Misconceptions about the dangers of childhood fever are very common. Many San Francisco parents lose sleep and experience unnecessary stress due to unwarranted concerns about the harmful side effects of fever in their children.
Fevers are part of the body’s effort to activate the immune system, so they are one of our innate protective mechanisms. Most fevers are good for children because fevers help them to fight infection.
When to Worry About Your Child’s Fever
The body’s temperature normally fluctuates throughout the day and peaks in the late afternoon and evening. For instance, an oral or axillary (under the arm) temperature can be 97.6° F (36.5° C) in the morning and go to a high of 99.5° F (37.5° C) in the evening. Similarly, a rectal temperature can be as low as 98.4° F (36.9° C) in the morning and become as high as 100.3° F (38° C) in the late afternoon.
If your child has a fever, remember to stay calm and use the following definitions to put your child’s fever into perspective (for children under 6 months old, you should immediately call your doctor):
- 100-102 F (37.8-38.9 C): Low-grade fevers are beneficial (Try to keep temps here*).
- 102-104 F (38.9-40.0 C): Moderate-grade fevers are beneficial*.
- > 104 F (>40.0 C): High fevers cause discomfort but are harmless.
- > 105 F (>40.6 C): Higher risk of bacterial infection.
- > 108 F (>42.2 C): The fever itself can be harmful.
* Unless your child is less than 6 months of age, then you should call your doctor immediately.
Childhood Fever Myths
Many people mistakenly believe that fevers cause brain damage and that temperatures above 104° F (>40° C) are dangerous. However, fevers caused by infection do not produce brain damage. Only body temperatures over 108° F (42.2° C) can cause brain damage, and body temperature only climbs to this level with very high environmental temperatures. For example, being inside a closed car on a hot day.
Fevers only need to be treated if they cause discomfort, and these are usually fevers over 102 or 103° F (38.9 or 39.5° C). The exact number of your child’s temperature or fever is not as important as how your child looks and feels. You should answer these questions to determine if you should seek a pediatrician’s care:
- Is your child alert, interactive, and curious despite the fever?
- Is he or she drinking and urinating?
- Is she or he complaining of pain or very uncomfortable?
If your child acts normally without any pain or discomfort and is drinking and urinating, then the fever will not require a trip to the pediatrician.
When Will Your Child’s Fever to Go Down
If you treat a fever, temperatures don’t always normalize. Treatments that can help your child feel a little better and often drop his or her temperature by 2 or 3 degrees Fahrenheit (1-1.5° C) are:
- Removing her or his clothing.
- Bathing him or her in cool water.
- Giving her or him ibuprofen to reduce the fever.
If these treatments do not help the fever “break”, this isn’t cause for alarm. Fevers that don’t respond to fever medicine (usually Advil/ibuprofen or Tylenol/acetaminophen, though we DON’T recommend Tylenol: why not?) can be caused by viruses or bacteria. There are no known medicines that kill viruses.
What To Do When Treatment Doesn’t Work
Fevers will not continue to climb higher and higher if not treated. Fevers from infection usually stop rising at about 105-106° F (40.6 or 41.1° C) or lower, because the brain’s thermostat keeps body temperatures lower than this.
Not every child with a fever is at risk for a febrile seizure. Only about 4% of all children will ever have a febrile seizure. If your child has a febrile seizure, though it is scary to watch, they cause no permanent harm and usually last less than 5 minutes. Children who experience febrile seizures have no increased risk of developmental delay, learning disability, or epilepsy.
To get more information about Getzwell Pediatrics, call one of our San Francisco offices at 415.826.1701.