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Fever: Friend or Foe?
Misconception about the dangers of fever are commonplace. Unwanted fears about harm from normal fevers causes lost sleep and unnecessary stress for many parents. Let the following facts help you put fever into perspective:
Myth: My child feels warm, so she has a fever.
Fact: Children can feel warm for many reasons such as playing hard, crying, getting out of a warm bed or being outside on a hot day. They are “giving off heat”. Their skin temperature should return to normal in 10 to 20 minutes. Once these causes are excluded, about 80% of children who feel warm and act sick actually have a fever. If you want to be sure, take their temperature. The following are cut-offs for fever using different
types of thermometers:
Rectal, ear or temporal artery thermometers: 100.4° F (38.0° C) or higher
Oral or pacifier thermometers: 100° F (37.8° C) or higher
Auxiliary (armpit) temperature: 99° F (37.2° C) or higher
Myth: All fevers are bad for children.
Fact: Fevers turn on the body’s immune system. Fevers are one of the body’s protective mechanisms. Normal fevers between 100° F and 104° F are good for children and help the body fight infection.
Myth: Fevers cause brain damage or fevers over 104° F (40° C) are dangerous
Fact: Fevers with infections don’t cause brain damage. Only body temperatures over 108° F (42° C) can cause brain damage. The body temperature goes this high only with high environmental temperatures (for example, if a child is confined in a closed car in hot weather)
Myth: Anyone can have a febrile seizure (seizure triggered by fever).
Fact: Only 4% of children have febrile seizures.
Myth: Febrile seizures are harmful
Fact: Febrile seizures are scary to watch, but they usually stop within 5 minutes. They cause no permanent harm. Children who have had febrile seizures do not have a greater risk for developmental delays, learning disabilities, or seizures without fever.
Myth: All fevers need to be treated with fever medicine.
Fact: Fevers need to be treated only if they cause discomfort. Usually that means fevers over 102° F or 103° F (39° C or 39.4° C)
Myth: Without treatment, fevers will keep going higher.
Fact: Wrong. Because the brain has a thermostat, fevers from infection usually top out at 103° or 104° F. They rarely go to 105 ° F or 106° F. While the latter are “high” fevers, they are harmless ones.
Myth: With treatment, fevers should come down to normal.
Fact: With treatment, fevers usually come down 2° or 3° F (1.1° C or 1.7° C)
Myth: If the fever doesn’t come down (if you can’t “break the fever), the cause is serious.
Fact: Fevers that don’t respond to fever medicine can be caused by viruses or bacteria. Whether the medicine works or not, doesn’t relate to the seriousness of the infection.
Myth: If I can “break the fever,” the infection will go away.
Fact: The fever will normally last for 2 or 3 days until the body turns off the virus’s attack and gets the upper hand. This process cannot be hurried. The source of this misconception is that during an infection, when the fever goes away, the child is usually on the road to recovery. It’s magical thinking, however, to assume that making the fever go away earlier (which is impossible), will make the infection go away earlier.
Myth: If the fever is high, the cause is serious
Fact: If the fever is high, the cause may or may not be serious. If your child looks very sick, the cause is more likely to be serious.
Myth: The exact number of the temperature is very important.
Fact: How your child looks is what’s important, not the exact temperature.
Myth: Temperatures between 98.7° F and 100° F (37.1° C and 37.8° C) are considered fever
Fact: Wrong, these temps are normal variation. The body’s temperature normally changes throughout the day. It peaks in the late afternoon and evening. An actual low-grade fever is 100° F to 102° F (37.8° C and 39° C)
Summary: Remember that fever is fighting off your child’s infection. Fever is one of the good guys.
Written by Barton D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books, Copyright 2005. Revised 8-22-2007.