Before I get into the meat of this article, let me get one thing out of the way: babies less than three months old have different rules about fever. If your newborn has a rectal temperature of 100.4o F or higher, call your doctor immediately.
You might have noticed that I write a lot of posts about things to not panic about - Enterovirus D68, flat heads, and febrile seizures to name a few, but now we're going to talk about something that every child will have at some point, and makes most parents raise their eyebrows at least a little: the fever.
What is fever?
A fever is a common response of the body, generally to a viral or bacterial infection. Everyone seems to have a different definition of what a "low-grade," "medium," and "high" fever is, but it doesn't necessarily matter. However, it's generally accepted that a true fever is a rectal temperature above 100.4oF. Other means of measuring temperature have different accepted definitions of fever, but keeping "100" in your head is a good start. A well-appearing child with a temp of 99.5 probably doesn't need to be whisked off to the doctor right away.
Neither, for that matter, does a well-appearing child with an actual fever, because believe it or not, fevers are generally good for the body. They are an indicator that something (usually infection) is occurring, but not necessarily bad themselves. Fevers have several important functions, including slowing down the infection and speeding up the response of your infection-fighting cells. It's a bit like casting Haste on the immune system. A fever may actually help a child recover more quickly from a virus.
Are fevers dangerous?
In general, no. I'm going to say something that seems very counterintuitive to many parents, but except in very unusual circumstances, fevers that are generated by the body do not cause brain damage. The rare exceptions to this include individuals with certain metabolic disorders, or who don't have a functioning hypothalamus, which sets body temperature. And it certainly hyperthermia, where the body is excessively heated from another source, or loses the ability to regulate temperature due to a rare complication of anesthesia or certain drugs, can be very dangerous. But I repeat, an otherwise healthy child is not in danger of harm from a fever, even a high one. So you don't need to feel like a fever of even 106 has to drop immediately to save your child's brain.
Do I need to treat my child's fever?
A fever does not need to be reduced simply because it exists. Fevers are helpful, but sometimes a fever also interferes with your child's ability to sleep, eat, or drink, all of which are also important in recovering from illness. Or your child might have pain or significant discomfort with the fever, and in those cases, yes please, give your child something to help. Acetaminophen (Tylenol) and ibuprofen (Motrin) are effective fever reducers, but ibuprofen is not generally recommended for children under six months of age. Aspirin isn't recommended for fever reduction in children because of the risk of Reye Syndrome.
1.) Treat the child, not the number. If they are acting in pain or uncomfortable (not just fatigued), it's okay to give a fever reducer. If your child has other symptoms that concern you, or is feeling ill even when the fever is down, call the doctor. But otherwise, it's okay to let a child have a fever.
2.) Don't wake a sleeping child just to give a fever reducer. Sleep and fever both help with healing!
3.) Always make sure you are giving the correct dose of fever reducer. It is much safer to dose with a syringe or medicine cup, using milliliters, than to dose by teaspoons.
4.) Don't alternate Tylenol and Motrin just to keep a fever down. If you need to reduce the fever to help your child feel better, pick the fever reducer that works best for your child, and make sure you are using the correct dose and interval. If you don't think it is working well enough, call the child's doctor.
So, in a nutshell, don't fear the fever. Sometimes when you have a fever, the only prescription is more cowbell.