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Fever & Fever Phobia

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When your child gets a fever, do you know what to do? Our favorite pediatrician, Dr. George Bengtson, MD, stopped by with essential information:

Fever is not a disease. It is a normal response of the immune system to infection or other problems.

DEFINITION -- Temperature above 38 Celsius, or 100.4 Fahrenheit.

MEASUREMENT -- Can be measured in armpit, oral, ear, forehead or that other way

  • Dr. George thinks feeling the child isn’t adequate
  • Armpit is adequate, easy and humane
  • Oral is probably better if cooperation is good
  • Ear measurement is proven OK, but surely it’s voodoo
  • Rectal is overkill


WHAT TO NOT WORRY ABOUT:

  • Don’t obsess over “breaking” a fever
  • Don’t worry about the “brain damage number” – no such thing, really
  • Fever isn’t damaging the brain – the DISEASE is


WHEN TO WORRY:

  • It’s not about the number, it’s about how sick the child looks.*
  • *If child is 3 mos. of age or younger, all fevers are urgent concern.


OK, THEN, WHAT SHOULD I ASSESS?

  • Breathing – feeding OK/color OK/breathing not labored
  • Circulation – warm fingers & toes
  • Mental status – alert & oriented
  • Skin – no suspicious rashes
  • Duration – fever for three days probably worth a look in the office
  • Other – no intuitive sense of problem
  • Also, be more vigilant if child has underlying medical problem(s)

Call doctor if concerned, otherwise you can….

TREAT IT -- First of all, why treat? Because fever gets in the way of nourishment and rest.

  • Loose clothing
  • Acetaminophen (Tylenol) or Ibuprofen (Motrin/Advil)
  • ALWAYS COMMUNICATE DOSES IN MG
  • Lukewarm bath
  • Generous fluids
  • Re-assess frequently