Is fever dangerous? — Will something terrible happen if you don't do something right away? Because fever is so common and will happen to your child, we want you to know some facts. First, humans have a range of normal body temperature (98° to 100.3° F), and most children tolerate elevated temperatures up to 102° with minimal discomfort. As the temperature goes higher, they will feel and look worse. The discomfort and strange behavior-stillness, glassy eyes, flushed face, talking about things we do not see or hear-is temporary and will go away when the fever does. Fever is a symptom, not a disease. Fever is harmless, no matter how high; however, high fever is scary for parents.

What causes fever? — About 95% of the time, the answer is infection, which is the invasion of they body by a germ, virus or bacterium. Once such an invasion occurs, the body's immune system recognizes and begins to fight against the infection. Certain white blood cells release a chemical messenger that goes to the body's thermostat, located in the base of our brain, telling it to raise the temperature.

Why does this happen? — The body reacts this way because it is more efficient in fighting off infection when the temperature is higher than usual. Unfortunately, this reaction is not finely tuned, and the body thermostat may operate wildly. Except during the first 6 weeks of life, a fever does not indicate how serious an infection is, even if the fever is high. Certain minor viral infections can cause fevers of 106° and above, with no risk of bodily harm, while some serious bacterial infections may not raise the temperature even to 102°.

How can you tell if the infection is serious? — Look for other signs that may indicate a serious problem. Is there a rash? Is your child vomiting, or experiencing labored or painful breathing or coughing? Is there pain in a bone or a joint? Is your child behaving in a way that indicates a sore throat or earache? Does your child's urine look and/or smell unusual? Is he/she grouchy, want to be held, or is he/she withdrawn or nonresponsive, or so irritable that you cannot calm him or her down? Grouchiness is a good sign; the more alert and interactive, the greater likelihood that the illness is minor.

Does teething cause fever? — Teething is behavior-constant chewing, drooling, restlessness when put down for sleep, or runny poop-that does not necessarily predict when teeth will come through, only that the baby is aware of their growth. Teething does NOT cause fever-not by our definition.

Should you treat a fever? — Try to make your baby comfortable. Even at a temperature of 101°, the cause of the discomfort may be headache or muscle aches going with the infection that is causing the fever. Your child may not be able to tell you that. The answer will always be: Treat apparent discomfort. If the temperature is 104°, but your child is not acting sick in any way, the answer is no. Watch your child carefully-trust your own instincts.

How do you go about lowering a high temperature, if you suspect that the fever is the cause of your child's discomfort? — Medicines recommended for fever are acetominophen (Tylenol or other brands) and Ibuprophen (Motrin/Advil). Acetominophen is recommended for children under six months. A dosage chart will be provided at your child's two-month checkup. Dosage is determined by your child's weight.

When purchasing fever reducers, read carefully! Both acetominophen and ibuprophen are dispensed as concentrated infant drops and syrup. Check your chart for recommended dose. If you are uncertain about the dose selected, don't be afraid to ask for help!

Occasionally, some children vomit when high fever is present. For these children, and for those children whose temperatures do not respond to fever reducers, try sponge bathing for 15-20 minutes. Use water that is warm enough that your child does not shiver. (Never use rubbing alcohol.) Shivering will raise the setting of the body thermostat and make the fever to less than 102°, but by lowering the temperature to 102°, your child will be much more comfortable.

Congratulations...you made all the right decisions last night. Your child's temperature is now 100° instead of the alarming 105°. Your child is sleeping peacefully and you are no longer frightened. But it is 6:00 A.M., and the rest of the household is waking for new activities...and so begins another day.

I've heard about children having seizures or convulsions with fever. Should I worry about this? — Most parents have heard about fever seizures, but they occur in only 5% of children, those who have inherited this predisposition. If there is an older family member who has had fever seizures, there is a greater risk that your child will experience this. Although fever seizures do not kill or cause permanent injury, they are frightening experiences. If your child has a fever seizure, you should seek medical attention promptly.

When should I call my pediatrician? — If there is an obvious cause like a cold, there is probably no need. If the cause is not obvious within 1 or 2 days in a child not old enough to talk, if there are signs of a more serious infection, or your child seems suddenly worse, call your pediatrician. If late at night or on a weekend, call the office for the doctor on call. He or she will gladly advise you. If anything serious is suspected, you will be directed to the Emergency Room. However, the ER can be a scary experience for your child, and also a source of infection in itself. And since fever alone is not regarded as serious, the wait can be a long one. It is therefore preferable to have an evaluation done at our office. Pediatric Associates offers care seven days per week.