Fever is a very common symptom during childhood. In addition to a child who doesn’t feel well, the fever can cause a great deal of worry for parents. A fever is generally defined as temperature at or above 100.5 degrees Fahrenheit (or 38.1 degrees Celsius). If you suspect a fever, we recommend taking your child’s temperature using a digital thermometer, either orally or axillary (under the arm). For very young infants a rectal temperature is most accurate. Below are some common myths regarding fever.
Myth #1: A fever is always dangerous.
A fever is the body’s way of turning on the immune system and increasing the number of active white blood cells that are circulating. This is how the body fights infections. The fever, then, is a protective mechanism. What indicates a serious illness is how the child is acting and feeling, not necessarily the height of the fever itself. The exception to this is that very young infants (less than 2 months old) are more at risk for serious bacterial infections because of their immature immune systems and since they have not yet received vaccinations. Fevers in this age group should always prompt an immediate call to the doctor. For the same reason, unimmunized children who have a fever are at higher risk for serious bacterial infections.
Myth #2: A fever can damage the brain.
The fever itself is not harmful to the brain. The body would need to reach temperatures greater than 107 to directly cause damage! This is extremely unusual without environmental causes. A small number of children experience febrile seizures. This is a specific condition that sometimes runs in families. Children outgrow these and they do not cause long term problems.
Myth #3: A fever should be treated until the temperature is back to normal.
Rather than treating the specific number, the decision to give a fever-reducing medication should be based on how the child looks and feels. If the child is not uncomfortable, it is fine to monitor without medication. Often the fever will come down on its own. If a child had a fever earlier but is sleeping comfortably, it is not necessary to wake them to give more medication. However, if the child is feeling uncomfortable then acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can be given. The appropriate dose is based on the child’s weight. Click on the “Medical Info” link at the top of this page and look under “Fever Information” for dosage charts regarding these medications.
Myth #4: If a fever comes back after medication is taken the cause must be serious.
It is normal for fever to return after the acetaminophen or ibuprofen has worn off. Since the body is still working to fight off the infection, this is expected to happen. A better indication of the seriousness of the illness is how the child is feeling. Any changes in behavior, severe symptoms, or fever that is lasting more than a few days should be further evaluated.
Myth #5: A fever indicates a bacterial infection.
Fever is a nonspecific response to infection or inflammation. This means that the height of the fever cannot tell us whether it is caused by a virus or a bacteria. Examples of viruses that cause fever are cold viruses (especially in younger kids), viral sore throats, gastroenteritis (vomiting/diarrhea) and flu viruses. Examples of bacterial infections that can cause fever are strep throat, pneumonia, sinus infections, urinary tract infections, or meningitis. The other symptoms that the child is experiencing will point towards the cause more that the fever itself.