The most important thing is to stay calm. This isn’t easy to do, but it’s absolutely essential in order to evaluate the situation accurately and take appropriate action. Remember that a fever is not a disease in itself, but a sign that the body’s regulation of temperature has temporarily changed. A child’s fever is most commonly a response to infection, and it is now known to serve a useful purpose by stimulating activity of white blood cells and other functions of the immune system.
The actual height of the temperature is important, but equally significant are the age of your child and what else is going on. Before calling the doctor, determine if there are other symptoms such as coughing, runny nose, sore throat, rash or (in children who are old enough to communicate) pain in some location.
Even more important is the way your child is acting. This can help you decide how urgent the problem is. A normal child will usually become somewhat irritable, less active, more clingy and less hungry when they have a fever. In a typical acute illness, such as a cold, your child may act like her old self again when the fever subsides. With more serious infections, however, changes in behavior tend to be more profound. If you are uncomfortable with what you’re seeing-for example, a noticeable lack of responsiveness-get medical help right away. You should also take immediate action if a baby under three months of age has a rectal temperature over 100.4 degrees Fahrenheit.
Illnesses involving bacteria will respond to specific antibiotic treatment, but most acute illnesses that produce a fever in infants and children are caused by viruses and will disappear on their own. If the fever persists for more than twenty-four hours, a call to your child’s physician and possibly an evaluation may help determine the problem. In the meantime, here are some things you can do that may be helpful.
- Dress your infant or child in light clothing and keep the room at a comfortable temperature. If he or she is shivering, provide a light blanket for comfort. (Remember, though, that shivering is a process that will raise the body temperature.)
- Give your child fluids of all kinds, since some body fluids will be lost as a result of sweating. Appetite is typically reduced when a fever is present. Large or fatty meals should be avoided, since fever tends to slow movement of food through the digestive tract.
- Your child does not need to be strictly confined to bed, but activities should be kept on the quiet side since vigorous exertion might increase the temperature. If the illness is potentially contagious (and most viruses are), your child should be kept isolated as much as possible.
- Sponge bathing an infant or child to bring down a fever is not necessary, except in unusual situations (such as heatstroke) where temperatures exceed 106 degrees Fahrenheit. Sponging may help the child feel more comfortable, especially if the fever is higher than 104 degrees Fahrenheit. It’s helpful to give a dose of acetaminophen or ibuprofen at least thirty minutes before doing so to lower the set point of your child’s thermostat. Otherwise, she will simply shiver her way back to her original temperature. To administer the sponge bath, set the child in an inch or two of lukewarm water and use a sponge or washcloth to keep body surfaces wet for thirty to forty-five minutes. You do not have to bring the temperature down to normal-lowering it a couple of degrees will help the child feel better. Do not use cold water, which will make her shiver, and do not use rubbing alcohol, which can be dangerous when absorbed through the skin or inhaled.
Note: Febrile convulsions-seizures precipitated by fever-occur in 2 to 5 percent of children sometime between four months and five years of age. These seizures often begin early in an acute illness, usually during the rapid upswing of a fever (which doctors refer to as a spike). In fact, an infant or child whom you find hot and cranky with a 104 degree F temperature is not likely to have a seizure in the immediate future because, with rare exceptions, she has already arrived at the high temperature without incident.
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