Thursday, March 27, 2008


Fever Danger Signs

There are two important warning signs that you should look for when your child has a fever. If she has either of these symptoms, get her to the doctor right away.

Neck and back stiffness
Check to see if your child can bend her head so that her chin touches her chest or if she can bend over and touch her toes. If she cannot, she may have a stiff neck or back.

If you're not sure if your child has a stiff neck, click on the link below called "How to test for a stiff neck."

Video: How to test for a stiff neck

If your child has a stiff back and neck, this could be a serious danger sign of meningitis , an infection of the lining of the brain and spinal cord. The stiff neck and fever may also be accompanied by a severe headache.

Meningitis is a medical emergency, and the child with fever, headache and a stiff neck should get medical attention immediately.

See Meningitis for more information .

Skin bleedings
When you are looking for rashes, make sure to undress the child completely and examine her whole body. Check to see if your child has a skin rash with little purplish or tiny bright red spots. This may be skin bleedings.

Skin bleedings (petechiae)

Typical signs of skin bleedings are purplish patches (purpura) or tiny bright red spots (petechiae) that do not fade (blanch) when you press on them. Skin bleedings may be a sign of serious diseases like meningitis and sepsis , which is an infection in the bloodstream.

How to test for skin bleedings with a glass

To see what these skin bleedings look like, you can click on the link below called "How to test for skin bleedings." Sepsis and meningitis are medical emergencies, and require immediate medical treatment in an emergency facility.

Video: How to test for a serious rash

NOTE: Meningitis and sepsis are diseases that require prompt medical supervision and acute hospitalization.

Be especially aware of these danger signs if there have been any recent outbreaks of meningitis where you live.

When to Seek Medical Advice

See the doctor immediately or call 911 if your child has:
  • A fever and is under 3 months old
  • A fever of 105ºF (40.6ºC) or higher
  • A fever and obvious breathing difficulties
  • A fever and is having trouble swallowing to the point where she is drooling because she is unable to swallow her own saliva
  • A fever and is lethargic or listless even after taking anti-fever medicines
  • A fever accompanied with a headache, stiff neck, or purplish patches or tiny red spots on the skin
  • A fever and severe pain
  • A fever and is having a seizure
  • A fever and has reduced immune defenses (i.e. if the child is on chemotherapy for cancer)

Make an appointment with your doctor if your child has:

  • A fever and is between the ages of 3 and 6 months
  • A fever measuring between 104ºF (40.0ºC) and 105ºF (40.6ºC)
  • A fever and a lack of fluid intake
  • A fever and pain when urinating
  • A fever lasting more than 24 hours and your child is under 12 months in age
  • A fever for more than 48 hours and your child is between the ages of 12 months and 3 years
  • A fever and sore throat for more than 24-48 hours
  • A fever for more than 2-3 days and your child is over the age of 3
  • A fever and has recently returned from a trip abroad

What Is a Fever?

Video: The Doctor talks about Fever

We say that a child has a fever when the child's body temperature, measured in the rectum, is 100.4ºF (38.0ºC) or higher.

Many parents see fever in a child as something very serious. But fever, in and of itself, is rarely dangerous. It is the cause of the fever that doctors focus on, rather than the actual fever. In fact, a fever can be an important part of the body's defense against infections and shows that the body is trying to kill germs - such as the common cold - that make your child sick.

Most fevers are not serious. In fact, most can be treated with lots of fluids to drink, rest, lightweight clothing, and fever-reducing medicine like acetaminophen and ibuprofen - Tylenol or Advil.

Video: An active child with 103 ºF fever

How to measure fever?

When taking your child's temperature, don't just feel your child's forehead. You need to really take it with a thermometer, and all parents of young children should have a thermometer at home.

There are several types of thermometers available. Mercury thermometers used to be the norm, but should no longer be used since mercury is a toxin. Glass thermometers now use alcohol to measure body temperature. In recent years, electronic and digital thermometers have entered the market.

For the most accurate temperatures readings, the thermometer should be placed in the rectum. Watch the video below for instructions on how to take your child's rectal temperature.

Video: How to take a child's rectal temperature

More information on taking your child's rectal temperature:

Forehead strips, temperatures taken under the arm, or in the ear, are not as accurate as temperatures taken rectally.

Video: How to measure fever 1

Video: How to measure fever 2

Causes of fever

If you have taken the child's temperature and found that he or she has a fever, i.e. the temperature is in excess of 100.4ºF (38.0ºC), this could mean that your child is ill. But children can have an elevated body temperature for other reasons as well.

Children may run a fever after receiving a vaccination. They can also have an increased body temperature if they are wearing clothes that are too warm or too tight or if they are participating in physical activity. Also prolonged heat exposure, especially when accompanied by dehydration, can also cause an elevated body temperature.

However, the most common cause of fever is an infection. Common infections in children are infections of the respiratory passages (ear, nose, throat and lungs) and gastro-intestinal infections.

Children who are attending day-care or in their first year of school are particularly susceptible to infections because they are in contact with other children who may be ill. Children can also be easily infected if someone else in the family is ill.

Febrile seizures

Some children may experience seizures resulting from their fever. These seizures are known as febrile seizures (convulsions) and is one of the most common causes of seizures in children.

Febrile seizures affects approximately 4% of all children, and those affected are most often between the ages of 6 months and 4 years. Parents will find these seizures very frightening, even though the causes of the fever are usually mild infections of the respiratory or gastrointestinal tract.

The infections that lead to these seizures are almost always caused by viruses. The seizures themselves are usually caused by a rapid increase in body temperature in the early stage of an infection, which often takes place before the parents have even realized that their child has a fever. The seizures normally last anywhere from 1-5 minutes and will usually stop without treatment.

However, because febrile seizures can occasionally be prolonged, and can be caused by serious infections, you should seek emergency treatment in when your child has had a febrile seizure.

Home treatment

If your child has a fever, you can try the following treatments:
  1. Letting your child rest in a quiet room can be helpful.

  2. Give your child plenty to drink because fever can lead to dehydration.

  3. Dress the child lightly to avoid overheating, remove overly warm comforters and reduce the room temperature. Feverish children may feel cold, but over-dressing them will only make their temperature go up.

  4. If your child has a fever but can still be active, she can determine her own level of activity. Bed rest is only necessary if she prefers it.

  5. Check your child regularly for a stiff neck or for skin rashes.

  6. Children who have a fever but are otherwise in good condition do not need to take fever-reducing medication. You can give fever-reducing medicines your child if she is over 3 months old and her fever is higher than 102ºF (38.9 ºC) or if she is uncomfortable, listless or seems unable to drink enough fluid.

    Information about fever reducing medications:

    • Do not give fever-reducers to babies under 3 months old except as directed by a doctor.

    • The most common fever-reducers for children are acetaminophen (also known as Tylenol) and ibuprofen (also known as Advil or Motrin), which can be administered as liquid, tablets or suppositories. Read the suggested dosage information on the medicine's packaging to make sure that you give your child the correct dose, based on her age and weight.

    • Do not give your child a fever-reducer that contains acetylsalicylic acid , such as aspirin. This particular drug can have dangerous side effects and can cause the development of Reye's syndrome.

    • All anti-fever medicines have side effects: please follow package directions carefully. If you have any questions about dosing, or your child's response to the medications, talk to your child's doctor.

    • Rectal suppositories are not as reliable as oral medications, and should only be used if a child is vomiting or unable to hold down the oral preparations.

      Video: How to give your child a suppository

  7. Give fever reducers to children who have had previous febrile seizures or to children with epilepsy or a known heart conditions when their temperature reaches 101ºF (38.4 ºC).

  8. Keep an eye on your child's temperature and overall condition. Do not hesitate to call your doctor if your child's temperature is going up or if she seems to be getting worse.

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