Fever tidbits

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All about fevers.



Fevers turn on the body immune system. They are one of our protective mechanisms

Many fevers can actually help the body fight infection.

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Fevers that are associated with most viral syndromes and infections do NOT cause brain damage. Our brain's thermostat will not allow a fever to go over 105 or 106.

Only body temperatures higher than 108°F (42.2°C) can cause brain damage. Fevers only go this high with high environmental temperatures (e.g., confined to a closed car.)



There are many methods out there for measuring a fever. I don't feel the need to invest in any expensive thermometers. I am quite happy with a digital underarm reading. The important thing is that however you take it, your thermometer seems accurate. Test it on other family members and take your child's temp when they are healthy to make sure you trust it.

One of my favorite brands is Becton Dickinson. These are reasonably inexpensive on Amazon and have been reliable in my experience.

If you have one of the new ear or temporal scanning gadgets, feel free to keep using that. Sometimes their "high" readings seem a little higher than I believe. Don't let this freak you out.


If your infant is under 8 weeks of age we want to be notified of any fevers, however there are a few common causes..


*over bundling....

Seriously, some times the babies come in with 10 blankets wrapped around them.

Please don't do that. The best rule of thumb is giving them one layer more than you are wearing.

If your baby was indeed over bundled, get some of those layers off and re take the temp in about 10 minutes to see if they have cooled down.


*dehydration....

Sometimes if moms milk isn't in yet, babies can be simply dehydrated and need to get some fluids. This is the time that you need to squirt some milk or formula directly into your baby's mouth. You can use a syringe or a dropper.

More often than not the elevated temperature will normalize fairly quickly.


If there is no obvious cause for an elevated temperature, and it doesn't resolve within 30 minutes your baby needs to be evaluated. Giving a fever reducing medication to a newborn should only be done under strict guidance from your pediatrician.




For any child older than 2 months, as long as your child is active and happy, I generally don't feel the need to "treat" a fever unless it is over 101.5 or so.



Parent's often ask me, "When do we need to worry about a fever?"

I am always much more interested in your child's overall mood and behavior than I am in any specific number on a thermometer.

I am way more concerned about the lethargic, whimpering child who has a 99 temperature than I am the singing child with 104.

But, here is the Nurse Judy's rule about fevers:


If the fever is over 102 ( It doesn't matter how you measure, just be consistent)


*Treat with proper dose of Acetaminophen or Ibuprofen

*Do a tepid bath or place cool compresses on the forehead, insides of elbows and neck

*Get them drinking. Really, any type of fluid will work.

Little sips at a time are fine. Breast milk is always a great choice if you have it.
Popsicles and ice-chips are good for older kids

*re check the temp in 45-60 minutes



If it is STILL over 102 and hasn't budged at all, that is a fever that I am concerned about.
It is time to get your child seen.

When children are in the process of spiking a fever, it is not uncommon for them to tremble and look shaky.

On the other hand, one of the more frightening aspects of a fever can be a febrile seizure. About 4% of children will have these.

Febrile seizures are scary to watch, but they usually stop within 5 minutes. They cause no permanent harm.

If your child is having a seizure they may have large jerky motions and their eyes may roll back.

Your job is to stay calm. Make sure their airway is open. It is perfectly reasonable to call 911


Once your child has had even one febrile seizure we tend to be more aggressive with fever control and will treat even a low grade fever. It is important to talk with your doctor about this so that you have a plan in place that you are comfortable with.

Most kids grow out of the seizures by the time they are 5 years old.


As I mentioned before, a fever by itself doesn't alarm me.

If the fever is accompanied by a very fussy child, I want them seen so that we can figure out what is going on.

Most of the time, if a fever lasts for more than 3 days, I consider it time to have a look so that we can make sure there isn't an infection source ( like ear infection, urinary tract infection, strep throat or pneumonia)

This month we are seeing lots of flu. Many or our patients have fevers that are lasting 5 days.

Because there is so much of this going around I am relaxing my "3 day rule" If the kids seems like they are 'managing' ( drinking, peeing, easy breathing, consolable, fever responds to meds) I am okay watching them for another couple of days



Temp° conversions

98.6° F =37.0° C

99.5° F=37.5° C

100.0° F=37.8° C

100.4° F=38.0° C

101.0° F=38.4° C

102.0° F=38.9° C

103.0° F=39.5° C

104.0° F=40.0° C

105.0° F=40.6° C