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Written by Dr. Kim Veldhuis

The cold facts on childhood fever

17/08/2015 1:22:16 PM | 0 comments |
Originally published in the summer issue of Healthier You magazine 
 
"It's 2 a.m. and my little boy has a fever. Should I take him to the hospital? "
 
 
That question has been uttered by just about every anxious new parent, and such a situation, day or night, may cause significant panic and stress. The concern stems from not knowing the cause of the fever, not knowing what to do next and worrying that there may be something serious going on with their child. 
 
But be assured, most fevers do not require a trip to the ER, or even a visit to your doctor. 
 
Any temperature above 38 C is considered a fever. Parents need to know that a fever is a symptom and not a disease. A fever is a healthy, physiological reaction to an often minor infection or other illness. Only on rare occasions can a fever be one of the signs of something more serious. 
 
The most common cause of fever in children is an infection. The infection can be caused by a virus (more common) or by a bacteria. A virus-related fever in children is usually caused by nothing more serious than the common cold, the flu, bronchiolitis or croup. Typically, infections caused by a virus will not benefit from any treatment; antibiotics should not be used. 
 
Less commonly, the fever can be caused by a bacterial infection, such as found in ear infections, bladder infections and pneumonia. Antibiotics can play a role in treatment for these kinds of infections. When a child has specific symptoms (such as ear ache or bladder symptoms) along with the fever, this child should be seen by the family physician for assessment. Keep in mind, that vaccinations have significantly reduced serious bacterial infections (meningococcal disease, for example) in babies and young children. 
 
Rare non-infectious causes of fever include reactions to their regular immunizations, drug fever, cancer and inflammatory conditions such as inflammatory bowel disease. 
 
Contrary to popular belief, teething does not cause a temperature of more than 38 C.
 
The most important thing for parents to know is that a fever in a healthy child is usually not dangerous. With a high temperature, a child will feel unwell. He or she may have decreased appetite, be a little more fussy than usual and play less, but the fever will typically go away in three to four days. Fevers are typically self-limiting, meaning the child will not need any treatment other than something to reduce symptoms.
 
What is the best way to make your child feel better until the fever goes away? Make sure they remain adequately hydrated, even if it’s just sips of water or formula or more frequent breastfeeding. It is also important for them to rest. Using medications such as acetaminophen (Tylenol) and ibuprofen (Advil and Motrin) can help make them feel better. The right dosage depends on the age and weight of the child. However, these medications are not always necessary.
 
If you’re unsure if your child needs to be seen by a doctor, call HealthLink BC (dial 8-1-1) to speak to a nurse any time of the day or night. 
 
Dr. Kim Veldhuis is a Family Practitioner in White Rock 
 

Temperature-Taking 

The best, and most accurate, way to take a temperature is to use a rectal thermometer.  You can also take a temperature from the armpit, mouth or ear. Remember that the number is not as important as the symptoms. Learn more about how to take a temperature.

When to worry about a fever 

Parents should recognize symptoms that may represent a more serious underlying cause for the fever and know when to go to their family doctor or to the Emergency department if their doctor is unavailable to see them quickly.   
 
The degree of temperature is less important than the associated symptoms. Children with a fever that should be assessed by a doctor – your family doctor or an Emergency physician – as soon as possible include:
 
  • Babies under three months with a fever and no other obvious symptoms. They can get very sick quickly and require an aggressive approach to investigate the underlying cause.
  • Children who experience seizures due to a rapid increase in temperatures
  • Children between three months and three years with a fever for more than three days and who appear ill (not drinking, very clingy)
  • Children with fevers lasting longer than seven days
  • Children with a known chronic medical condition
  • Children with a new rash
  • Children who are clearly very unwell – lethargic, listless, rapid breathing, not drinking, poor interaction, inconsolable 
If you’re unsure if your child needs to be seen by a doctor, call HealthLink BC (dial 8-1-1) to speak to a nurse any time of the day or night. 
 

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