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When to Call the Doctor When Your Child Has a Fever

March 3rd, 2011 by Dolly Garnecki, BA, DC

Fevers are a bad thing... right?

The media hype on fevers can make even the most calm parent nervous when a baby feels unusually warm. However, the fever is the body's way of fighting disease... and, that's not necessarily a bad thing.

According to an article written by Dr. Peter N. Fysh, DC in Dynamic Chiropractic, May 7, 1993:

Fever is a symptom and not a disease. It is the body's normal response to infections, a response which stimulates the immune system by releasing and activating white blood cells and interferon.

According to the article (great read, by the way) by Linda B. White and Sunny Mavor in Fever in Children: A Blessing in Disguise:

It may help parents to remember that fever is only one part of the picture of an illness. In fact, for children under eight years of age, and especially for infants, the severity of a fever is an unreliable indicator of the severity of the child's illness. For example, infants and toddlers can be very sick with a low or even subnormal temperature. Conversely, children three to eight years old can be running about quite cheerfully with a fairly impressive fever. The important thing is how your child is acting, not the thermometer reading.

When should I be concerned about a high temperature?

First and foremost to take a temperature, you need a thermometer. According to the textbook Chiropractic Care for Pediatric Patients by Peter N. Fysh, D.C., F.I.C.C.P. published by the International Chiropractors Association Council on Chiropractic Pediatrics,

Temperature should be checked and recorded in infants who present with upper respiratory infections, earache symptoms or other signs of infection.

What is a fever?

In most adults, an oral temperature above 100F (37.78C) or a rectal or ear temperature above 101F (38.3C) is considered a fever. A child has a fever when his or her rectal temperature is 100.4F (38C) or higher.

NOTE: In the first two months of life, any baby with a fever of 101F (38.3C) or higher should be immediately evaluated by an appropriate physician because the immune system has not yet had time to become competent to defend against invading pathogens.

A rectal or ear (tympanic membrane) temperature reading is 0.5 to 1F (0.3 to 0.6C) higher than an oral temperature reading.
A temperature taken in the armpit is 0.5 to 1F (0.3 to 0.6C) lower than an oral temperature reading.
Home Remedies for Children & Babies with Fever

In many cases, there are things you can do at home to help your child become more comfortable with a fever... and you can even reduce a high-grade fever to a low-grade level where it can still burn off an infection without making your child miserable. Consider the following:

Spend as much time with your child as possible, and help get his mind off of discomfort by reading books and snuggling with him
Provide diluted juices or breastfeed more frequently to help your child remain hydrated. Coconut water or carrot juice are beneficial for feverish children. Breastmilk will help your baby or toddler increase immunity against the infection.
Give your child a sponge bath or sitz bath in tepid water - especially if it's a high grade fever, or your child is hot and sweaty. Alternate between warm and cool (tepid) water - cycling every 30 seconds to flush out the fever. Add tea tree oil or lavender essential oil to the water for external use only.
Your child may lose his appetite due to the fever, and only desire to ingest fluids for a couple of days. Consider the fruit or vegetable juices noted above. Once your child is over the fever, he'll need to regain his energy with nutrition-dense foods, void of sugar and processed dairy.Add grass-fed beef, chicken, eggs, wild-caught fish, hearty vegetables, clear soups, yams, and antioxidant-rich berries to his post-fever meals.
Remove extra clothing and bedding to help your child with temperature regulation. A single layer of a cotton shirt and pants and a thin cotton sheet will help your child regulate and cool down.
When to call your Doctor

If your child's temperature exceeds 104F (40C) AND/OR
If your child is limp, lifeless, unresponsive, and doesn't make eye contact AND/OR
If your child is irritable - cries non-stop for hours in a monotonous tone, and is inconsolable AND/OR
If your child is expressing symptoms of meningitis (such as a high fever, a stiff neck, neck pain, vomiting, convulsions, rash, sensitivity to bright lights. In a newborn, a bulging cranial suture).
Temperature Reading Options

The most accurate readings on a newborn are rectal readings. Until a child is at least age 5, you can't get them to safely an accurately hold a thermometer under the tongue for an accurate oral temperature reading. Axillary or armpit temperature readings may work secondarily, but they're not as accurate as oral (for children over 5 years of age) and rectal (from birth to age 5).

Tympanic (inner ear) readings are the least accurate, and they require a new covering for each reading. Oral temperature readings are affected greatly if a very hot or cold drink was ingested just prior to the temperature reading.

A new study in peer-reviewed American Journal of Critical Care found temporal artery thermometers superior since they are comparable to rectal readings... and they can take a reading in less than 2 seconds!

References:

1. Fysh PN. Chiropractic Care for the Pediatric Patient. International Chiropractors Association Council on Chiropractic Pediatrics. Arlington, VA; 2002. p. 63.

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