Fevers are common in children who are fighting a virus or bacteria. Although most fevers are caused by viral infections from which children quickly heal on their own, misinformation about fever abounds and causes parents a lot of worry. Let us put fever into perspective so we can ease your mind the next time your kid gets sick.**

If my kid has a fever when should I be worried?

When your child’s temperature begins to climb, it is a sign that their body is responding appropriately to an infection. If the infection is viral (and remember that most are), the best you can do is to provide supportive care while your little one’s body fights the infection and creates immunologic memory. With this memory, the next time they are faced with the same virus, the immune system will know how to fight it and there won’t be any symptoms.

It’s a common myth that a fever requires action to bring the temperature down, but this isn’t necessarily true. If the fever is accompanied by a runny nose or nasal congestion, cough and sore throat, or diarrhea, the infection is likely viral and will pass on its own. Most children with viral illnesses are subdued but still make eye contact, drink fluids well and are intermittently playful and interactive, and sometimes even feisty. It’s when they are obviously uncomfortable, can’t stay asleep, and/or are too subdued to be interested in staying hydrated that we recommend the use of a fever reducer, typically ibuprofen (Advil) over acetaminophen (Tylenol). Treat misery, not the number on the thermometer.

However, if your little one has trouble breathing, a fast respiratory rate, a frequent cough, is out of it or confused, won’t move or doesn’t want to be touched, has burning when urinating, hasn’t urinated in more than 8 hours, or is in pain and won’t stop crying despite ibuprofen, the infection may be bacterial and it’s time to reach out to us.

What body temperature would mean a trip to the ER?

The human body will not create a temperature high enough to cause physical damage to itself. We’ve frequently seen children with temps as high as 104-105 F who still make eye contact and interact well. Furthermore, there is no threshold temperature above which a child must be taken to the hospital (though at 106 F we would tell a family to go – that said, we’ve never seen a temperature climb that high). However, fever with severe sleepiness, no interest in drinking (many children with fever aren’t interested in solid food and that’s OK), frequent vomiting, or misery despite fever/pain-reducer should instigate a call so we may decide on a course of action together.

One fact to keep in mind is our circadian rhythm. The human body temperature changes throughout the day based on our ancient biological clock. In the morning, our temperatures are naturally lower. In the peak of the afternoon (around 3:00-4:00 pm) our temperatures are at their highest, so expect the highest fevers during an illness to be in the late afternoon and evening.

What is supportive care?

There are many ways to support the body’s defenses and relieve pain so that your child gets through the fever (and the infection causing it) and is stronger on the other side.

If you need to treat misery, we recommend ibuprofen over acetaminophen (see our prior post about the dangers of acetaminophen).  If there is only fever and no other symptoms, and he/she remains playful, alert and comfortable, then there is no need for a fever-reducer. Often the first sign of a virus is the fever and cold symptoms will develop later.

At the start of any illness, as soon as you notice symptoms, we recommend these in order to support the immune system and shorten the sickness (available for convenience at GetzWell’s 2 San Francisco locations):

  • Boiron Oscillococcinum relieves runny nose, fever, and cough.
  • Boiron Cold Calm relieves minor sore throat, sneezing and nasal congestion.
  • Double or triple the dose of vitamin D3 for a few days (if you don’t already take vitamin D, talk to your doctor for dosing advice).
  • Bone broth. There really is a connection with grandma’s chicken soup and getting better. Bone broth helps thin mucus. It also bolsters immunity and gut health.
  • Start taking or increase your dose of probiotics. Good gut flora keep us healthy. (Powder and capsule options are great for kids and both of GetzWell’s office carry trusted brands. Stock up now and keep them in your fridge.)
  • Check out our prior post on non-pharma ways of keeping your family healthy.

**Please keep in mind, all the advice in this article is geared towards children over six months who have been vaccinated. If your child experiences any symptoms you’re concerned about, trust your intuition and call one of us (we’re available 24/7 to GetzWell members!) or take them to an urgent care or ER that specializes in pediatric care.