Parents tend to worry much
too much about fever.
Have no fear.... fever is your friend! It alerts you that something may be wrong so that you
can be more observant and better care for your child. It is also one of the most important
ways in which the body mobilizes it's own defenses to fight off disease. Fever accompanies
almost any type of illness, and usually helps you get better. Neither it's presence nor
its height indicates how serious the illness causing it may be or what course of
action should be taken. To determine these things, one must focus instead upon the
other symptoms. Fever itself does not hurt you directly in any way. Indeed,
controversy exists within the scientific/medical community over whether routine treatment
to bring down a fever is even appropriate at all.
Fever is uncomfortable.
child with a high fever will often seem irritable, lethargic, glassy eyed, listless, and
otherwise "not himself". The reason to treat fever is to relieve this
distress. Usually, once the fever comes down the child will seem happier, more alert,
and more active. This may be used as a "test": the child who's lethargy
or irritability does not improve with a reduction of his temperature is likely to have a
more serious underlying illness causing his fever and perhaps should be seen.
On the other
hand, there may be no reason to treat even a high fever if your child seems happy, active,
and alert. Again, do not let
fever be the overriding factor in you deciding how sick your child is.
The exception to the above
is the infant less than 3 months old. A newborn's physiologic response to illness is
immature, and unfortunately they do not always show the symptoms they are "supposed
to" for a particular illness (i.e. they could have a pneumonia with no cough,
meningitis with no stiff neck, etc.). Thus, fever in this age group (rectal temperature
above 100.4°F) may be the only sign of a serious illness. For that reason, ALL
infants less than 3 months with a fever should be examined.
A small percentage of children may be prone to convulsions with
fever, or what is known as "Simple Febrile Seizures". This tendency runs in
families, although a family history is not necessary for it to occur. The convulsions are
related more to how quickly the temperature rises than to how high it actually is. They
tend to occur between the ages of 6m and 6y - eventually being outgrown. They last less
than 5 minutes, (usually less than one minute) and are characterized by loss of
consciousness, stiffness, eyerolling, grunting noises, and shaking. They are followed by a
15-60 minute period of drowsiness. Simple febrile seizures are self limited and harmless -
although they are one of the most
frightening events a parent can witness. If this happens to you try to stay calm - make
sure the child is breathing, loosen the clothing, and protect him from harm such as falls
or bumps. This is not an emergency unless it fails to stop or breathing is impaired.
Patients having febrile seizures for the first time will need to be seen to be sure that
in fact that is what it was. Children experiencing repeat febrile seizures are seen only
as their other symptoms may indicate. Fever control measures may be somewhat more
important in children with a family history or known tendency towards this phenomenon.