7 Things You May Not Know About Fever in Babies

Evonne Lack

It’s heartbreaking to witness any kind of discomfort in your baby, but there’s something about fever that’s particularly unnerving. High temperatures have been known to cause such fear among parents that it has its own catch-phrase among medical professionals: “fever phobia.”

Have a touch of fever phobia yourself? Arm yourself with the facts, and you’ll rest much easier.

1. Fever starts at 100.4

Your baby wakes up with flushed cheeks, his skin radiating heat. Sure enough, the thermometer confirms your suspicions, reading 99.9 degrees. Should you dive for the medicine, or better yet, the phone? Nope. In fact, your baby doesn’t even qualify as having a fever.

Even for the very youngest infants, a core body temperature below 100.4 degrees is simply a variation of good old 98.6. Babies’ temperatures – like adult temperatures – can rise slightly for all kinds of reasons, from physical exertion to a warm bath to being overdressed.

Even time of day can have an impact, with body temperatures rising in the late afternoon and dropping in the early morning. So unless the thermometer reads 100.4 degrees or higher, you can consider your little one fever-free.

2. Bacterial fever is different from viral fever

One reason parents tend to worry when the mercury climbs is that they confuse garden-variety viral fevers with the more serious bacterial fevers.

A viral fever occurs when the body fights off an illness caused by a virus, be it an intestinal illness, the flu, or the common cold, explains Carrie Brown, a pediatrician at Arkansas Children’s Hospital.

Viral fevers tend to subside within three days. Antibiotics have no effect on viruses and should not be prescribed.

Bacterial fevers, on the other hand, occur when the body fights off a bacterial infection, such as an ear infection (which can be bacterial or viral), a urinary tract infection, or bacterial pneumonia. Bacterial infections are less common than viruses – and more concerning, because they can lead to serious illness if left untreated. Antibiotics are usually required.

If your baby’s fever lasts longer than three days, it’s time to see a doctor.

3. For babies under 3 months, fever is urgent

If your baby is under 3 months old, your fever phobia is warranted. A temperature of 100.4 or higher in a baby this young is considered a medical emergency.

Call your baby’s doctor immediately, and make sure he or she understands that your baby is younger than 3 months. If medical advice is unavailable, go to the emergency room, even if it’s the middle of the night. Don’t administer fever medicine (unless the doctor advises it) – you don’t want to mask any symptoms before your baby is examined.

There are two reasons for the urgency. First, explains Brown, the protective layer of cells between the bloodstream and the central nervous system is very thin in young babies. This means that in bacterial infections, the bacteria can “cross over” and cause damage rapidly.

Second, as New Jersey emergency room physician Tyeese Gaines explains, “Young babies don’t show signs of severe infection like older babies do.” It’s scary to think about, but a young baby can develop a full-fledged blood infection (sepsis) and not display the typical symptoms.

If the fever is viral, there’s no need to worry about sepsis. But the problem is that it’s impossible to distinguish between a bacterial fever and a viral fever with the naked eye. For this reason, young babies with fevers may need blood and urine tests to determine whether there’s a bacterial infection and a spinal tap to see if it’s meningitis.

4. Rectal temperatures are the most accurate

You may be reluctant to take your baby’s temperature this way – but the best way to get an accurate temperature reading is with a rectal thermometer.

“Only a rectal thermometer gives a true core temperature,” says Gaines. “Underarm readings, forehead thermometers, and even ear thermometers aren’t nearly as accurate.”

Because some non-rectal thermometers read too high, their use can lead to both unnecessary stress and wasted emergency room visits.

5. Treat the symptoms, not the number

Many parents believe that the higher the fever, the sicker the child, but that’s not the case. A baby with a temperature of 103 degrees may appear perfectly comfortable, contentedly playing on his mat, while a baby with a temperature of 101 may be fussy, tired, and need constant holding.

Does this mean that if your feverish baby is comfortable, he doesn’t need a fever reducer? That’s right. As pediatrician and American Academy of Pediatrics spokesperson Janice Sullivan puts it, “Treat discomfort, rather than fever.” And keep in mind that fever actually helps the body fight illness.

Instead of focusing on the thermometer’s fluctuations, pay attention to other signs to determine how sick your child is. “It’s much more important to look at symptoms,” says Gaines. “Listlessness and fatigue, for example, are better indicators of illness than temperature.”

6. Use medications judiciously

Before whipping out the fever medicine, try bringing the fever down with a sponge bath. This old-fashioned remedy can be surprisingly effective. Use tepid water (85 to 90 degrees) to wipe down your baby’s skin, particularly the forehead and underarms.

If your baby seems very uncomfortable and sponging doesn’t do the trick, fever-reducing medication is a good way to go – with some important caveats:

• If your baby is younger than 6 months, doctors recommend acetaminophen rather than ibuprofen. Starting at age 6 months, most babies can take either acetaminophen or ibuprofen.
• Determine the dosage by your baby’s weight, not his age.
• Never give a child aspirin, as it has been associated with Reye’s syndrome, a rare but serious and sometimes fatal condition.
• Never wake your peacefully sleeping baby to administer fever medicine! If he’s sleeping, let him sleep – and get some rest yourself.

7. Fever is a healthy response

Despite what you may have heard, fever will not injure your child’s brain.

“In and of itself, fever does not cause any harm,” says Gaines. Even the febrile seizures that some children have in response to fever have never been shown to be damaging (nor can they be prevented by anti-fever medications).

When you’re rocking your hot baby in your arms and the anxiety starts to creep in, try to remember that fever is actually a sign of health. And don’t worry, your baby’s fever won’t climb indefinitely. Under normal circumstances, the body automatically begins to cool off at 106 degrees.

As Gaines explains, a rising temperature is the body’s way of fighting off invaders, whether from a virus, infection, or immunization. It may not be enjoyable – but at least you can rest assured that your baby’s immune system is doing exactly what it’s supposed to do.

Source: babycenter