Dr. Zorba Paster: Not all children's fevers should be treated the same - Madison.com
Dear Doc: Whenever my child is sick, I get out the thermometer. If their temperature is above 98.6, I treat it. I've heard that might not be the best thing for my child. Any truth in that? — Kim, from Edgerton
Dear Kim: My mom was one of those — if I felt hot, she took my temperature and then dissolved an aspirin in a spoon and gave it to me. Tylenol had not been invented, nor had ibuprofen.
I can still taste that disgusting stuff in the spoon — and, by the way, it was the wrong medicine to give. If a child has a viral infection and you give aspirin, it can cause Reye's syndrome, a rare serious event that causes swelling of the liver and brain. It can affect kids and teens, especially after influenza. Bad choice of drug for those situations.
And that's why you have to wonder whether we should give fever-reducing drugs in the first place. For a fever of about 100 degrees, it's best not to give anything. Better to make your child more comfortable by putting a cold washcloth on their forehead and making sure they're hydrated.
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Fever is nature's way of fighting infection. Some doctors, and I'm one of them, think if the fever is minimal, let it run its course. That might be better for your child's body in the long run because you might be helping them produce a more robust immune response.
Now, how do you take their temperature? Well, back in the day, it was only with an oral mercury thermometer; I bet lots of my readers remember those. Your mom would put it in your mouth and you had to keep it under the tongue for a good 5 minutes.
Try that sometime when you're sick and nauseous. Yuk. My mom wanted to take my temperature the more accurate way, using a rectal thermometer. I won't go into the specifics, except that when I was 8 years old or so, I refused to do it and my mom was furious. But enough of that.
The new oral thermometers you can read in 30 seconds are good, if your kid closes their mouth and it's under their tongue. The ear thermometers are good, as long as your kid's ear isn't stuffed with wax — in which case, it will give you an error message.
As for the forehead thermometers, which have gained in popularity over the past few years, they're not as accurate if your child is sweating or if you hold it too far away from the forehead. Read the instructions carefully before you use it.
And don't depend on one reading. Take one, wait a minute or two, and take another. You'll get better accuracy with two readings than with one.
So, before you dose your child with fever-reducing medication, try a cool washcloth, as I mentioned above. Putting on cool clothing, keeping the room cool and making sure your child isn't overexerting themselves also will help.
And remember hydration, hydration, hydration, especially with something kids love — popsicles.
Now, there is one caveat here: Infants and newborns 3 months or younger. If they have a fever, it's a horse of a different color. That means call your doctor to tell them about the fever; your child needs to be seen.
A fever in a child that young could be something very serious, and every child that age with a temperature needs to be examined. For older kids, a fever of 104 or greater that lasts more than 24 hours means they should be seen, too.
My spin: If your child has a low-grade fever of 100.4 or less, try to treat it without giving them Tylenol or ibuprofen. If their fever is higher, treat it based on symptoms. If it's 104 or greater, especially with treatment, and doesn't get better, it's time for a phone call. Stay well.
This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.
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