A fever is one of the most common reasons parents bring their children to the emergency room. Those parents have all kinds of great questions about childhood fevers and what they should do the next time one strikes.
We asked Dr. Whitney Minnock, Beaumont emergency medicine physician, to share some facts about fevers that often surprise parents in the specialized pediatric emergency units at Beaumont Hospital, Royal Oak.
“When your child is ill and gets a fever, the fever is a sign that your child’s immune system is having a normal physiologic response. Your child’s body is working hard to take care of an infection and is functioning as it was designed to. Though it does make your child feel bad, the elevation in the temperature is your child’s first defense against an infection."
When should I be concerned and seek care?
- If your child is 3 months of age or younger and they develop a temperature of 100.4 degrees F (38 degrees C), you should seek care immediately.
- If your child has a chronic medical disease, please follow the instructions from your provider regarding what to do with a fever.
- Your child is breathing fast, particularly when the fever is down. Pneumonia and respiratory infections can be serious causes of fever.
- Your child is not drinking well and/or has decreased urination. Little to no urine in 10-12 hours is a sign of dehydration. When your child has a fever, they don’t drink as much and loose extra fluid because their body is working hard to fight off infection.
- Your child is ill appearing and not acting normal.
- Your child has a recurrent fever for 5 days or more.
The fever’s degree of elevation does not correlate to severity of disease. There is not a specific degree of elevation that would independently necessitate a trip to the emergency room. Some children do have febrile seizures secondary to the rise in temperature, but this is not due to the degree of elevation. If your child has a febrile seizure, they should be taken to the emergency room immediately.
Tylenol (acetaminophen) and Motrin (ibuprofen) do not treat the infection but help reduce the temperature. This will help your child feel more comfortable and may help them feel well enough to hydrate and sleep. However, these medications will wear off and the fever will likely come back until the infection clears.
Dosing recommendations on the bottle or box of these anti-fever medications are based on weight ranges but are not exact. Consult with your pediatrician to obtain a precise dosing for your child. You should not give Motrin (ibuprofen) if your child is under 6 months of age. Tylenol (acetaminophen) can be given to children of any age. Some children with kidney or liver disease should take extra caution when taking these medications, and always discuss with your pediatrician for specific recommendations for your child.
THINK AHEAD
Thinking ahead is a key component to being prepared for a potential emergency situation, whether it involves a fever or not. Think about which emergency room you would prefer for your family.
Is it a dedicated pediatric emergency room with technology, specialists and programs just for kids? Is it important to you that if your child needs to be admitted he or she stay close to home at the hospital connected to the emergency room? Considering these important questions in advance of an emergency will help you remain calm and make the best possible decision for your child.
TRUST YOUR INSTINCTS
Planning ahead and educating yourself will help you make good decisions when it comes to childhood emergencies. But, don’t underestimate the value of trusting your instincts either. If you feel your child needs to get to the emergency room, there’s a good chance you’re right. You know your child the best. You’re the best one to make that decision.