urinary tract infections (see “Patient education: Urinary tract infections in children (Beyond the Basics)”)
There is little or no scientific evidence to support the widespread belief that teething causes fever. Although it is difficult to disprove this notion completely, alternative causes of fever should always be sought and temperatures above 102°F (38.9°C) should never be attributed to teething.
Bundling a child who is less than three months old in too many clothes or blankets can increase the child’s temperature slightly. However, a rectal temperature of 101°F (38.5°C) or greater is not likely to be related to bundling and should be evaluated. (See ‘Evaluation recommended’ below.)
Some childhood immunizations can cause fever. The timing of the fever varies, depending upon which vaccination was given. (See “Patient education: Vaccines for infants and children age 0 to 6 years (Beyond the Basics)”.)