When Baby Has a Fever

As a new parent, perhaps the hardest thing to come to grips with, is the realization that this precious being is wholly dependent on your care and good judgment. This realization comes into explicit focus when your baby has their first fever. Unless you have medical training, you need to get information from someone that you can trust. In most cases, your pediatrician is the best person to provide this and it’s a good idea to ask for his/her recommendations during one of your early check ups.

It’s also a good idea to supplement your understanding of childhood illnesses with books like the Merck Manual or research on the internet. In a pinch, your insurance provider may have a Help line where you can to speak to a registered nurse 24 hours a day. Being prepared with some basic information about fevers will help alleviate some of the fear that is natural for a parent to feel when their child is sick. As a former nurse and mother of four, I’d like to offer some basic guidelines to help you get your bearings when confronted by a feverish babe.

General guidelines are:

•  If your baby is less than 3 months old and has a temperature of 100.4 degrees F (38 degrees C) or higher, call your doctor immediately or proceed to an emergency room if you are unable to reach your doctor. A baby this young needs to be checked for serious infection or disease.

•  For a baby between 3 and 6 months old, call your doctor if their temperature reaches 101 degrees F (38.3 degrees C) or higher.

•  If your baby is 6 months or older, call if their fever reaches 103 degrees F (39.4 degrees C) or higher.

When you call, the doctor or medical practitioner will ask you about other symptoms. Besides their temperature, the most important thing is how your baby looks and acts. Make sure to mention any changes in their behavior and appearance, such as a rash, a cough, difficulty breathing, signs of ear pain, vomiting, or diarrhea. Loss of appetite, low energy, being noticeably pale or flushed, or extreme irritability can all be signs that they need be seen by a physician. With all this information, the doctor will be able to tell you how to care for your baby and whether or not you need to come into the office.

Often, a fever that doesn’t stop your child from playing and feeding normally may not be cause for alarm – especially if there are no other abnormal symptoms. Keep in mind that everyone’s temperature rises in the late afternoon and early evening and falls between midnight and early morning. This natural cycle of our internal thermostat explains why most emergency room visits for fever occur in early evening.

Should I give them fever reducing medicine?

If your baby is under 3 months old, your doctor will probably ask you to bring them in to be examined. She may tell you not to give your baby any fever-reducing medicine until she has taken an accurate temperature reading.

If your baby is 3 months or older and has no other symptoms that suggest a serious illness, your doctor may advise giving them children’s acetaminophen (or ibuprofen, if your baby is at least 6 months old) to bring down the fever.

You should never give a baby under 4 months old acetaminophen, or any drug, without your doctor’s okay because the side effects could be dangerous. Never give your baby aspirin. Aspirin can make a child more susceptible to Reye’s syndrome, a rare but potentially fatal disorder.

Unless your baby is less than 3 months old, your doctor will probably tell you that if your baby is reasonably alert, taking fluids, and has a temperature that you’ve been able to keep below 102 degrees F (38.9 degrees C) with the recommended dosage of acetaminophen or ibuprofen, you can wait 24 hours before bringing them in. Because fever is often the first symptom of an illness, a doctor may not find anything significant if your baby is examined too early. In 24 hours, the crisis may have passed or other symptoms may be present that will help your doctor to diagnose your baby.

Be very careful when administering medicine to your baby. Their weight must be known to determine the right dose. Always use the measuring device that comes with the medicine or an oral syringe to give your baby exactly the right amount. Never give any fever-reducing medicine more often than is recommended.

No matter how old your baby is, if they have symptoms that suggest a serious illness or infection, the doctor will instruct you to bring them in to be evaluated, either to her office (if you call during working hours) or to an emergency room.

Why is it important to try and bring a fever down?

Fever is a symptom that can be associated with a wide range of diseases and conditions. Studies have shown that fever helps the body to fight infection by creating an internal environment that is inhospitable to bacteria and viruses, which thrive around 98.6 degrees F, or 37 degrees C.  A fever also triggers the body to make more white blood cells and antibodies to fight infection. A fever indicates the body’s immune system is hard at work.

On the other hand, if your baby’s temperature is too high, they will be too uncomfortable to eat, drink, or sleep, and that will make it harder for them to get better. If your little one’s fever isn’t affecting their behavior, you don’t need to give them anything to lower it. Offer your babe plenty of breast milk or formula and water to prevent dehydration, and don’t overdress or bundle them up when they’re sleeping.

Are there other ways to bring my baby’s fever down?

You can try to lower your baby’s fever by sponging them down with lukewarm (not cold) water or giving him a lukewarm bath. I have soaked my children’s cotton socks in cool lemon water and then, after wringing them out by hand, put them on their feet. While this is a folk remedy, it seemed to pull the fever away from their head and their socks dried out quite quickly. Lemon seems to have a drawing effect and I’ve used it to soak  a washcloth to place on their foreheads as well.

Never try to reduce a fever by sponging down your baby with rubbing alcohol. Isopropyl alcohol will be absorbed into your baby’s bloodstream through the skin and can be toxic. It can also cool them down too quickly, which can actually raise their temperature.

Why does my baby’s fever keep coming back?

Fever-reducing medicines bring down body temperature temporarily but they don’t affect the bug that’s producing the infection. Your baby may run a fever until they have fought off the infection and won. This is one of the ways that their immune system is strengthened. This process can take at least two or three days. Some infections, such as influenza (the flu), can last five to seven days. If your baby has been given antibiotics to fight a bacterial infection, it may take 48 hours until you see a significant drop in temperature.

My baby has a fever and no other symptoms. What’s wrong?

There are many viral infections that can cause a fever without any other symptoms. Some, such as roseola, cause three days of very high fever followed by a light pink rash on the trunk. Babies very often get a fever associated with teething pain or after receiving a vaccination. More serious infections, such as meningitis, urinary tract infections, or bacteremia (bacteria in the bloodstream), may also trigger a high fever without any other specific symptoms. If your baby has a high fever and no other symptoms – call your doctor.

Get in touch with your physician immediately if:

There are convulsions or if he or she is confused and disoriented.

They have pain that is acute and persistent.

They have diarrhea and vomiting.

Any time the child complains of hurting when urinating.

They have any unexplained rash.

The child complains of ear pain.

They have labored and rapid breathing.

They have sudden personality change, such as an active baby becoming dull and listless.

They have headache, with complaints of their neck hurting.

Finally, when you do see your doctor, it’s a good idea to have a written record of the child’s symptoms and temperature readings at various times of the day. If the symptoms have changed over a period of time, have them written down as you may forget to mention something that could be important. Also, write down the last medication given and the name and dosage of the drug given.

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