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Nothing worries a parent more than the first time their child has a fever. It is important to recognize that a fever is not dangerous and it is the body’s normal response to help fight off infections from both viruses and bacteria. The major exception with fever is any infant under 3 months of age. In this age group, a physician should evaluate children with a fever, as this could be the only sign of a serious infection. It is common for young children to have fevers as high as 104 and most of the time this does not mean they have a serious illness. Temperatures over 105 F are also not unusual but may signify a more serious infection and talking with their child’s doctor’s office would be prudent.
Most of us are aware that the normal body temperature for a human is 98.6 F. What many do not realize is that our body temperature changes throughout the day. We are often cooler in the morning and our temperature is higher in the late afternoon and early evening. Eating, sleeping, exercise, clothing, hot weather, and hormonal changes such as occurs during a woman’s/teen’s menstrual cycle all cause changes in a person’s temperature. In general, a person’s temperature may vary from 96 to 99.5 when the temperature is taken by mouth. The most accurate means of taking a temperature is either by placing the thermometer under the tongue or rectally. These methods are less prone to user error. Ear thermometers in children over 6 months of age and temporal artery thermometers are also good measures but may give a false reading if the user is not doing it properly. The temperature that we typically define as being a fever in a child is 100 F when taken by the mouth or 100.4 F when taken rectally.
When to treat a fever with a medicine such as acetaminophen or ibuprofen is often confusing for parents. For low-grade temperatures, which we define as less than 102 F, you do not need to treat unless your child appears uncomfortable. If they are playful or sleeping with a fever it is best not to treat them at that time. For fevers above 102 F treating with medications may make them more comfortable.
Fevers from infections do not cause brain damage. The body’s temperature needs to be over 108 F before brain damage would occur, and this would only typically occur from environmental causes and not infection. Even if a child has a seizure due to a high fever they will not have any brain damage. Only about 4% of all children will ever have a febrile seizure and this usually only occurs one time.
When should a parent call their child’s physician for a fever? If the child is under 3 months of age. If the temperature is over 105. If their child is not responsive, has a bad headache, stiff neck, or having difficulty breathing, then they should be seen immediately. If a child is older than 3 months of age and still interacts with their parents, is consolable, and drinking fluids then it may be reasonable to give them up to 3 days for the fever to go away before seeking medical attention. Hopefully, by taking away some of the fears about fever parents will rest a little easier and have one less worry for their children.
Dr. Mark Schane is a board certified pediatrician at Longmont Clinic. He can be reached at 720-494-3133.
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