Fever
Self Breast & Testicular Exams
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FEVER Fever is a bitter-sweet bit of biology. Too many caring parents fear the slightest fever as a near-fatal experience while some experts say "fever is our friend". Fever is a state in which the body's temperature is elevated above normal. This is most often seen in association with infections [most often viral], but slight fever can be the result of excessive clothing, a hot bath and hot weather. Some unusual diseases, that are not infections, also cause significant fever. Teething probably does not cause fever. Fever is determined by use of some form of a thermometer although a feeling of feverishness by touching the forehead is right most of the time. When a child is hot to the touch, fever is present 75% of the time. A "normal temperature" varies with how the temperature is taken. Fever is defined as a temperature above:
Causes and usefulness of fever Most fever is caused by a complex set of reactions that affect a part of the brain called the hypothalamus. There are receptors in this area that are sensitive to various chemicals called interleukins, made by various, usually blood, cells in the body in response to infection with viruses or bacteria most often. The blood cells send chemical signals to the brain calling for help in fighting infection; "help us in this fight" by elevating the body's temperature. That fever enhances the immune system in its fight against infection including:
Bad effects of fever It is easy to see how fever can be helpful, but the same chemicals made by blood cells that cause fever are probably responsible for your child feeling bad during a fever. He/she may be listless and sleep a lot. This too has a purpose. The body doesn't want to waste energy playing while it is busy fighting an infection. Seizures are a feared complication of fever, but these are rare events and in a huge majority they are harmless though frightening to observe. Some feel that these rare brain reactions are caused by the chemicals that cause fever and not by fever itself in the child who is susceptible in someway to this complication of fever Only with fever of 107 degrees and higher is there a serious threat of permanent brain damage. How and when to treat fever Treatment of fever is dictated by how sick your child is with that fever. Fever of 102 or less should not be treated unless it makes the child feel better to do so. Remember that fever serves a useful purpose helping your child fight the infection. Treat all fevers with lots of fluids and by avoid over-wrapping/clothing and over heating the home. Popsicles and iced drinks are good. Shivering elevates body temperature so cover with a light blanket if this occurs. For fever greater than 102 treat only if your child seems sick. Use an antipyretic [acetaminophen, most commonly called Tylenol, and ibuprofen] first. Never use aspirin or aspirin-containing drugs. Acetaminophen is the drug of choice for fever and usually acts within 30-45 minutes and lasts 4-6 hrs. Ibuprofen seems to work better in some infections. It acts a little faster and for longer than acetaminophen, 6-8 hrs. See the dosage charts. Antipyretics First line acetaminophen Second line ibuprofen No aspirin Do not mix or alternate acetaminophen and ibuprofen unless ordered by your doctor to do so. This practice is fraught with dangers. Sponge for persistent fever of 104 or more with tepid water only after giving an antipyretic at least 30 minutes prior to sponging. If you sponge without having given an antipyretic shivering will ensue and further elevate the body temperature. Sit your child in a tub containing 2 inches of warm water. Wet the skin repeatedly. The evaporation cools. Never use alcohol. If a fever stays at or over 105 after an antipyretic at the proper dose and sponging call your child's doctor. ©2002 South Valley Pediatrics
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