Fever by itself is not harmful or dangerous, and unless it is very high (over 41 C ), then it is unlikely to cause brain damage or other problems. Also remember that a child’s temperature can vary during the day, and can normally reach a high point of 37.7 C at about 6pm.
Fever is not a disease, instead, it is a symptom that can accompany many childhood illnesses, especially infections. In general, you should call your pediatrician if your infant under three months of age has a rectal temperature above38 C, if your infant aged 3-6 months has a temperature above38.33 C, or if an infant above 6 months has a temperature above 39.44 C.
For most older children, it is not so much the number, but rather how your child is acting that is concerning. If your older child is alert, active and playful, is not having difficulty breathing, and is eating and sleeping well, or if the temperature comes down quickly with home treatments (and he is feeling well), then you don’t necessarily need to call your doctor immediately.
However, it is important to keep in mind that a fever is not the only sign of a serious illness. While some children are fine with a temperature of 39 C, others can be deathly ill with a temperature of 38 C or even without a fever or a low temperature. Whether or not your child has a fever, if he is very irritable, confused, lethargic (doesn’t easily wake up), has difficulty breathing, has a rapid and weak pulse, is refusing to eat or drink, is still ill-appearing even after the fever is brought down , has a severe headache or other specific complaint (burning with urination, if he is limping, etc), or if he has a fever and it is persistent for more than 24 to 48 hours, then you should call your pediatrician or seek medical attention immediately.
Also, you should call your doctor if your child has a fever and another medical condition (heart disease, cancer, sickle cell, immune system problems, etc.).
When in doubt, call your doctor when your child has a fever, especially if you think that your child is ill appearing.
Treatment of a fever can include using an over-the-counter fever reducer, including products that contain acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). If you child has an infection, using a fever reducer will not help your child to get better any faster, but they will probably make him feel better. You should also give your child a lot of fluids when he has a fever, so that he does not get dehydrated. Keep in mind that treatment of a fever is usually to help your child feel better, so if he has a fever, but doesn’t feel bad, especially if the fever is low grade, then you do not need to treat the fever.
Is it safe to alternate acetaminophen and ibuprofen? If you are using the correct dosage of each medicine at the correct times, then it is probably safe in most children, although there is no research to prove that it helps or that it is safe. The problem is that it is easy to get confused and give an extra dose of one or the other medicines. And in some children, especially if they are dehydrated or have other medical problems, giving both medications can cause serious side effects, especially with the kidneys. If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines so that the correct medicine is always given at the correct time.
Do you have to treat a fever? Not necessarily. In most cases, fever is treated as a comfort measure. Treating a fever, especially if it is caused by an infection, will not help your child to get better any faster, but it may help make him feel better. If your child has a fever, especially if it is low grade, but does not feel bad, then you don’t really need to give him a fever reducer.
Should you really starve a fever? Yes, but only in the sense that you don’t need to push your child to eat if he doesn’t feel well and has a fever. Instead, try and get him to drink extra fluids. If he is hungry and feels like eating, you can continue with his regular diet.
Things to avoid when your child has a fever include:
- Ignoring any fever in an infant under three months of age.
- Giving your child a sponge bath with alcohol.
- Using cold or hot water when giving your child a sponge bath for a persistent fever. Use lukewarm water instead.
Most fevers are caused by infections, such as upper respiratory infections, ear infection, urinary tract infections, strep throat, and many types of viral illnesses, but there are other causes of fever that aren’t caused by infections. Some children with fever, especially if it is persistent, can have an inflammatory or immune system disorder, such as Juvenile Rheumatoid Arthritis, Kawasaki disease, etc. In many of these cases, treating the fever with an anti-inflammatory medicine actually treats the underlying illness and will make the fever go away.
