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What causes baby's fever and what's the best treatment?
A baby's fever often sparks concern in parents. Read our answers to these
commonly asked questions about children's fevers, and learn when to worry.
1. What is a fever?
By definition, a fever is present when a child's temperature is elevated
to 100.4 degrees or more rectally, 99.7 degrees orally, 99 degrees by
axillary reading (taken in the armpit), or 100.4 degrees by tympanic reading
(taken in the ear).
A fever isn't an illness in itself but usually a physical sign that a
child is fighting an infection, inflammation, or disease.
"A
fever is not necessarily bad," notes Christian Patrick, MD, PhD,
FAAP, deputy chief medical officer and director of academic programs at
St. Jude's Children's Research Hospital in Memphis. A fever helps stimulate
the body's white blood cells, which attack and destroy the viruses and
bacteria that cause the majority of all fever-related infections. When
a fever starts to climb over 106 degrees, though, it can lead to brain
damage.
2. How should I take baby's
temperature?
Experts believe that a rectal reading is the most reliable in detecting
low-grade fevers in babies. Before using a rectal thermometer, clean it
with an alcohol-soaked cotton swab, or wash it in warm (not hot) soapy
water, and rinse it with cool water. Shake the thermometer until the mercury
line falls below 96 degrees. The mercury in the thermometer is toxic,
so be careful not to break the glass.
Coat the thermometer bulb with petroleum jelly. With your child lying
facedown or on her side with her knees up, gently insert the thermometer
about one inch into the rectum. Keep the thermometer inside the rectum
for at least two minutes.
3. How
should I treat a fever?
According to the Association for the Care of Children's Health, a Bethesda,
Maryland-based education and advocacy group, parents should follow the
four steps outlined in the C.A.L.M. action plan when their child has a
fever:
C: Check your child's temperature.
A: Assess other signs and symptoms your child may have.
L: Lower the temperature to make your child more comfortable.
M: Monitor your child's behavior and temperature reading.
To help lower your child's temperature, remove any warm clothing from
your child, use cool--but not cold--compresses on her forehead, have her
take a tepid bath, and give her plenty of fluids.
Margaret Fisher, MD, FAAP, an epidemiologist at St. Christopher's Hospital
for Children, offers her own recommendation for a low-grade fever: "I'm
a big believer in chicken soup and tincture of time," she says.
4. Should I give my child medicine to
lower the fever?
Medication can be used to help lower a fever, notes Mark Stegelman, MD,
FAAP, a pediatrician at Egleston Children's Healthcare System at Emory
University in Atlanta. Acetaminophen can be used for everyday fevers and
after immunizations, he says, while ibuprofen, a longer-lasting anti-inflammatory
drug, is recommended for higher fevers and for times when a parent and/or
child desires six to eight hours of relief, such as at bedtime. Aspirin,
on the other hand, should not be given to children because of its association
with Reye's syndrome, a rare but dangerous brain disorder. Discuss these
options with your pediatrician before administering any medication to
your baby.
Some pediatricians have become increasingly concerned about parents' high
level of anxiety about their children's fevers and their resulting dependence
on fever-reducing medications. Because of concerns about overdosing and
overuse of medicines, Dr. Fisher advocates a period of watchful waiting
when a child has a low temperature and isn't uncomfortable. "If you
give your child antifever medication unnecessarily, you may actually prolong
his illness," notes Dr. Fisher. "Fever is the body's way of
dealing with infection and inflammation."
5.
When should I call a doctor?
In deciding whether to contact a pediatrician, follow these guidelines:
If your child's symptoms are mild, it's best to watch for any changes
in your child's condition before calling your pediatrician.
Call the pediatrician immediately if your child's temperature exceeds
103 degrees or if your child seems particularly ill.
Use your judgment in seeking medical attention if, in addition to a fever,
your child has any of the following symptoms: abdominal pain, headache,
sensitivity to light, neck pain, rashes or skin spots, irritability, or
sleepiness.
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