Understanding Pediatric Fevers

Understanding Pediatric Fevers

One of the most common pediatric complaints that we see in the Emergency Department is fever. Despite being a very common occurrence it can be really confusing for parents who are trying to do what is best for their child. There are a lot of misconceptions about fevers in the community which only lead to further confusion.

Myth 1: Fever is a bad thing. Although the cause of the fever may or may not be serious, the fever itself is a good thing. Fever is one of the ways that your body combats viral and bacterial illnesses. By resetting your body’s thermostat, your brain is making it harder for the virus or bacteria that is causing the illness to grow and multiply. This makes it easier for your immune system to defeat the invading illness.

Myth 2: The higher the fever, the sicker the child. Fever is defined as any temperature greater then 100.4 degrees Fahrenheit. Although it would seem to make sense that a child with a fever of 103 is sicker than one with a temperature of 100.4, there is no research to support this assumption.

Myth 3: If the fever gets too high it will hurt your child. Although your child will feel worse with a high fever, the brain will regulate the temperature naturally in a way that will not lead to any damage. The exception is heat stroke, in which the brain loses control due to external heat and bodily harm is possible.

So what should you do if your child develops a fever? First of all, don’t panic! Try to keep your child as well hydrated as possible. Usually this is best achieved using fluids that have a mix of salt, sugar and water which helps lead to more fluids being absorbed. Examples include Gatorade, Pedialyte or fruit juice. For comfort, you can treat the fever with Tylenol and if the child is above the age of six months you can add Ibuprofen. The easiest thing to do is alternate these medications every four hours so that there is always something in the child's system. Make sure that you use the appropriate weight-based dose, which should be on the medication bottle. When in doubt call your child’s doctors office to talk with on call personnel to discuss the situation.

So when should you bring your child to the ER for a fever?

It’s really up to you. As an ER doctor, however, things that worry me are when children with fever are:

  • Not acting normally when their fever resolves.
  • Becoming dehydrated. Decreased wet diapers, frequency of urination, or if they are losing fluids from diarrhea and vomiting that they are not replacing orally.
  • Complaining of abdominal pain, headache, or stiff neck.
  • Not up-to-date on their vaccinations.
  • Less than four months old. Newborns and infants should always be evaluated by a healthcare professional.



By: Devin Bustin, MD
Emergency Medicine Specialist, Tallahassee Memorial HealthCare

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