One of the most common complaints today that we see in our office, is fever. Any type of pediatric fever is a cause for parents to get very concerned, because it is usually a sign that there is something wrong with their child, whether it’s a viral illness or a bacterial illness. It always tends to be scary, especially with your first baby, and it’s definitely one of the most common things that we see here in our office.
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What is the definition of a fever?
A fever, medically speaking, is a temperature of 100.4 degrees or greater.
How do I take a temperature?
There are different ways of taking temperatures. You can take a temperature rectally, which is one of the methods that we recommend most for babies under two months old, and a lot of times for any baby that is less than six months old, because it is the most accurate temperature reading that we can see in a child.
The next form, which is one of the easiest, is to take a tympanic temperature. That’s your typical thermometer, which does give a pretty accurate result as long as you use it correctly. If you do not know how to use your thermometer, please bring it to the office. We’ll be more than happy to show you how to use it.
The other form is orally. Of course, the problem with orally is it has to be under the child’s tongue and has to be there for a few moments, so sometimes that can be a problem.
Another form which we don’t recommend very much is the axillary temperature. The thing about is that they can be off by one degree, and sometimes it’s accurate; sometimes it’s not. So this is where you find people saying to add a degree, which we typically don’t recommend. What I usually tell people is if you have an axillary temperature of over 99.5, you may want to go ahead and do a rectal temperature or an ear temperature just to verify it.
There are those new devices that can measure temperature on your forehead, which are called temporal thermometers. However, these tend to be a little inaccurate, depending on the technique that you use. So I typically say it’s best to use the ear thermometer for bigger children that are under age five but are over four to six months.
When should I be concerned about a fever?
The most important thing in determining how much to be concerned and whether your child should be taken to the emergency room is how the child looks. You can have a child with a 101 temperature who is very sick. They can be lethargic, throwing up, and/or dehydrated. I would be more concerned about a child with a 101 fever than the child with the 104 fever who is running around the office and having a good time, which we honestly do see sometimes.
So it’s not so much the height of the fever, but what the child looks like as well. If the child is drinking well and if they’re somewhat active, then we say it’s all right to treat them at home and they don’t need to go to the emergency room. But when in doubt, with any fever over 104, we will likely tell you to go ahead and take your child to the emergency room, and the fever doesn’t necessarily vary by age. However, for any child under two months of age, those children with any temperature must go to the ER immediately.
What are Febrile Seizures?
Many parents believe that if their child has a high fever, they’re going to have a seizure. But febrile seizures really only occur in a small percentage of the population, less than 10 percent, and your child would be prone to the seizure regardless of the height of the fever, whether it’s a 101 or a 104. If your child is already prone to having febrile seizures, they will have a seizure. However, we still want to keep all children with fever comfortable, whether they have a risk of febrile seizures or not.
Fevers and Medication
To keep your child with a fever comfortable, you do want to use ibuprofen and acetaminophen, and our office can provide you with the doses. You can always call our nurses station, or we can actually give you a handout when you’re in the office. So please feel free to ask for those, and they go all the way up to age 12. For any question that you may have regarding your child’s fever, please feel free to contact our office.