by Kimberly Allen RN
Frequently I have parents coming to complain that their children have a fever. It’s 98F and humid out and the children are wearing t-shirts and pants. Everyone is hot when the temperature outside is hot. A fever in healthy kids is usually not an indication that something is wrong. Infants and young children are unable to regulate their body temperature because the hypothalamus, the body’s thermostat, is not fully developed. As a rule children’s temperature fluctuates as they run around and play and it is usually higher in the evening .
Though it can be frightening when your child has a fever the fever itself is not harmful and in many cases is a good thing. a fever is usually a routine symptom and is the body”s way of fighting an infection. However, it’s important to note that a high fever does not necessarily mean a serious infection. In truth while a minor or mild illness can cause a high fever a serious illness may only cause a low fever. Fever’s are one of our body’s natural defense mechanisms against viruses and bacteria that are unable to survive at higher temperatures. That’s one of the reasons doctors recommend not treating “low grade fevers”, unless there are other problematic symptoms with the fever.
Because we are all individuals with individual metabolisms etc there is no exact body temperature that is considered to be normal but a range. In a healthy adult, male or female, the range for a “normal” oral temperature is 91.8-100.8F (33.2-38,2C), for under the armpit 95.9-98.6 (35.5-37.0C), ear drum 95.7-100F (35.4-37.8C), and rectal is 93.9-100F (34.4-37.8C). In the Harrison’s text book of internal medicine a fever is defined as being over 98.9F in the morning or over 99.9F in the evening. Your “normal” body temperature is affected by many factors including your age and sex, environmental temperature, time of day as well as your activity level to name a few. for example when you exercise your body temperature rises but it’s not considered a fever. In the same way children will have higher body temperature when running around and playing which frequently seems more pronounced when it’s a hot day. On the other hand many elderly people tend to have lower body temperatures because their ability to generate heat has declined so a temperature of 99.1F may be significant if their “normal” is lower.
There are different types of fever depending on it’s pattern. a continuous fever is when your body temperature stays above “normal” all day without fluctuating more than 1degreeC in a 24hour period. An intermittent fever is when the temperature is above “normal” for only a time and then returns to “normal” and then rising again cycling back and forth. A remittent fever is one that is above “normal” all day however, it fluctuates significantly. The Pel-Ebstein fever is specific to Hodgkins lymphoma alternating high one week then low the next.
Do not confuse hyperthermis with fever. Hyperthermia occurs because of a malfunction in the way your body responds to heat. Hyperthermia is almost always caused by your environment like when it’s very hot out or you’re in a very warm room.
Fevers above 104F require immediate treatment at home and then either at your Doctors office or your local emergency room. While low grade fevers do not require treatment frequently treating low grade fevers can either prolong an illness or even mask symptoms making it more difficult to diagnose the underlying cause. In fact many experts believe that aggressive treatment of fevers inhibits our body’s natural immune response. Many fevers can be treated by removing some clothing, unbundled your infant if it’s warm. A cool bath, not cold, and loose light weight clothing may be all that’s needed. If your child is uncomfortable you can give either children’s ibuprofen and never give aspirin to children. Other medications may be given depending on the underlying cause of the fever. Your Dr will only prescribe antibiotics if there is a bacterial infection.
Try to remember it’s best to use as little medication as possible to avoid over doses or damage to the lever or kidneys. be sure you and your children are hydrated and use non-medicinal methods like minimal loose light weight clothing and cool baths to reduce body temperature. Also remember that if it’s a hot day and you’re hot and miserable your children usually are too.