FAMILY TIME: Fretting and Sweating Over a Feverish Child

I TURNED AROUND and looked into the glassy eyes of my 3-year-old, who minutes before had been playing happily.

“Mommy, my whole body hurts.”

I knew instantly. Her eyes told it all.

“Sweetheart, I think you’re sick,” I said as I put my hand on her suddenly hot little head.

We zipped her forehead with our “forehead thermometer” -- why we waited three years to get a temporal artery thermometer, I don’t know -- and measured her fever at 102.4 F. It was time to break out the children’s ibuprofen.

Half an hour later, her fever was way down. But, after a movie, she was starting to droop again, her fever at 102+. Fifteen minutes later, it was 104.5. I served up the children’s acetaminophen, gave her some ice water to sip and watched for the telltale signs of the fever dropping.

Instead, her cheeks flushed and she didn’t want to drink. Within minutes the temp soared past 105. Time to take a bath. We’d been through this once before when she was a baby. Her temperature had reached 105 and the doctor had advised a lukewarm bath.

This time, though, she wasn’t a baby and wasn’t so excited about the prospect of getting wet. It didn’t matter though. Within minutes, her temp was 106.3 and I was done fighting it on my own. I re-dressed her in loose-fitting clothes and ran her out to the car, then headed to the emergency room.

They took her right away and checked her vitals. Thankfully, the fever had started to drop. We spent four hours in an ER treatment room. They monitored her fever, maintained the acetaminophen/ibuprofen schedule I’d started and tested her for common, fever-inducing maladies such as ear and bladder infections, strep throat and the flu, which is apparently going around.

In the end, we were sent home with a sick, acceptably-feverish kid with some sort of virus. “I wouldn’t have done anything differently,” said the kind and reassuring nurse, “except maybe take off her clothes to help let the heat escape before bringing her in.”

This fever was gone within two days, but I know it won’t be the last. At home, I decided to learn a bit more about fevers.

According to the Evergreen discharge papers they gave us, a fever is present when someone’s temperature is above 99.5 degrees Fahrenheit when taken orally and over 100.4 degrees when taken rectally or in the ear. “Fever is a natural reaction of the body to an illness,” the papers state. “It actually helps the body to fight infections. In most cases, the temperature itself is not harmful.”

In fact, it says that temperatures under 101 oral or 102 ear or rectal do not need to be treated unless the child is uncomfortable or has a history of febrile seizures – and those are quite uncommon.

Pediatric Associates, which has offices around the Eastside including Totem Lake, addresses several myths about fevers on their website, www.mypediatricassociates.com, based on information from "Your Child's Health," by B.D. Schmitt, MD.

They debunk several myths that I found interesting. First, a high fever does not necessarily indicate that the child has a serious illness. Instead, how sick your child looks and acts is a better indicator. Second, a high fever doesn’t cause brain damage until around 108 F, and that apparently doesn’t happen from infection or virus. A temperature that high can only be caused by an environmental factor such as a child being trapped in a hot car.

THIS IS ALL vaguely comforting. But, as a mom, I still want to do what I can to manage my children’s fevers. While this is not a complete guide to caring for your sick child and is in no way a replacement for checking with your own healthcare provider, here is a summary of how to care for your child’s fever, according to the Pediatric Associates site:

1. Take your child’s temp. Rectal and temporal artery measures are the most accurate, followed by mouth, pacifier and ear. Armpit measures are the least accurate, but recommended for babies under three months because they are the easiest. (Note: If your newborn has an armpit reading over 99, it is recommended that you take a rectal reading and see a healthcare provider immediately.)
2. If your child’s fever is under 102 F, the only recommended treatment is light clothing to help keep the child cool and plenty of fluids to keep him/her hydrated.
3. If your child is uncomfortable, which typically happens over 102 F, you can provide appropriate dosages of acetaminophen and/or ibuprofen. See the Pediatric Associates website for more information, or check with your own doctor.
4. If your child’s temperature goes over 104 F, you can help reduce it with a sponge bath. Place your child in 2 inches of lukewarm water and sponge water over his or her skin. Rather than cooling through immersion in cold temperatures, this more effective cooling method works through evaporation.
5. Call your doctor immediately if your child is under three months old, has a temp over 104 F that has not responded to fever medication after two hours or your child looks or acts very sick.

So, all in all, fevers really are our friends. They help our bodies fight the germs and generally pose no real danger. As long as you manage discomfort, stay hydrated and allow the heat to escape, most fevers will run their course – and win their fight – in just a few days. When they get to high, like my daughter’s did the other day, it’s a good idea to call in the pros. But chances are, these fevers too will settle out, do their job and leave us on the mend in a matter of days.

For now, though, I’m happy to report that we are fever free. So long, friend. Thanks for stopping by and doing your job. We hope you’d don’t come knocking though, for a good long while.