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Treating Fever in Young Children
Q: What do you do about a high fevers in a young child? My three-and-a-half-year-old son recently had a cold and stuffy head, and was running a moderate fever (around 100 degrees). We put him to bed, gave him lots of juice and water, and some children's Tylenol for the fever. Since I don't like to give him medicine too often, I was wondering if there is an agreed-upon temperature at which a child should be given medication, or does it depend more on how a child is behaving?
A: Fevers are very common, often making young children feel uncomfortable and just not act like themselves. In turn, fevers also cause lots of anxiety in parents. It is important for you to understand fevers so that you can feel comfortable in your approach to caring for your child.
A temperature greater than 100.4 degrees F is defined as a fever. A healthy child's temperature fluctuates within a normal range. We all tend to have higher temperatures in the later afternoon and into the evening. Fevers are common with many of the routine illnesses like ear infections, throat infections, and even the common cold. High fevers do not cause brain damage. Fever is actually a positive sign that your child's immune system is functioning to fight infection. In fact, some infectious disease specialists even recommend not overmedicating your child with things to bring the fever down. It is also important to realize that it's not necessarily how high the fever is, but how comfortable or uncomfortable your child is with the other symptoms of the illness. As you point out, fever alone may make a child very uncomfortable, and if he is, using one of these medications (e.g., acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) may help.
There are things you can do, other than giving medication, when your child is not feeling well and has a fever. Dress your child in light clothing. Give him a bath with lukewarm water. Encourage him to drink liquids as much as he can and allow him time to rest. If your son is not behaving the way you're used to giving a dose of acetaminophen or ibuprofen may help. If it doesn't, then a phone call to your child's doctor is warranted. How is your child behaving? How comfortable are you with your child's degree of illness? These factors are more important than how high his fever is.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.