December 13, 2012

Melissa Arca: Don't fear the fever

Runny noses, congestion and coughs abound in pediatric clinics right now.

Runny noses, congestion and coughs abound in pediatric clinics right now.

After all, we are smack dab in the middle of cold and flu season. And with that comes plenty of fevers. When a child spikes a fever, parents are immediately put on edge and worry seeps in. I can't tell you how many calls and office visits health care providers encounter based on fever alone.

So in an effort to alleviate some worry and debunk some common myths, here are three most frequently posed fever questions, answered.

How high a fever should I be worried about?

It's not the actual number on the thermometer that matters. What matters most is how your child looks and feels. That being said, children tend to start feeling pretty crummy when their temperatures start climbing above 102 degrees.

Parents often wonder if there's a fever "threshold," one that would signal an immediate call in to their pediatrician. The reality is that even relatively high fevers, such as 104 or even 105, do not pose any danger to children. The brain has a built-in thermostat, so to speak, and does not allow fevers associated with infection (viral or bacterial) to rise above 106 degrees.

On the other hand, a body temperature above 106 degrees associated with heatstroke is dangerous and a medical emergency. This can happen when exposed to high heat and humidity, such as being trapped in a car on a hot day.

So just remember, when it comes to fevers, the number on the thermometer is not as important as treating your child's symptoms of a cold or flu. Fever itself does not necessitate the need for an antipyretic.

The only exceptions to this are infants younger than 4 months old with any fever (100.4 degrees or higher). They need to be evaluated by a health care provider regardless of associated symptoms, or lack thereof.

What's the best way to take my child's temperature?

There are many choices these days on how to take your child's temperature. Some boast greater accuracy while others are preferable because of ease of use.

Rectal and oral thermometers are the most accurate. Rectal thermometers are preferred for infants younger than 6 months old because of their accuracy and because this is the only time that the actual number does matter.

A relatively new device called a temporal artery thermometer has also been shown to be highly accurate.

Ear thermometers have a middle-of-the-road accuracy. The actual temperature can vary by 1 degree in either direction. However, I love these for children older than 6 months because they are less invasive, and again, we are not so concerned about the exact number.

Axillary thermometers, which measure the temperature under the armpit, and pacifier thermometers are the least accurate.

Doesn't a fever mean my child is really sick?

Actually, no. Fever simply means that your child is fighting off an infection of either the viral or bacterial type. But it has no bearing on how sick your child is. It simply means your child's immune system has been activated to do its job. Which is a good thing.

The most important thing you can do is not be blinded by your child's fever. Look at your child, not the number on the thermometer. That more than anything will clue you in about the seriousness of her illness.

So as cold and flu season kicks into high gear, ditch fever phobia once and for all because in most instances fever is your sick child's best ally. Aside from you, of course.

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