In Childhood Fever, When to Call Your Doctor?

welling_child_feverIn an active Homeopathic practice around 20% patients are from the pediatric age group. Though offering positive change to their health is a very satisfying feeling in itself, sometimes, over anxious parent especially the first time parents take even a slight increase in temperatures as something very serious.  Further,in India, conventional doctors prescribe antibiotics over enthusiastically to please parents, while the innate immune power of the child would have been enough to fight off the infection leading to fever.

A fever is usually a sign that the body is fighting an illness or infection. Fevers are generally harmless. In fact, they can be considered a good sign that your child’s immune system is working and the body is trying to heal itself. While it is important to look for the cause of a fever, the main purpose for treating it is to help your child feel better.

What is a fever?

A fever is a body temperature that is higher than normal. Normal body temperature varies with age, general health, activity level, and time of day. Even how much clothing a person wears can affect body temperature.

Most pediatricians consider a temperature above 100.4°F (38°C) a sign of a fever.

When to call a doctor?

In general, you should call your Pediatrician or seek medical attention for fever when:

  • an infant under two to three months old has a temp at or above 100.4 degrees Fahrenheit (38.1 degrees Celsius)
  • an infant that is three to six months old has a temp at or above 101 degrees Fahrenheit (38.3 degrees Celsius)
  • an infant six to twelve months old has a temp at or above 103 degrees Fahrenheit (39.4 degrees Celsius)
  • a child over twelve months old has a temp at or above 103 degrees Fahrenheit (39.4 degrees Celsius) and the fever does not improve with home remedies and a fever reducer

Remember that how high a fever is doesn’t necessarily tell you how sick your child is. Whatever your child’s temperature, even if your child doesn’t have a fever, if your child is very irritable and doesn’t have some playful moments or is not eating and sleeping well, you should still call your Pediatrician.

It is important to keep in mind that children normally have higher temperatures than adults, so a rectal temperature under 100.4 is often considered to be normal in a child under age 3 years. And it is hard to believe that he would have regular fevers for 4 months without any other symptoms.

Some Important Facts About Fever

  • Fevers are most worrisome in children less than 3 months of age. At this age, a child with a rectal temperature of 100.4° F or greater should be seen by a doctor immediately.
  • When a child has a fever, the main concern is how sick your child seems. This is much more important than the height of the fever. High fevers are not usually dangerous. The height of the fever alone does not indicate the seriousness of the infection.
  • Temperature strips on the forehead are inaccurate.
  • Ear thermometers are not very reliable in children less than 6 months of age, or for temperatures over 102° F.
  • High fevers do not cause brain damage unless greater than 107° F or associated with diseases that affect the brain, like meningitis (an infection of the fluid that covers the brain and spinal cord).
  • Do not give over the counter tablets to infants younger than 2 months of age with a fever without notifying your doctor’s office first. If your baby is less than 3 months of age, and you are concerned that he or she feels warm, take a rectal temperature, which is definitely the most accurate method for infants. Call your doctor immediately if the temperature is 100.4° F or greater. If your baby is bundled, this can cause an elevated temperatuare. Unwrap your baby and retake the temperature in a half hour.
  • Breathing rates and heart rates are increased with a fever.
  • Seizures associated with fevers only occur in about 3 to 5 percent of the population and these are called febrile seizures. They are generally harmless. See febrile seizures below.
  • Teething does not cause a significant fever (not greater than 100.4° F).
  • A common viral infection called roseola affects infants from 6 months to about 3 years of age. There is a fever for two to three days and then as the fever goes away, a rash develops. The rash is flat and pink or slightly raised dots. It looks like an intense heat rash. It is mostly on the neck and body and lasts one to two days. Once the fever is gone for 24 hours, the child is not contagious. There is no specific treatment for the rash. About 10 percent of viruses cause fever and rash.
  • Fevers are usually caused by viruses or bacteria. Viruses are the most common cause of fever in childhood.
  • External sources of heat can be dangerous. Heat illness occurs because of excess heat exposure. There is a range of severity of this disease. Mild symptoms can include muscle cramps, stomachache and headache. Heat stroke is a life-threatening emergency associated with temperatures over 106° F (41° C) and confusion, and is usually brought on by vigorous exercise in the heat.

Seven serious symptoms in babies that you should never ignore:

1. Blue lips (cyanosis)

Cyanosi is when  your baby’s lips are turning blue, or the mucus membranes in their mouth or tongue turn blue. This can be a sign that they are not getting enough oxygen.

If your baby is turning blue, go immediately to the nearest hospital.

2. Strained breathing

All babies grunt and groan from time to time. But if their breathing is consistently hard and fast, and you can see that they are using their chest muscles more than they should be and that their nose flares out, it may be a sign of respiratory distress,

If your baby has strained breathing call your pediatrician right away, and if it is after-hours, consider a trip to the nearest Hospital.

3. Fever over 100.4 F or 38 C in a newborn

If your infant is less than two months and has a rectal temperature greater than 100.4 F, call your pediatrician. Fever in a newborn is very non-specific, it can be anything from a cold to meningitis, and we treat a fever more seriously in newborns. Always take a newborn’s temperature rectally because other ways are not as accurate in newborns

Call your doctor if your newborn has a fever. A fever is not always serious in older children with more developed immune systems.

4. Worsening jaundice (yellowing of the skin)

If your newborn is getting yellower and yellower after birth, he or she may have worsening jaundice.

Most jaundice is not dangerous, some is normal and will go away on its own, but if it is increasing as opposed to going away, it may need an evaluation.

Bilirubin is produced by the liver. If bilirubin levels skyrocket, they can affect the brain, causing seizures and permanent damage.

Most doctors will recommend feeding your infant more frequently, so that the baby gets rid of excess bilirubin in his or her stool.

The next step is to place the baby under ultraviolet (UV) lights (phototherapy) to increase the breakdown of bilirubin.

5. Dehydration

You should be worried about dehydration if your baby is not making wet diapers, there should be one diaper for every day old up to six days of age, and then six wet diapers a day going forward.

That at least means two diapers for two day-olds, three diapers for three-day-olds, and so on. Others signs of severe dehydration may include dry mouth, sunken eyes, and lethargy.

Call your doctor for advice right away if you think the baby is dehydrated

6. Throwing up bright green bile

Children throw up all the time. They throw up from coughing too hard, crying too hard, eating too much, and from those ubiquitous stomach bugs.

If they throw up greenish bile, however, it is serious. Vomit that looks like dark coffee grounds can also be serious.

Green bile can indicate that the intestines are blocked, which needs immediate attention.  Call your pediatrician immediately when your child throws up green or dark bile.

In general, it’s always better to be safe than sorry. When in doubt, always trust your gut and call your doctor.

What is your experience in managing childhood fevers? Mention in the comments.

3 thoughts on “In Childhood Fever, When to Call Your Doctor?”

  1. Dr.Sourabh Welling,M.D.

    Thanks for dropping down to read our blog.

    Generally Homeopathy is safe for any age group. Being gentle on the body and medicines being easier to be taken, its perfectly fine to start the Homeopathy treatment anytime the child is ill.

  2. Thanks for the info Doctor. We have been following this advice
    for the last 2 years since my kids have started the homeopathy treatment at
    Welling Clinic.

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