Fever In Children: 5 Facts You Need To Know

Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children can even have seizures due to a quick spike in body temperature. So it isn’t surprising that beginning as early as the newborn consultation, parents ask questions about what to do when their child gets a fever. Parents are also told sometimes to take medicine “in case” there’s a fever like with vaccines. This is not the best idea.

Concern about childhood fevers is long-standing in our history. Fever superstitions and ancient fever remedies are ribboned throughout all cultures. For example, Romans would trim the fingernails of those affected with fever. Using wax to attach the fingernail clippings to a neighbor’s front door was thought to transmit the fever to that household. (Sidenote; maybe avoid having Romans as neighbors.) And, even today, I will occasionally see children whose elders have used a method called cupping to literally suck the fever out of them.

So, here are five fabulous facts about fever. Some of these may be the exact opposite of what our mothers have said about fever. However, the goal of this blog is not to discredit grandma, but to decrease fever phobia and treat fever correctly. And with the right information, maybe the next time our pink-cheeked kiddos come to us with warm foreheads, we might not be so eager to jump to our medicine cabinets.

Please note: The following facts are NOT true for infants under the age of 3 months. Please talk to your pediatrician about newborns with fever.

1. There is no “number” on a thermometer that requires a trip to the Emergency Department 

Nope, not even 40°C (104F) degrees. With very specific exceptions, kids do not have to maintain a “normal” temperature during times of illness. Fever is a normal, healthy way for the body to fight common infections. Bacteria and viruses that attack our bodies love normal body temperature but cannot successfully replicate in hotter conditions. Fever, therefore, reflects a robust immune system’s defense against these pathogenic attackers. The bacteria and viruses are the enemies, not the fever they cause. Fever also helps the immune system work better which is why we see it with vaccines, and it’s a good sign that protection is on the way. 

So remember: fever is a symptom of illness, not a disease. Seeing a high number on the thermometer means your child’s body is doing its job to fight an infection.

2. The severity of fever does not always correspond with the severity of illness

So, what does that mean? A fever is generally defined as over 38°C (100F) degrees. However, with few exceptions, the degree “number” over 38°C really doesn’t matter. In fact, a fever of 38.5°C does not make more difference to me than a fever of 39.5°C. I have kids running and playing in my office with high fevers. I have other children who look sluggish and sad with a reasonably mild fever. Every kiddo reacts to a fever differently. So regardless of the actual numerical value, look for signs of serious illness in your child. 

Observe his/her level of discomfort, level of activity, breathing and ability to maintain adequate hydration. If you are concerned, call your pediatrician to discuss the next steps. A child who is up and down is a good sign, so when fever is down after medicine and child is almost normal, this tells us the infection is likely a mild one, perhaps a virus. More severe illnesses are seen when children don’t “bounce back” when the fever is less.

3. Fevers do not have to be treated with medication

Yes its true! Fevers help the body fight infection. Treating a fever is only necessary when you think your child is uncomfortable and suffering. The goal of administering antipyretic (anti-fever) medications is not to get a high temperature back to “normal.” They are simply medications to make your child feel better. The temperature is rarely “normal” as remember, the body is fighting the infection so when you lower it, its puts it up again. It’s trying to help after all. But if your child was suffering that period of improvement is a good time to get fluids and some food into them. Fevers can make kids feel pretty lousy. Children can have altered sleep, unusual behavior, and poor oral intake. If these symptoms are upsetting to your child, please give a fever-reducing medication. Treating the fever does provide comfort and may decrease the risk of dehydration.

Furthermore, if you are heading to the pediatrician’s office or Emergency Room because your child has a fever, and he/she is uncomfortable, please give your child a fever-reducing medication prior going there. You do not have to wait until the doctor “sees them with a fever.” A comfortable child is much easier to examine. And a good exam will often determine the cause of the fever, allowing for accurate treatment. It is actually really helpful for a doctor to see a child when the fever is down as if they are normal, you might be embarrassed (but don’t be), and we are reassured things seem ok which is what we both want.

4. Half of you are dosing fever medications incorrectly

As many as half of all parents do not administer the correct dose of fever-reducing medication to their child. This includes both under-dosing and over-dosing. Medications should be dosed according to your child’s weight, not age. Always use the measuring device that comes with the medication. If you lose the dosing device, use only a standard measuring instrument (syringe, medicine cup) as a replacement. Household spoons and measuring spoons are not always accurate. 

I often hear parents deliberately under-dosing their child. They say, “I didn’t really want to give him medication, so I just gave him a half-dose.” A “half-dose” will do nothing. Don’t bother

If you feel that your child needs medication, give the correct dose. If you have questions about your child’s dosage or the proper measuring device to use, call your pediatrician.

5. Fever does not cause brain damage

In a person with a normal functioning brain and the ability to cool oneself, fever is a normal response to infection. It will never go too high as it is the body way of trying to help. Every normal brain has an internal “thermostat” that will prevent a person’s temperature from getting high enough to cause brain damage. 

It is only when hyperthermia, or heat stroke, occurs when damage to the brain and other organs will occur. Hyperthermia happens in the rare instances when an individual’s brain cannot regulate temperature well (as in a rare case of brain injury) or when an individual is not able to cool oneself (as in a closed car on a summer day.) Fever due to illness in a normal child will not cause organ damage.

Febrile fits are also something parents worry about. However, almost never lead to any long-term problems and they don’t mean your child has epilepsy. They are a reason why sometimes parents give medicine early but in fact they are very hard to prevent with medication. They normally occur early on in the infection and are triggered by a change in temperature as it rises. This means they often surprise parents, so please don’t ever think you did something wrong or could have prevented it. Of course, if it happens always see a doctor promptly.

I hope the above help to empower you to manage fever better. If you are ever worried, seek advice, of course, but perhaps following these rules will help in managing your worry before calling your doctor.

Need to see a pediatrician? Reach out to Dr. Dave here if you want to book a consultation or call 800 1999