Of everything we pediatricians get called about, I think that fever is the most common. Which isn’t surprising, given that fever can be a sign of illness. But despite the fact that it is so common, fever is often misunderstood — and often frightens people more than it should. Here are four things all parents should know about fever.
Fever is a symptom, not a problem.
We doctors are always going to be more concerned with what is causing the fever than with the fever itself. We are going to ask a whole lot of questions about other symptoms, like pain, cough, vomiting or rash. If the answers to those questions (and what we find when we examine children who come see us because of fever) reassure us, we aren’t going to be too worried despite a high fever — and on the flip side, if the answers don’t reassure us, even a low fever could worry us.
Fevers are not usually dangerous.
Again, it’s the cause that worries us, not the temperature. Fever can actually be a good thing when there is an infection; it helps get rid of germs, since they don’t like higher temperatures. Often parents worry about seizures with fever. It’s true those can happen, but they are actually pretty rare — and many children who suffer from them get them as the temperature is rising, meaning that sometimes the first indication that their child has a fever is when they have a seizure. If your child has had a seizure with fever, talk to your doctor about what you should do. Otherwise…
Concentrate on making your child comfortable, not on getting rid of the fever.
As I said, fevers are one way our bodies fight infection. If your child is a shivery, miserable mess and refusing to drink you should absolutely give medication to make them feel better (and hopefully get them to drink, as children with fevers can get dehydrated if they don’t). But if your child is acting okay, leave the fever be. You don’t always have to use medication, either. A lukewarm bath or sponge bath (not a cool one — shivering brings fevers up) can help, as can a cool cloth on the head. Keep clothes and bedding lightweight. Distraction, rest and TLC can help too.
There are some situations that always warrant a call to the doctor.
While most fevers can be managed at home without medical help, in certain situations it’s important that you call us. They include:
- Any fever in a baby less than 3 months old
- Any fever in a child who has an illness, or is taking a medication, that makes it harder to fight infection (your doctor will likely have alerted you to this, but if you aren’t sure, ask)
- Any fever with a rash that is dark red or purple and doesn’t get paler when you press on it
- Fever accompanied by severe pain anywhere
- Fever accompanied by a stiff neck
- Unusual sleepiness in a child with fever
- A high fever (102 or higher) that lasts more than a day or so — we may not do anything, but we’d want to ask some questions
- Any fever (including a low fever) that lasts for more than three or four days
- A fever that was getting better that suddenly gets worse
- Any trouble breathing, a seizure, severe vomiting or diarrhea or other symptoms that worry you, no matter what the fever
These don’t happen often, though. Most of the time, kids do just fine. So take a deep breath, keep a close eye on your child, call if you have questions — and don’t worry.
About the blogger: Dr. Claire McCarthy is a primary care pediatrician at Boston Children’s Hospital, an assistant professor of pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications and an official spokesperson for the American Academy of Pediatrics.