When an infant fever is just a fever
Last week I was taking care of a 9-month-old brought in by his grandmother. His parents had gone away for a week-long vacation for the first time after having a baby, and nearly immediately after they left, he began sneezing and coughing. His very nervous grandmother told me, “I can handle anything as long as he doesn’t get a fever!”
The fear of fevers is very common in pediatrics. It begins because we tell parents of newborns to call “immediately” for a fever over 100.4 — for the youngest babies, fever can indicate a serious infection. What we forget to do is to tell parents when to relax about fevers. As a result, parents who handle vomiting, wheezing, and even minor cuts and bruises with ease can come undone by a fever. People often have preconceived notions that fevers in later infancy and childhood indicate something ominous, or that the fever itself can cause damage to the child. The time it takes for typical fever reducers (referred to as antipyretics) to take effect add to the anxiety of the caregiver. Many call with concerns when a mere fifteen minutes have passed between medication administration and re-measurement of temperature if it has not “gone down,” when in reality it often takes an hour to lower the body temperature.
For these reasons, it is a great idea to discuss fever management at each well and sick visit for your child. That way, fever doesn’t have to cause undue worry and stress and allows you to be prepared, no matter the time of day. Here are a few tips for getting ready to calmly handle the inevitable.
- At each visit, ask about appropriate fever reducers and their dose. The dose changes with weight, not age, so particularly in the first year, you need to reconfirm the correct dose at each visit.
- There is one fever reducer from 0-6 months: acetaminophen. It has many different brand names; one is not better than another. Have a bottle stocked at each home your baby visits regularly.
- From 6 months onward you may choose between acetaminophen and ibuprofen. Again, each one has many brand names. Having a bottle of each at home is a reasonable thing to do. The dose of each is not always the same. Make sure you follow your doctor’s recommended doses for each medication individually.
- We treat fevers to help children feel more comfortable, not because they are dangerous to the child’s brain.
- Fever is defined as 100.4 degrees Fahrenheit or higher. It does not matter to your doctor if the temperature was taken orally, rectally, under the armpit, or on the forehead.
- You do not have to prove to the doctor that the child has fever. If fever is present and you are headed into the doctor’s office for an exam, please treat the fever with medication before you leave home. Your visit will be much more enjoyable and your doctor will get a better picture of what is going on if your child is comfortable.
- It’s okay to call your doctor’s office after hours if your child has a fever. They would much rather you call than wind up in the emergency room unnecessarily because you were frightened.