Category: Fever
Posted by Dr. Molly OShea on Sun, Dec 7, 2008 at 10:32 PMFever gets a bad rap; here's when to worry
It's 2 a.m. Saturday night and my cell phone at my bedside rings. "Hi Dr. Molly, I am so sorry to wake you up but Joe's burning up! He has a fever of 104 and we are loading him in the car to take him to the ER!"
I get this sort of call all the time. As freaked out as you might get, fever is not dangerous! Fever is a good thing because it helps fight the infection that is causing it. You have to get to a temperature above 108 degrees before you need to worry about brain damage.
"But what about a seizure, Doc? Won't he have a seizure if his fever is this high?" That's usually the next question I hear and I reassure parents that if their child was able to get to 104 degrees without a seizure chances are he will never have one. Only about 4 percent of children ever have a febrile seizure. I know it's cold comfort but even if a child has a febrile seizure, that doesn't cause brain damage (although talk about freaking out - you'd be made of stone if you didn't if your child has a seizure).
"OK, but should I put him in a tepid bath?" Nope. It may lower his fever temporarily but it won't solve the problem. Plus he will cry his head off because he feels so crappy at 2 a.m. and you are putting him in a cold bathtub!
"If you say so, but should I alternate Motrin and Tylenol every two hours to keep his fever down?" Nope, this could actually be dangerous. If you are going to alternate between both fever reducers during the same illness, be sure to leave at least four hours between doses. The point of the medicine is to make Joe comfortable, not to bring his temperature down to normal. Medicine will only lower it by a degree or two. Remember though that fever is a good thing because it helps fight the infection that is causing it. Most bacteria and viruses can't replicate as well in a hot environment so as long as Joe can sleep, you don't have to wake him to give him fever-reducing medicine.
"But if I don't give him medicine won't his fever just get higher and higher?" Nope. The temperature will level off at some point well below the danger zone of 107 or 108 degrees.
Of course I have asked important questions about other symptoms, making sure Joe isn't otherwise needing immediate attention at the ER. If fever is the only worry sign and the child is over 3 months old, I won't be sending him in. I don't really care what the measured temperature is. It could be 100.4 or 104. If the child is acting OK, I won't be worried. On the other hand, regardless of the degree of fever, if a child is lethargic or so irritable you can't calm him down, you should make that trip into the ER for sure.
Comments
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Favorite link
Here is a great resource of all the Pediatricians in Detroit to add to the links you have:
http://click2connect.com/location/detroit-mi/pediatrics
I looked at the site and it does contain good information on the pediatricians listed but is hardly comprehensive. My practice wasn't even found in the search and two others in my zip code were missing as well.
Dr. Molly
tics
My daughter has a tic - do they ever go away? She has had it for a couple of years. some days are worse than others.
If you daughter has had a tic nearly every day for that long, it is not likely it will go away and stay away. Assuming her tic is mild and not disruptive, I wouldn't bother seeking a neurologist's opinion about medication to diminish it.
Every kid has their quirks, some kid's have a tic, others have a goofy laugh, while others twirl their hair. My point is that tics are no more serious than any of these other quirks as long as they are not disruptive to life and your child is otherwise healthy.
Hope this helps!
Dr. Molly
fevers
I learned this same thing about fever years ago from a local herbalist, but no one believed me because I didn't hear it from a doctor. I've cut out your article and now have a bit of extra info to back up this point of view. I wonder, where else can I find articles on this view of fever? There are a lot of holistic articles addressing this but some people will only believe something if its written by a doctor.
Aromama I have several Web-based resources that are from children's hospitals or very reliable medical sources:
Rady Children's Hospital San Diego
Texas Children's Hospital
Mott Children's Hospital, University of Michigan
I hope this helps!
Dr. Molly
108 Fever
Thanks for great article on fevers!
There should be a ban on thermometers... what's the point?
We didn't own one when we had a baby in our house.
I almost completely agree. The only time the actual temperature measurement matters to me is when a child is 3 months old or younger. When they are that little, the fever isn't dangerous but may be the only sign their little bodies can muster that indicates a serious infection is there. When babies are under 3 months old, I do recommend taking their temperatures when they seem off their game and if the reading you get under the arm or rectally is 100 or higher you should be calling your doctor right away, even if its the middle of the night.
When taking an under the arm temperature, there is no need to add a degree to the reading, just tell your doc what you got and how you took it.
Dr. Molly
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