Parents often worry when their child gets a fever—and understandably so. You never want to see your child feel badly as this could be a sign of illness starting to take hold. However, research has shown that many parents may overreact to their kids' fevers. This happens often enough, in fact, that there's a term for it: fever phobia. One 2016 study finds that it is very common among parents of all backgrounds and socioeconomic statuses. At NiteOwl Pediatrics, we understand that it can be concerning when your child has a fever, so we want to go over some of the things you can do if your child has one as well as when to seek medical attention.

Before we begin, it is important to remember that a fever is a symptom, much like a cough, runny nose, or a sore throat. Also, despite what most people think, the degree of fever doesn't tell you how sick your child is.

What Is a Fever?

A fever is a rise in your child's body temperature above normal levels (around 98.6 degrees). A fever is thought to help interfere with the growth of some infections and help boost the body's immune system response, however, sometimes this natural defense can get a little out of hand.

Fever occurs in response to certain fever-inducing substances called pyrogens. These are either substances already inside the body that are released by cells in response to infections, or they are germs that cause infection, including bacteria, viruses, and toxins. In response to the pyrogens, chemicals inside your child's body work to raise their internal thermostat in an attempt to drive these pyrogens from the body and arrest their growth and spread.

Though normal body temperature is 98.6 degrees, most medical professionals only consider a higher body temperature a fever when it reads 100.4 degrees or above.

Causes

Most parents think 'infection' when their child has a fever but it is important to remember that various conditions cause fever and many have nothing to do with an active infection.

Conditions that cause fever include:

• Viral infections (flu, cold, RSV, roseola, chicken pox, etc.)
• Bacterial infections (ear infections, strep throat, scarlet fever, pneumonia, Rocky Mountain spotted fever, urinary tract infections, etc.)
• Other infections, including parasites (malaria) and fungal infections
• Rheumatic diseases, such as juvenile rheumatoid arthritis and lupus
• Cancer (such as leukemia or lymphoma)
• Familial Mediterranean fever, cyclic neutropenia, Kawasaki disease, periodic fever syndrome, aphthous stomatitis, pharyngitis, and adenopathy (PFAPA)

Fever can also be a side effect of medication use (drug fever), a blood transfusion, or vaccines, so if your child has recently been to the hospital, keep this in mind.

Although the above list is rather comprehensive in regards to the myriad causes of fever, it is important to remember that the most common cause of a fever is a viral infection. It is, however, a good idea to see your pediatrician if your child has a prolonged fever or frequent fevers as this is an indication that something is happening that needs medical attention.

Taking Your Child's Temperature

There are many types of thermometers available for purchase, and which one you decide to use largely comes down to circumstance and personal preference.

Although temporal thermometers (thermometers that scan across your child's forehead) and ear thermometers are becoming popular among parents because they are fast and easy to use, they can also be expensive. More simple, mercury-free digital thermometers are much less costly but do take longer to get a reading, which can be a problem if you have a fussy child who won't stay still. When choosing which thermometer is correct for you particular situation, it is very important that you consider the age of your child, their temperament, and the amount of time you have available to take your child’s temperature.

Rectal thermometers may be preferred in certain cases, such as when an infant is very ill.

Fever Treatment

If your child has a fever, you may want to consider giving an over-the-counter fever reducer if he or she is irritable or uncomfortable. If the fever doesn’t seem to be bothering your child, this course of action isn't always necessary.

Aspirin should not be given to a child or teen for fever or pain relief as it may trigger a rare, but possibly fatal condition called Reye’s syndrome.

If your child has a fever, be sure they are drinking extra fluids. They may also feel more comfortable after taking a lukewarm sponge bath and changing into lighter clothing.

When to Call the Pediatrician

Usually, you can manage your child’s fever at home with these treatments. However, you should call the pediatrician if your child seems sick or if they meet the following conditions:

• An infant under 2 to 3 months old has a temperature at or above 100.4 degrees F
• An infant that is 3 to 6 months old has a temperature at or above 101 degrees F
• An infant 6 to 12 months old has a temperature at or above 103 degrees F
• A child over 12 months old has a temperature at or above 103 degrees F and the fever does not improve with home remedies and a fever reducer

When to Go to an Urgent Care Facility

Though not as common, there are times when a fever means a serious infection. If you cannot reach your pediatrician for advice as to whether or not to head to the emergency room, follow these guidelines:

• Newborns to age 3 months: A baby under 3 months should be taken to see a medical professional for a temperature of 100.4 degrees F or higher or a fever accompanied by difficulty waking up, problems with breathing, a rash, vomiting, and/or non-stop crying.
• Ages 3 months to 3 years: Children ages 3 months to 3 years should be taken to an urgent care facility for temperatures of 102.2 degrees F or higher.
• Ages 3 and up: A child who has a temperature of 102 degrees F for two or more days needs immediate medical attention. A fever accompanied by breathing or swallowing problems, problems with urination, abdominal pain, rash, stiff neck, and/or problems with waking up warrants a trip to the emergency room. Lastly, a child age 3 or older who is behind on vaccinations with a fever that has lasted for two or more days should be taken to an emergency room.

With older children, you can make a determination on whether a trip to an urgent care facility is necessary based on their behavior and activity level. Your child’s behavior can give you a good idea of how sick they may be and, for the most part, older children will be able to express the level of discomfort they are feeling.

If your child experiences fever with other symptoms—sore throat or rash, for example—you should call their doctor to see if a visit is warranted. Persistent and frequent fevers, with or without additional symptoms, should also be brought to the attention of your child’s doctor.

With all of this said, a parent's gut-check isn't something to be ignored. Keep the above information in mind when deciding on next steps, but always seek the advice of a physician if you are not sure how to properly treat or manage your child’s fever.

We hope that this blog has been informative and that you have learned more about the cause of a fever, steps to take to reduce your child’s fever, and when it is necessary to seek medical help when treating a fever. If your child ever suffers from a fever and you are concerned with how it is progressing, please reach out to us at NiteOwl Pediatrics to schedule an appointment. We have been providing pediatric urgent care services for years and will work to make sure that your child recovers as quickly as possible.