Fever
What is a fever?
Fever is an elevation of the body's rectal temperature above 100.4 degrees Fahrenheit.
It is important to remember that fever is only a symptom, not a disease. It is one of the body's defense mechanisms against infection.
The body's defensive cells and immune mechanisms work better at increased temperatures. Also, many germs do not grow as well above normal body temperatures. It is more important to know the cause of the fever than how high the fever might be.
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How high is too high?
Fluid requirements go up 10% for every degree of fever, and fevers make children uncomfortable.
Also, 4% of children will at some time have a fever convulsion or seizure, so keeping body temperatures within reasonable limits is prudent.
If a child is uncovered and dressed lightly (so heat can radiate away) and has plenty of fluids (so sweat can also carry heat away), it is almost impossible for body temperatures to go above 106 degrees. Temperatures below 106 level are not harmful. Fevers below 106 degrees will not "cook the brain," as many used to believe.
However, there is little evidence that the advantage of temperatures above 103 are worth the disadvantages, so keeping temperatures below 103 seems reasonable.
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How should I respond?
When your child has a fever, the most important thing is to evaluate, "How sick does he or she look, aside from the fever?"
If you would not otherwise be overly worried, it is reasonable to get warm clothes and covers off, be sure water intake is adequate, give some acetaminophen or ibuprofen if temperatures are above 102 or 103, and call your physician's office during the next office hours for an appointment to find out whether the fever is due to an infection for which antibiotics may be indicated.
There is an exception for infants under 6 weeks old, as their body defenses are less developed. The infant's physician should be called promptly in the event of a fever.
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What medications reduce fever?
Acetominophen (Tylenol) and ibuprophen (Motrin or Advil) are equally effective at decreasing fever. The dose of acetaminophen is 7 milligrams (mgm) per pound of your child's body weight, every 4 hours. The dose of ibuprophen is 5 milligrams (mgm) per pound of your child's body weight, every 6-8 hours.
The common practice of alternating the two medications is unnecessary and most textbooks, the FDA and the medication manufacturers recommend against it. It is better to stick with one medication and give it on a regular schedule.
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