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Quick reference medical handouts used by Pediatric offices


Child Feverish? Keep your cool


Even in an age of medical sophistication, there still exists fear and misunderstanding about fever in children. "Fever phobia" makes it difficult for parents to know when to be worried and when to stay calm when the thermometer starts to climb. Take the following true/false quiz; knowing the facts will help take the worry about caring for a feverish child.

Any temperature over 98.6 degrees is a fever.

FALSE. Most doctors feel that a temperature is not considered a fever until it is at least 100.4 degrees F. taken twice, thirty minutes apart, and the child is unbundled, quiet, and in a normally cooled room. Many body variables determine a child’s "normal" temperature. For example, temperatures up to 101 degrees F can be caused by exercise, excessive clothing, a hot bath, or hot weather. Warm foods or drinks can also raise an oral temperature. In addition, a child’s temperature may vary depending on the time of day it is taken (higher at night) and the age of the child (younger children generally have somewhat higher temperatures than school-age children.) A young child's thermostat is far more sensitive than an adult’s; consequently a 1040F temperature in a 9 month old is equivalent to about 1010F in an adult.

Placing a hand on a child’s forehead is an accurate way to read a fever.

FALSE. Studies have shown that most parents could tell if their child did not have a fever by touch, but could not tell how high body temperature was if their child did have a fever. Fever makes the child’s face hot and a 101 degree temperature might feel the same as a 103 degree F temperature.

High fever can cause brain damage.

FALSE. There have been numerous scientific studies done to show that fever is not harmful at levels seen with most infections. Temperatures reaching 104 degrees F are commonly found in athletes during strenuous exercise. Therefore, it is not true that fever causes brain or any other organ damage. Certain infections, such as meningitis and encephalitis, may damage the brain, but it is the infection and not the fever that caused the problem.

Fevers can trigger seizures

TRUE Actually it is not the height of the fever that causes febrile convulsions but how fast it goes up or down. Only 20% of youngsters are susceptible to this type of seizure which occurs more frequently if there is a family history of seizures with fever. They are unusual after the age of three years.

Any fever in a child under two months is important

TRUE. Because of their immature immune system, a young infant will not handle infections well and may not show any other signs of a serious illness other than the fever. Therefore, when a little one has a temperature over 100 degrees, the youngster’s physician will want to know what other symptoms are present (poor feeding, vomiting, pale color, lethargy, etc.) and may want to examine the infant to determine the source of the fever.

All fevers should be treated

FALSE. Remember, fever is not an illness but a symptom and almost never harms a child. The only reason to lower a youngster’s temperature is to make the child more comfortable or avoid a febrile seizure (in the seizure prone child). New research has shown that fever may actually be beneficial. Elevated body temperature increases metabolism and produces infection fighting cells. Viruses have been seen to explode under a microscope in 104 degree F heat. Some antibiotics work better in the presence of a fever. Therefore, lowering body temperature may prolong the illness!The best advice when dealing with fever is to "treat the child, not the thermometer."

The higher the temperature, the more serious the illness.

FALSE. The numbers on the thermometer do not indicate the severity of the disease. A youngster could have walking pneumonia or an ear infection with no temperature and meningitis with 101 degrees F. On the other hand, pediatricians see children many times a day with fevers over 104 degrees F caused by a viral infection that will run its course without treatment. The general condition of the child is the main determining factor between a "very sick" and a "somewhat ill" youngster, not the youngster’s temperature.

A child's behavior is a better indicator of sickness than temperature.

TRUE Probably the best indicator of a child’s illness is their level of activity and behavior. A youngster whose temperature is 104 degrees F but seems active and normal is probably healthier than a child who is listless, refuses food or drink, and has a body temperature of 101 degrees F. Fever is one sign of illness but it is certainly not the only or the best one.

Teething causes fever.

FALSE Sorry grandma, but there is very little scientific evidence to prove that teething causes a fever. Although some physicians feel that the baby’s inflamed gums can cause a low grade fever, the temperature is probably caused by a mild viral infection modified by maternal antibody’s passed on to the baby during the pregnancy.

An alcohol rub is a safe way to reduce a fever

FALSE The alcohol rub is now considered dangerous since alcohol can be absorbed through the skin and cause intoxication. The best ways to lower temperature include:

* Pushing fluids. Babies should continue drinking breast milk or formula; older children can have water, juice, Jell-O, ice cubes, Popsicles, or flat 7UP.

* Keeping them cool by removing heavy clothing and blankets and by turning on a fan.

* Giving medication to lover fever such as ibuprofen or acetaminophen.

* Trying a sponge bath that contains an inch or two of lukewarm water.

One medication to avoid is in lowering body temperature is aspirin (including children's aspirin), which has been linked with Reye's syndrome in children and

teens. This serious viral illness develops as flulike symptoms and can cause brain damage and, in some cases, death.

A child with a fever should not receive a routine immunization.

FALSE Immunizations are only contraindicated when the illness causing the fever is severe. A mild illness (such as an ear infection) is not a reason to withhold a vaccine, even if the child has a fever.

It is difficult to eliminate all the myths regarding fever. Nevertheless, it is important for parents to realize that they should not panic when their youngster develops a temperature. The only time to worry about fever is if the child is less than two months old.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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