So many of the calls that I get either at the office or during the night are from parents whose child has a fever. For those who are wondering how we Pediatricians define a fever, it is a temperature of 100.4 or more. Parents are often panicked because they are so afraid that their child will end up having a seizure or brain damage from the fever, and I will address these concerns below. I do want to state right off the bat that a child under 2 months old with a fever of 100.4 or more is an emergency as babies that young have immature immune systems and are in general at higher risk of serious infections. Other than that, a fever is not harmful. It is the way our bodies fight an infection, a sign that we are ill. It is not a disease but is a symptom that our immune system is being challenged. You do not have to treat a fever if a child is acting normally but often treatment is given because when the child feels ill, he or she doesn't usually want to drink fluids. Remaining hydrated is very important during an illness.
I do want to address the seizure/brain damage concern first. There are children that have a seizure with a fever and these are called febrile seizures. The incidence is 2-5% of children ages 6 months to 5 years. These children are prone to this and there is no way of knowing until it happens. A detailed explanation of this entity is beyond the scope of my blog but suffice it to say that these are not common, look scary but are not dangerous and have nothing to do with how high the fever is but rather how fast it went up. I also want to add that in 16 years as a Pediatrician, I have never seen brain damage from a fever. It is extremely rare as high fevers of 106 are also extremely rare. There are many old wives tales about fevers but please just keep the following in mind:
Treating a fever usually involves an over-the-counter medication such as acetaminophen or ibuprofen depending on the age of your child and some other factors. I also recommend having the child sip some cool fluids and place her in a tepid or lukewarm bath. Do not apply rubbing alcohol to the child's skin or in the bath water to lower their temperature. The alcohol can be absorbed through their skin and is toxic. It can cause a coma.
The bottom line is that all children get sick, and all children will have a temperature at some time or another. It is normal and does not mean that your child has a weak immune system. On the contrary, their immune system is doing what it was designed to do. Your job is to support them through the illness by keeping them comfortable and hydrated.