By Margaret Hennessy, MD, Pediatrician, Wheaton Franciscan Medical Group – All Saints
As parents, we tend to know a lot about fevers and kids, but there is still a great deal that is oftentimes misunderstood. Let’s break down myths:
- Knowing what is a fever. Part of the confusion stems from understanding what a fever is. The majority of clinicians use the cutoff temperature of 100.5 degrees Fahrenheit. Children with body temperatures exceeding that have a fever that you’ll want to pay attention to.
- Gauging a fever. How to check for a body temperature also makes a difference. The optimal way to check the temperature from a child is rectally. No other way is quite as accurate. But keep in mind, the only time this really matters is in the youngest of infants (under the age of 2 months). At that age, it is very important to know exactly how warm the baby is, so I would recommend only checking their body temperatures rectally.
Many people will try to take a temperature in the ear or under the arm or even across the forehead. For older infants and children these alternative methods are ok. No need to add a degree. The real temperature difference from your ear to your bottom is not even a whole degree. Also, 99 degrees is not a fever even if your normal temperature “runs low." Your body temperature will naturally vary between 97 to 99 degrees throughout the day.
- How hot is too hot? So, when do you have to worry about the fever? You may be surprised to learn that fever is actually good. Fevers help fight an infection. However, it does indicate that you are sick and is a nice marker to follow during the course of an illness. Fevers may slow you down and make you feel achy, but it is actually good to have a fever.
Realistically, a fever that is going to hurt an adult has to go above 107 degrees. Your body is too smart to let your fever go that high with most infections. For young children with viral infections, we often see fevers as high as 104 and that is ok. That fever is helping the child’s body destroy the virus.
What matters more is how long does the fever persists. A fever that last for 1 to 3 days usually indicates a viral infection. After 3 days of fever, we may want to check for a bacterial infection that we may be able to treat.
- Do you ever have to treat a fever? The real reason to provide something for fever is not to stop the fever itself, but to make the child (or adult) comfortable. Fevers make your body ache and you do not feel well. We provide medications such ibuprofen or acetaminophen to make the child feel better. I do not recommend alternating the two during an illness, even in children with febrile seizures. There is the risk of overdosing acetaminophen, and this can be deadly. You may be surprised to learn that after taking a dose of anti-fever medications, your body temperature does not always change much. And that is ok. The purpose of the medication is comfort, not to get rid of the fever. Also, ibuprofen should not be used with children until after age 6 months.
- Preventing fevers. Should you try to prevent fever before vaccines with acetaminophen or ibuprofen? The answer here is a little tricky. Giving these medications to a child before getting a vaccination may not do much to prevent fevers. In addition, there is also some research that suggests that by blocking the fever, you may be blocking the full immune response to the vaccine. We no longer recommend that you automatically “pretreat” before vaccines. After the vaccination, if your child is in pain, you certainly can provide them some pain relief.
- If you treat fever, what dose do you give? This answer is best left up to your own primary health care provider. Different types of pain relievers come in varied dose forms and the whole thing is becoming a little tricky. So, talk to your health care provider or pharmacist. They should be able to provide you with a dosing table for your medication.
Find more information about treating fevers in the Health Library on the Wheaton Franciscan Healthcare website.