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