Now that you have taken your child’s temperature, what do you do with the information?
As discussed previously, a fever is defined as a body temperature above 100.4 degrees. If you take your own temperature all day long it will be quite variable as will your child’s, and body temperature often goes up as the day goes on. If your child has 100 degree temperature in the morning, the mother and pediatrician in me thinks that by the end of the day they may be running 101 degrees or higher. I would keep that child home that day to see what happens with the temperature. If you’re wrong and their temperature stays down, back to school or day care the next day. If it goes up you have not exposed everyone else throughout the day.
All infant’s under two months of age with a documented temperature (preferably rectally) above 100.4, should be seen by their doctor. That is a phone call day or night, to find out if your doctor wants to see you in the office or go to ER etc. Do not give this age infant any acetaminophen, before talking to your doctor. Many times this age child will be admitted to the hospital, so be prepared for that discussion with your doctor.
Once your child is over two months of age but still younger than six months, it is important to discuss your child’s fever with the nurse or doctor. There are certain things they will ask you that will help determine if your child needs to be seen that day or night.
After six months of age it is easier to judge a child’s degree of illness by not only the reading on the thermometer, but by how they are acting. The hardest thing to teach any parent (me included) is that the height of the fever does not necessarily correlate with degree of illness. During flu and viral season, it is not uncommon to see temperatures in the 103 to 104 degree range.
Try not to react to the number on the thermometer, but rather look at your child. Go ahead and treat the fever with either acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) and then watch your child over the next 30 – 40 minutes. Reducing their fever will often improve how sick they look. Whenever a pediatrician walks into a room the first thing we do is look at how the child is interacting with the parent. Whether that is a toddler in a lap, or a big kid on the table, a quick look at a child is really worth a thousand words. If your child will smile (okay just briefly), make good eye contact, responds to the pediatrician by kicking and screaming (a toddler for sure), can play on the Nintendo DS, eat cheerios or candy or chips (I know, they won’t eat well when sick, do you?) and tell you just how crummy they feel, they are probably okay. I describe this as pitiful, and pathetic, but not critically ill. That is what we are trying to distinguish on a busy day in the office, and that is the same thing you want to look for in your own child. It takes practice, but as a parent, you will be dealing with children and fevers for the next 21 years and you too will get better at dealing with fever. It is always scary the first time you see your child sick, but fever is not the enemy. It actually means that your child’s body is fighting the infection.
So remember the mantra: Fever is your friend. I think we will be saying this a lot this winter. More fever topics later.
That’s your daily dose, we’ll chat again tomorrow.