Ask What is considered a mild, moderate and high fever in a child?
by Marilyn M. Doyle, MD

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Fever is a symptom; it lets you know your child has an infection. The infection is the problem, not the fever. Although most parents fear fever, it is not dangerous; in fact fever helps the body fight infections. The body maintains the temperature in a safe range, below 105 F. Infants and young children have immature immunologic systems and cannot fight infection as well as older children and adults. Generally they need to see the pediatrician earlier in the course of an illness. Infants<3 months of age with temperature > 100.4 F must be evaluated by the pediatrician as soon as possible. This is especially true for infants < 1 month of age who are usually admitted to the hospital for antibiotics and observation. Most pediatricians will want to be notified when an infant of 3 to 6 months has a temperature > 101 F and an infant > 6 months of age has fever of > 103 F.

More important than the height of the fever is an assessment of how ill the child appears. If your child continues to eat and drink well and is somewhat playful and active, it is unlikely he/she has a serious illness and you may observe at home. A child who is lethargic, has severe sore throat, ear or abdominal pain, cough, repeated vomiting or skin rash should be evaluated by the pediatrician.

Because fever is actually helpful in the face of infection, it is not necessary to treat it especially if it is less than 101 F. Treat the fever if the child is uncomfortable, has history of febrile convulsions, or a chronic disease which impairs the ability to tolerate fever. Treatment is usually with medicines such as acetaminophen and ibuprofen. Generally ibuprofen should only be used in children older than 6 months. Sponging is a time-honored and effective home remedy. Use tepid, not cold water, and do not use rubbing alcohol.

Fever may be confused with heat-related illness or heat stroke. The body temperature may rise above 105 F and occurs when a child is placed in a hot environment such as a closed car in the summer, or is bundled and overdressed in hot humid weather. This is an emergency; the child should be cooled by sponging with cool water, moving the child to a cooler environment, and seeking emergency medial care.

Occasionally fever will precipitate seizures in young children (6mos to 5 yrs). These seizures tend to occur early in the illness and may be the first clue that the child is ill. The seizure is usually generalized (the whole body shakes or stiffens as a unit) and brief (less than 5 minutes). Frequently there is a family history of febrile seizures. While the episode is frightening to parents, febrile seizures are almost always harmless; they do not cause brain damage. However, the child needs to be evaluated by the pediatrician or in the emergency room especially if the seizure is prolonged (>10 minutes), occurs more than once, or starts in one part of the body.

Ask is intended for consumer education only. Always seek the advice of a physician or other qualified health care provider with questions regarding your personal health or medical condition.