Fevers in children can be very scary and nerve-racking; we certainly understand and appreciate that. There are, however, a lot of myths and misinformation out there about fevers that often lead many parents (as well as some doctors at times) to have a certain level of “fever phobia” when it comes to kids. With this in mind, we wanted to provide some information to help in guiding you when your child spikes a fever at 3am and you are unsure of what to do.
As an important disclaimer, the following advice DOES NOT apply to infants under 2-3 months old or children with immune-suppressing conditions. Fevers in these children are considered an emergency and should be treated differently than those in older and generally healthy kids; call us right away in these situations.
The most important thing to remember about fever is that it is a symptom rather than a disease. Fever, in and of itself, is not necessarily a problem but rather is part of the body’s natural response in fighting off infections (whether they be viral or bacterial). Fevers reflect a healthy immune system and actually serve a beneficial or protective effect in raising the body’s temperature to higher degrees in which these viruses and bacteria have a harder time surviving.
One of the most common things we are asked about fever is what temperature is considered “too high” and warrants an immediate evaluation. The truth is that there is no set number that should cause us to panic or rush off to the emergency room (even those in the 104-105 F range). The height of the fever does not always correlate with the severity of illness. There are some self-limited and ultimately harmless viral infections that may cause very high fevers while other more serious bacterial infections may only lead to lower fevers. It is more important to again regard the fever simply as one symptom and view it in the context of the bigger picture of how your child is feeling and what other complaints he/she has. If there are other serious issues going on with the illness (such as respiratory distress, alterations in mental status, severe pain, or concerns of dehydration) then an emergent evaluation would be indicated, otherwise it is generally fine to “ride it out” and monitor the course of illness over a few days while treating symptoms as needed. You do not necessarily need to medicate the fever or worry about bringing the temperature down if your child is otherwise feeling and acting okay but if he or she is fussy or uncomfortable you may certainly go ahead and give acetaminophen or ibuprofen (check with us on dosing if you are unsure).
It is also important to know that high fevers do not cause brain damage or other lasting effects in people with normally functioning brains. The brain has very sophisticated temperature-regulation controls and does not allow body temperature to rise to dangerously high levels. It is true that a small subset of children may experience seizures associated with fever (referred to as “febrile seizures” and deserving of an entire discussion on their own) but even these, although very scary, will cause no long-term issues. The only body temperature elevations that can cause permanent damage occur in situations where there are external sources raising the temperature of the body (such as in cases of heat stroke) or in very rare brain injuries that disrupt the body’s internal “thermostat”.
Please let us know if you would like further clarification about any of this information or if it has prompted further questions. Here are some other resources that we have found, which provide some further thoughts on this topic and may be helpful: