Wednesday, August 8, 2007

Fever - what is it and when to worry

Fever is often a very scary symptom for parents. It is estimated that 30% percent of visits to a the Pediatrician are for a child’s fever. Interestingly parents attitude towards fever hasn't changed in over twenty years.

Fever is an important bodily response to illness. Fever is often present at the beginning of an illness as it helps fight all types of infections. Many parents think that fever will harm the child or that the temperature will rise to very high degree. In the absence of extreme external factors (a locked, hot car), the body does an amazing job at keeping the temperature appropriate for fighting infection and for preservation of normal function. Fever itself does not cause injury nor long- term damage.

Many parents will give acetaminophen (Tylenol) or ibuprofen(Motrin/Advil) for fever thinking that these medications will "cure" the fever. Parents are frequently surprised that the fever returns when the medication wears off. These medications will suppress fever but will not cure the underlying illness. Many viral cold illnesses have fever associated with them and require no intervention. There is actually a theory that suppressing fever (and all the good things it is doing to help fight infection) actually prolongs the illness.

So when should parents call the doctor? Because infants three months of age and younger have no way to tell us they are ill, they should be seen by a physician if they have a rectal temperature of 100.4F (38C) or greater. If the child seems lethargic (acting very ill, barely arrousable), irritable, is having trouble breathing, or having fewer than two wet diapers during waking hours, the child should be seen. If your child has had fever for three-to-five 3-5 days or greater, you should seek care from your Pediatrician. Parents should not fear fever, just for being a fever, but if your child is not acting normal and"right", if you’ are worried, your pediatrician will be happy to see him.

By Zoey Goore, MD, MPH

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