August 28, 2016

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What Does It Mean When My Child Has a Fever?

What does it mean when my child has a fever?The clock ticks to 2:00 am. and there you sit, rocking your sick baby trying to do what you can to make things better. Her forehead feels warmer than usual and her face looks red and sweaty and you fear that now she is running a temperature. You ask yourself, will she be OK until I can get her to the clinic in the morning?

What Does a Fever Do?

Parents often ask what to do when their child has a fever and just how much they should be concerned as temperatures fluctuate when their little one is sick. First of all, fever itself isn’t bad, to a certain degree. A fever is the body’s way of reacting to something; it is trying to create a hostile environment within the body to try and fight off the bacteria or virus causing the illness. It also gets the immune system revved up to start fighting off infections. Your body has what is called a “core temperature”. The core temperature is the temperature of the blood as it’s going through the heart. A fever is a core temperature of 100.4°F or higher.

When Should You be Concerned about Fever?

For infants less than two months of age, 100.4°F or greater is a fever that we get very concerned about. If your baby’s temperature exceeds 100.4°F, you should see your doctor right away even if it is the middle of the night! It is also very important that you do not give any medication to infants less than 2 months of age. When you bring them in, we need to be able to confirm the true core temperature. If the temperature is in fact greater than 100.4°F, your baby will be admitted to the hospital right away so that we can try to figure out what is wrong.

For children over two months of age, it’s hard to throw a number out there and say what level of temperature is too high. There are many viruses out there that can cause the temperature to rise to 104-105°F and it isn’t necessarily a bad thing and can be an appropriate response to the illness. Of course the higher the temperature is, the more concern we have. The core temperature has to be extraordinarily high, 107-108°F, to cause brain damage and at that time the bigger question is what is causing it to be that high.

When Should You Treat a Fever?

Remember that fever does have some benefits and it’s our body’s way of fighting off illness, so if we try to get rid of all fevers it actually impairs the body’s ability to do it’s job. You really have to look at the child to see how they are acting, rather than taking the approach that every fever needs to be treated with medication; newborns under 2 months of age of course being the exception.

KerriAnn Mahon, MD, ACMC-Willmar, Pediatrics

KerriAnn Mahon, MD, ACMC-Willmar, Pediatrics

I tell parents to think about their child’s comfort when treating fevers. You know how you feel yourself when you are sick, sometimes you feel cruddy and sometimes things just feel a little off; everyone reacts differently. You can have one child that has a fever of 101.8°F that is running around, playing like nothing is wrong and another child can hardly get up off the couch. Give medication for comfort when it’s needed and if your child is tolerating the fever, let it run it’s course.

Is My Child Contagious if They Are Running a Fever?

If your child has a fever, it is because something is going on inside their body, some type of infection. They may have an ear infection and the ear infection itself isn’t contagious but the cold that triggered the ear infection i

Public health agencies have adopted guidelines that state if your child has a temperature of 100.4°F or more they shouldn’t go to school or daycare.  It is not acceptable to use medication to bring the fever down and if you are doing so, they should stay home.

Remember that what appears to be “just a cold” for your child could, for another child lead to more serious illness such as bronchiolitis, a respiratory infection that can progress to cough and wheeze.  Sometimes, especially in young children or children who were born prematurely, bronchiolitis can become severe and require hospitalization.  Even if your child isn’t running a fever you should still consider keeping them home to prevent others from contracting the virus that is causing their cold symptoms.

When Should You Call the Doctor?

Remember that at any time you can always call your child’s doctor and talk about the symptoms to see what is advised. Also remember that if your gut is telling you that there’s something wrong, something different about what is going on, it’s probably worth bringing them in to be seen.

Stay tuned for next week’s article Taking Temperatures and Treating Fevers with Medication


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  2. Sharon K. Cook says:

    I am concerned about my 4 1/2 yr. old grandson who, in the past 3 mos., has had bouts of fever, vomiting, general malaise, loss of appetite, and fatigue. It seems to go away within 24 hrs., but I am wondering if there could be something else going on. He always says he hurts all over and won’t eat and sleeps a lot.
    Could this possibly be something that is more serious than just a “bug”?

    • Hello and thanks for your comment, Sharon,

      It sounds like your grandson should be evaluated by a physician particularly at the time he is ill. It may be that he has been unlucky and ended up with a few consecutive viral infections, but it’s certainly worth having him checked out next time he is feeling poorly.

      Dr. David Ross
      Family Medicine

    • It would also be helpful to keep a diary of symptoms, including going back and trying to recall the dates of previous illnesses. If there is a specific periodicity to the episodes, that can help with the diagnosis.

      Dr. KerriAnn Mahon

  3. savannah says:

    Good Morning

    my daughter who is 4 years old. Was sick about 3 weeks ago, she went to see the doctor and was told she had tonsillitis, she took her meds and was healthy within a week.
    Now she has gotten sick again, we had a second visit to the doctor about a week ago, and he said this is just a normal cold, she has been taking her meds but last night she got a sudden fever, she also vomited during the night, but this i think was due to a little coughing fit she had, she seemed to sleep okay but was up quite alot for water and to use the toilet.

    I am very worried and not sure if i should go to the doctor again?
    please advise.

    • Hello Savannah,

      Re-checks are important in primary care as illnesses may evolve with time, or a specific diagnosis may become more obvious with time. I tell my patients that any time that little voice in your head is telling you something is not right with your child, it is worth having your doctor take another look. Sometimes just having the reassurance that all looks ok is beneficial, and other times something new is found that requires treatment.

      David M. Ross, MD, MBA
      Medical Director of Patient Relations and Communication

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