January 19, 2017

My Baby Has a Fever

Every mother has felt that sense of dread after taking her baby’s temperature and realizing “uh oh, there’s a fever”. Let’s talk about fevers in infants and children and what you should do.

First, make sure you have a thermometer in the house. This can be a plain digital thermometer or a fancier temporal or tympanic thermometer. A digital thermometer can be used rectally or axillary (under the arm). They are accurate and easy to use. Do not use a tympanic (ear) thermometer on a baby under 1-yr old. They have proven to be inaccurate and accuracy counts in a small baby. Temporal (scanning the forehead) thermometers have been found to be fairly accurate, easy to use, but are more expensive. Learn what your baby’s normal temperature is by checking it several times when they are well. You need to feel comfortable with taking a temperature and know what your baby’s normal range is. Normal range for an infant is 97.5 – 99.5 degrees Fahrenheit.

If you think your baby feels warm, check his temperature and if it is over 100 degrees, undress the baby, or just remove some layers and take it again in 10 minutes. If your baby is 3 months or under and still has a temperature over 100 degrees (or 100.4 rectally), it is time to call the doctor.

Do not give a baby under 3 months old Tylenol or any fever reducer medication. A fever at this age can signify a serious infection and the baby should be evaluated by a doctor. Newborns do not have the immune system established to fight a serious infection. You do not want to mask the fever with Tylenol. If it is after office hours, go to your nearest emergency room.

If your baby is over 3 months old, a fever still warrants a call to the doctor. But there is a better chance she may recommend some Tylenol and then an appointment with the doctor. Remember Tylenol dosages are based on weight, so best to ask your health professional for a correct dosage on your baby.

After 3 months old, always take a baby of any age with a fever of 102 or more (that you cannot reduce) to the doctor or hospital. They are at risk for febrile seizures and the fever needs to be gotten under control. If the child is over a year, you can also use Ibuprofen for fever reducing. A good technique often used by health care providers is to alternate doses between Ibuprofen and Tylenol, but again confirm this with your doctor over the phone before you do. You can also use lukewarm baths (not cold, but just below body temperature) or sponging with warm water. The evaporation of the water helps to reduce the fever.

Fevers are a normal course of any infection. But, what kind of infection it is can sometimes be tricky. It cannot be stressed enough to consult your doctor. Ask them what their policies for fevers are. But, whenever in doubt, contact them. An ordinary looking cold can cause a fever and if it remains under 102 (for a child over 6 months) and there are no other alarming symptoms (breathing problems, vomiting, diarrhea), it can usually be managed at home with just supportive care. If any of these other symptoms are present, a trip to the doctor or nearest Emergency Room is in order.

First and foremost, DON’T PANIC. Fevers are the body’s normal reaction to any infection, even mild ones. It is the body’s defenses gearing up and fighting the infection. Fevers can be our friend. Just remember these basic guidelines for babies and you will be good to go.

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About Julie Warren, RN

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