Fever in children

Fever in children: What to know about your child’s temperature

Don’t get caught in the heat of the moment
June 22, 2017

Having a fever can be a real drag, but it’s normal: It’s the body’s way of fighting an infection. As a parent, a slight fever can cause instant panic, but a fever isn’t always something to worry about. An expert from the Texas A&M College of Nursing shares what you should know about your child’s fever.

What is significant

In very young babies, those younger than eight or 12 weeks old, a fever can be the only sign of something wrong, since their immune systems are underdeveloped. “We worry about fever of 100.4 degrees Fahrenheit or greater in very young babies,” said Katie Hepfer, DNP, PNP, clinical assistant professor at the Texas A&M College of Nursing. “They’re not vaccinated for major illnesses, and their immune systems aren’t as strong as one of an adult or older child.”

As a child’s immune system begins to learn to fight off common viruses and other pathogens, a fever may be less common. In children ages 5 years and older, a temperature of 104 F is the number where a fever is worrisome. At that point, call your health care provider and set up an appointment or go to an emergency department or urgent care clinic.

“An older child has a stronger immune system and can fight off pathogens that it has encountered previously,” Hepfer said. “A fever under 104 F means the illness can be self-limiting, and treating the symptoms and keeping the child hydrated could be enough to treat their condition.”

However, if that fever lasts over five days, then that can be problematic—especially if the fever is not responding to fever-reducing medication. Fever-reducing medications, such as acetaminophen or ibuprofen, are best used to treat mild-to-moderate fevers. If your child has a high fever, these medications are best given to children for fevers at or under 102 F.

“A fever is a sign that the body is fighting off something. It is a normal response to illness”, Hepfer said. “However, If the fever persists for five days or longer, your child should be seen by a health care provider to make sure something else isn’t going on.”

When to relax

Although a fever is a prominent sign of an underlying illness, sometimes it can be the only indication. If your toddler or older child’s only symptom is a fever, then there is less cause for concern.

“Children can act fine with a fever,” Hepfer said. “If they seem healthy and are eating and drinking fluids, and the only symptom they have is a fever, then it’s typically okay.”

A fever is typically defined as over 100.4 F, while a normal body temperature is 98.6 F. Everyone’s body temperature can vary throughout the day and can differ due to factors such as age and activity level—so don’t be alarmed if your child’s temperature is slightly above normal (under 100.4 F) and if that’s the only symptom they’re presenting, Hepfer said.

Also, if your child was recently immunized, a low-grade fever can be normal, if it lasts less than 48 hours. During this time, your child’s immune system is adjusting to the vaccine and becoming more equipped to fight the pathogen.

Talking to your health care provider

One of the most important symptoms indicating that your child should be checked by a health care provider is behavior changes. While a fever is a key indicator of a problem, it can lead to worsening complications when it causes changes in eating or drinking behavior.

“Sometimes a mild fever will be enough to keep a child from wanting to stay hydrated,” Hepfer said. “Then you may just be adding dehydration to whatever initial illness there may be.”

Also, when it comes to measuring your child’s fever, you want to aim for accuracy. Hepfer recommended that parents measure the temperature in babies under 3 months of age with a rectal, forehead or ear thermometer for the best accuracy. Older children can use an oral thermometer as long as they can tolerate it under their tongue without moving it or experiencing discomfort.

If your child starts to develop a fever, and you’re not sure whether to take them to their provider, trusting your instincts is key. If your child’s habits have changed or have you concerned, then calling or visiting your primary care provider is appropriate. When it comes to your child’s health, it’s best to err on the side of caution.

— Dominic Hernandez

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