As a pediatrician I often receive questions from parents regarding fever. These usually come in the form of: Should my child be evaluated with each fever? When should I be concerned? When do I give Tylenol or Motrin? How much Tylenol or motrin?, etc…
These are all very valid concerns, and as a mom, I know It can be difficult to not to see fever as a threat. I know it can generate anxiety.
You can use the questions referenced below to help you decide if your child should be evaluated by a pediatrician. I always encourage parents to have their child evaluated by a medical provider if the answer to any of these questions do not seem very clear.
Before jumping into the list of questions, I want to briefly cover basic things to keep in mind.
- Fever, is a rectal temperature of ≥38◦C or 100.4◦F. If temperature was obtained orally or axillary, add 0.5°F (0.3°C) to 1°F (0.6°C) for a comparable rectal result.
- Fever is not an illness in it of itself, rather it is a sign triggered by an illness
- It is preferable to use a digital thermometer
- AAP discourages use of mercury thermometers in homes to prevent accidental exposure and poisoning.
- A temporal thermometer can be used in children 3 months an older
- A tympanic thermometer can be used in children 6 months an older
- Be sure to label rectal thermometers to avoid accidental use in mouth
- While fever can be a result of a myriad of causes, by far, the most common cause of fever in pediatric patient, will be a viral illness.
Now, the list of questions:
• Is child acting normal?
A child’s activity level is an important sign in pediatric world. Clinicians take this into account when performing an evaluation. By activity level we mean how playful yourchild is.
• Is child drinking enough
Your child may have a fever due to a relatively benign cause but if he or she is not drinking enough, it places them at risk for dehydration. Opt for electrolyte fortified solutions instead of juice
.• Which other symptom is present?
As for the following symptoms, these should ALWAYS prompt a doctor’s visit. Stiff neck, severe headache, severe abdominal pain, recurrent vomiting, severe sore throat (child typically refuses to eat), unexplained rash and if fever is persistently high 104F.
Keep in mind that an infant or toddler will not be able to communicate pain, instead they will manifest that pain as crying inconsolably or being irritable.
• Age of the child?
Infants younger than 3 months should always be evaluated in the presence of a of a temperature of 100.4°F (38.0°C) or higher.
• Any other diseases?
If child has immune system problems, such as diabetes, sickle cell disease, cancer, or is taking steroids
.• Duration of fever?
if fever is present for more than 24 hours in a child younger than 2 years or more than 3 days in a child 2 years of age or older.