Fever: Friend or Foe?

Misconceptions about the dangers of fever can cause lost sleep and unnecessary stress for many parents. Let the following facts help you put fever into perspective:

MYTH: My child feels warm, so she has a fever.

FACT: Children can feel warm for many reasons, such as playing hard, crying or getting out of a warm bed. They are simply “giving off heat.” A child’s skin temperature should return to normal in 10 to 20 minutes. Once these causes are excluded, about 80 percent of children who feel warm and act sick actually have a fever. If you want to be sure, take your child’s temperature. The following are the cutoffs for fever using different types of thermometers:

• Rectal, ear or temporal artery thermometers: 100.4˚F or higher
• Oral or pacifier thermometers: 100˚F or higher
• Axillary (armpit) temperatures: 99˚F or higher

MYTH: Fevers are bad for children.

FACT: A fever between 100˚ and 104˚F is usually good for a sick child because it helps the child’s body fight infection normally.

MYTH: All fevers need to be treated with medicine.

FACT: Fevers need to be treated only if they cause discomfort. Usually that means fevers over 102˚ or 103˚F.

MYTH: Without treatment, temperatures will continue to rise.

FACT: Because the brain has a thermostat that regulates how hot the body can be, fevers from infection usually top out at 103˚ or 104˚F.

MYTH: Fevers can cause brain damage, and fevers over 104˚F are dangerous.

FACT: Body temperatures have to be over 108˚F to cause brain damage. Body temperatures only climb this high as a result of exposure to extreme environmental temperatures (for example, if a child is confined in a closed car in hot weather).

MYTH: With treatment, fevers should return to normal.

FACT: With treatment, fevers usually come down two or three degrees.

MYTH: If you can’t “break the fever,” the cause is serious.

FACT: Fevers that don’t respond to fever medication may be caused by viruses or bacteria. Whether the medicine works or not doesn’t relate to the seriousness of the infection.

MYTH: If I can “break the fever,” the infection will go away.

FACT: Fevers will normally last for two or three days until the body fights off the virus’s attack. This process cannot be hurried.

MYTH: Temperatures between 98.7˚ and 100˚F indicate low-grade fevers.

FACT: They are normal. Body temperatures change throughout the day, peaking in the late afternoon and evening. Low-grade fevers are actually between 100˚ and 102˚F.

MYTH: Febrile seizures (seizures triggered by fever) are harmful.

FACT: Febrile seizures are scary, but they usually stop within five minutes and cause no permanent harm. Children who have had febrile seizures do not have a greater risk for developmental delays, learning disabilities or seizures without fever.

MYTH: Anyone can have a febrile seizure.

FACT: Only four percent of children have febrile seizures.

Written by Barton D. Schmitt, MD, author of Your Child’s Health, Bantam Books, revised November 2007.