Infections cause
a variety of responses from the body and elevated temperature is
one of the most noticeable. Children's temperatures seem to rise
faster and higher than a n
adult's does.
Fevers
help to fight infections because white blood cells move faster
and kill viruses and bacteria better at 102 degrees than they
do at 98.6. Additionally, many germs have a limited range of viability
and do not grow as well when the temperature is higher.
The problem is
that most children do not eat, drink or sleep very well when they
have high fevers. They are also not easy to assess medically at
102 either. To a parent or a doctor, a child with a high temp
looks pretty bad even when the illness causing the fever is "just
a cold."
There are two reasons
to bring down the temperature:
- To make a child
more comfortable so they have an easier time staying hydrated
and getting a little more rest.
- To be able to
observe a child with a lower temperature and realize that it
was a large fever and a small underlying illness making them
look a lot worse than they really are.
In adults, the
height of the fever often correlates well with the severity of
the illness. In children, this is not always the case: a two-year-old
can develop a 105 fever with a viral cold or could be sick with
pneumonia but only have a 100.8 temp. Bringing the temp down on
that first child will give you a fairly normal child for an hour
or so but bringing the temp down for the kid with pneumonia or
some other more significant illness won't do anywhere near as
much to make them feel a lot better.
I recommend long
lukewarm tub baths as the best way to lower temperatures when
you need to. Also, make sure to "unwrap" your baby or
child to allow heat to radiate out from the body rather than being
trapped underneath heavy clothing or blankets. This is much more
important than many parents realize.
Most doctors also
recommend Tylenol type drugs or Advil/Motrin type anti-inflammatory
medicine. Some families also rely on a homeopathic medicine like
belladonna. More natural approaches favor not bringing down the
fever at all but just working for good hydration and comfort while
allowing the immune system's natural mechanisms (including fever)
to work on the infection. This is not a bad course of action but
a lot of parents I know are not very comfortable watching their
child's temp go up and stay up. If this is the way you feel, try
lowering the temperature at least once to reassure yourself and
your doctor that under this big fever is a small illness.
Aspirin must never
be used in childhood or teenage years because of the statistical
association with Reye's syndrome, a potentially fatal liver disorder.
A word about febrile
seizures: From about 18 months through age five years or slightly
later, about 1 out of 50 children will have a convulsion with
the fever. This is an innocent occurrence about 99.99% of the
time but one of the most frightening things you'll ever see. Remain
as calm as you can, call your doctor right away, and do not put
anything into your child's mouth. Hold them upright and slightly
tilted forward so that they have an easier time with secretion
or vomit. The seizure will last 1-3 minutes (it will feel like
an hour) and then your child will sleep or act very lethargic.
Immediate medical evaluation is needed for at least the first
of these seizures. Over half the kids go on to have a second convulsion
with a fever but virtually none of them develop epilepsy or other
complications. Call your doctor. Most families also call 911 and
this is not a bad idea except that transporting your two-year-old
by ambulance to the nearest hospital may put you in an ER inexperienced
or over reactive to sick kids. Over reaction may be better than
a laissez-faire approach by far, but it is not the best way.
To summarize: fever
is natural, helps end the infection faster but may need lowering
for the child's comfort or the parents' reassurance. |