Thursday, June 16, 2011

Fevers In Infants And Children

When to Call the Pediatrician

View full article HERE.

If your child is two months or younger and has a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, call your pediatrician immediately. This is an absolute necessity. The doctor will need to examine the baby to rule out any serious infection or disease.

You also may need to notify the doctor if your child is between three and six months and has a fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or greater, or is older than six months and has a temperature of 103 degrees Fahrenheit (39.4 degrees Celsius) or higher. Such a high temperature may indicate a significant infection or dehydration, which may require treatment. However, in most cases, your decision to call the pediatrician should depend on associated symptoms, such as a severe sore throat, a severe earache, a cough, an unexplained rash, or repeated vomiting or diarrhea. Also, if your child is very fussy or sleeping more than usual, call your doctor. In fact, your child’s activity level tends to be a more important indicator than the height of the fever. Again, fever in and of itself is not a sickness. It is a sign of sickness.

If your child is over one year of age, is eating and sleeping well, and has playful moments, there usually is no need to call the doctor immediately. If a high fever persists for more than twenty-four hours, however, it is best to call even if there are no other complaints or findings.

If your child becomes delirious (acts frightened, “sees” objects that are not there, talks strangely) while he has a high fever, call your pediatrician, particularly if this has not occurred before. These unusual symptoms probably will disappear when the temperature returns to normal, but the doctor may want to examine your child to make sure they are a response to the fever and not something more serious, such as an inflammation of the brain (encephalitis) or membranes covering the brain and spinal cord (meningitis).

Other circumstances should prompt an immediate call to your pediatrician. For example, contact your doctor if your child is feverish and has been in an extremely hot place, such as an overheated car. Also, talk to your pediatrician if your youngster has a fever and has a condition that suppresses immune responses, such as sickle cell disease or cancer, or if he is taking steroids.

If your child has a febrile convulsion (or seizure), he should be examined by your pediatrician or taken to the pediatric emergency room after consulting with your pediatrician as soon as possible, particularly if this is the first time it has occurred, or if it is more severe or prolonged than others he has had. You need to be sure that the convulsion is due to fever and not to a more serious condition such as meningitis.


I normally don't post about fevers, because it is something that relies on a parent to judge for themselves by looking at their own child, whether or not something more needs to be done. This article and/or post should not be taken in place of medical advice. This post is simply to explain that there are many times a child has a fever that it is important that they see a Dr. immediately...and many times that it is not necessary for them to see a Dr. at all.

The main point I wanted to show in this article is that if your child has a fever, but is acting normal...running around, eating, playing, talking, getting into trouble (LOL...that's a sure sign of good health!), chances are your child is just fine. It's when they are lethargic, not moving, not playing, not eating, not drinking, and talking nonsense, that they need to be seen by a Dr.

Personally, I don't get upset or worried about a typical fever. To me, it's just a sign that their little bodies are doing exactly what they were designed to do...fight off viruses and infections by heating the body to a point that makes it unpleasant for those things to live in their bodies. By heating up, the body naturally kills off viruses and infections...and as long as things don't get out of hand, is completely fine.

My fever story:
For the first time in three years, I sent my son up to Emerg. with my husband a couple of weeks ago. He had a fever when he woke up, and immediately after getting out of bed, he threw up what was about a mouthful of bile. We went downstairs, and even though he looked kind of rough, he was eating and drinking. Within a couple of hours, he threw up again. I put him on the couch with a pillow and blanket and his Blue (stuffed bear), and he was watching cartoons. When he stopped wanting to get up, I felt him, and his entire body was very very hot. I try not to give my kids any type of medication unless I HAVE to, and this was one of those times I felt it was needed. I gave him the dose written on the side of the Children's Advil bottle, and fully expected him to start feeling better within the hour. When he wasn't, I was getting concerned. I tried giving him
pedialyte, and even though he normally loves it, he didn't want it. I can't FORCE him to take it...he's the size of a 4 year old, and can put up a pretty good fight when he thinks he has to. I also didn't want to upset him, I was trying to keep him calm so he wouldn't throw up again, so I tried giving him popsicles. He ate most of one, then turned pale. He looked like he was going to vomit, but didn't. He just kept getting hotter and hotter, and it was too soon to give him any more Advil. We don't have any Tylenol in the house because I don't want to give that to them, so my hands were tied...and I was getting nervous. My son started saying things that didn't make sense...and that's just not something I've ever had to deal with. He couldn't make a coherent sentence, and the words I did understand didn't fit together.

By this time, my husband finally got up (he was working afternoons and didn't get home until 2am, so he sleeps in in the morning). By that time it was after noon, on a Wednesday...our Dr's office was closed. (They close Wednesday afternoons.) Since I didn't want to leave him any longer, I had my husband take him up to Emerg.

As soon as they arrived, they were put immediately into a room and quarantined. They were concerned because my son had pooped green twice in two days, and because of his high fever. They were afraid he was contagious. My husband called me to tell me what was going on, and I really started freaking out. I was terrified, and I couldn't be there with him...they only allow one person to be there with the child when they're in quarantine, and I have two other children at home to care being a 6 month old infant who's breastfeeding. I was so afraid that he would have to stay in quarantine, and I couldn't be there because if he was contagious, I could get it and just through contact alone, give it to the baby. But see, I'm a mother BEAR. If my young are hurting, if they are afraid and need me, I will tear the head off of anyone who gets between us. I started looking into milk donors, just in case I had to go and be with him...I didn't want to give my baby any formula, and didn't know what was going to happen. I didn't want to wait until I was leaving for the hospital before I thought about how I was going to feed her.

Over the next four hours I got calls from my husband, and realized that the reason that my son probably had green poop was from the PURPLE JUICE he had been drinking the day before!!! (I know it turns green if he has BLUE juice, so why wouldn't it turn green with purple juice?!) When I told my husband that, he gave that message to the nurse, and suddenly my "highly contagious" son, was considered not so contagious. LOL Thank goodness for Momma Bear remembering that little poop fact! (Yes, this is what my life is now. Hahaha)

It was 5 hours after they left for the hospital that they returned home. I saw my husband pull into the driveway, and I ran outside to meet them. I had the side door of the van open before my husband even had time to get out. I wanted my boy! When I opened the door, he looked a little better than when he left, and still sounded weak when he spoke, but he was talking sense again.

My husband told me that I wasn't giving him enough Children's Advil. He was heavier than I thought he was, and so I was under-dosing him by 3mLs. That's a big difference when it comes to dosing for weight! My boy, who was born 10 weeks early and weighed 3 lbs., 14 oz., was now not quite 3 years old and was the height and weight of a FOUR YEAR OLD! I never would have guessed!

The Dr. who finally saw him (after 4 hours there) said that my son had a "stomach bug"...he was dehydrated, and needed to be kept inside for 3 days, and kept off of milk for 3 days. My husband was told that my son had "gastroenteritis", and he'd need to wait 3 days before eating solids again. When my son was feeling better, I Googled the things my husband had told me. I am 99% sure that my son had

The day after the big hospital fiasco, my older daughter (my son's twin), came down with it. I knew what it was as soon as she threw up a mouthful of bile. That was exactly what had happened with my son. She spent a day on the couch, and because she is definitely less than 34 lbs., I knew the dose of Children's Advil that I gave her would be fine. She ate soup and apple sauce for a couple of days, and as usual, made it through that illness much better than her brother did. (He's always been the sicker, weaker twin...right from the very start.)

What I'm happy about is knowing that if, in fact, they did have Rotavirus, each time they get it, it is easier and easier...and eventually they will have immunity to it. I would NEVER vaccinate my children against something that was perhaps the most mild form of a "flu" that I've ever seen.

This was also a good refresher for me when it comes to fevers. It had been over a year...closer to a year and a half...since either of them last had a fever that even needed meds. It was a good example of why we need to know how much the kids weigh. And it showed the very clear difference between a "typical" fever, and a fever that needed medical intervention. I'm glad we don't have to deal with these out of control fevers very often, and I'm glad that now I know how much the big boy weighs, so that if he gets another one that isn't "typical" in the future, I'll be able to treat it properly at home, and avoid the whole drama of quarantine.

**I do want to give the hospital credit for not trying to push vaccination on my child, even though I am sure that it is very clearly stated in his file that he is not vaccinated. I was expecting them to use this as a scare tactic, and I appreciate very much that they didn't try to do that here. It's amazing how different they are treated by the REAL doctors...the HEALERS...the ones at the hospital who still remember what their job is. xoxo

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