Doc Talk: Common questions and misconceptions about children and fevers

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Every family has been through it: the uncertainty when your child has a fever. Even though it's common, there are many misconceptions about it.

Every family has been through it-- the uncertainty when your child has a fever. Even though it's common there are many misconceptions about it.

Dr. Clint Pollack from Valley Children's Hospital has a few answers to common questions and clears up some common misconceptions.

  • Fever is 100.4 in infants and 101.0 in children. Temperatures less than that do not need to be treated with medicine.

  • Fever is almost always a symptom of infection.

  • Most infections in children are caused by viruses and do not require antibiotics.

  • Fever is not harmful or dangerous. It is a normal part of the immune response to illness.

  • Fever does not cause brain damage.

  • Fever can sometimes cause a seizure in young children, but these are generally harmless.

  • Fever makes the heart beat faster and makes a child breathe faster than normal.

  • Fever should be taken rectally in infants to be reliable.

  • Besides giving medicine, the best way to reduce fever is to remove clothing and wet the skin.

  • Children with fever should rest and drink plenty of liquids

  • A normal healthy child with fever for a few days does not need to see a doctor, unless there are other concerning symptoms.

  • These children should see a doctor:

  • - A newborn less than 3 months old with fever of 100.4 or higher.
    - A child with fever of 105 or higher.
    - A child with high fever every day for 5 days.
    - Children who have other serious medical problems.

  • The dose for Tylenol (acetaminophen) is 15 mg/kg and can be given every 4 hours.

  • - Liquid acetaminophen = 160 mg/teaspoon. 1 teaspoon = 5 ml.
    - That equals about 1ml for every 5 pounds.
    - Maximum dose = 1000mg or 4000mg/day.

  • The dose for Advil/Motrin (ibuprofen) is 10 mg/kg and can be given every 6 hours.

  • - Liquid ibuprofen comes in two strengths.
    - Infant drops = 50mg/1.25ml
    - Children's ibuprofen = 100mg/teaspoon
    - Maximum dose = 600mg or 2400 mg/day.

  • Acetaminophen and ibuprofen can be alternated every 3 hours, if necessary.

  • - Always check the box for proper dosing.


Here is the full transcript of our conversation with Dr. Clint Pollack:

Tony Cabrera: Dr. Pollock there are a number of misconceptions about fever. We all deal with it. We all get scared. We all get nervous. But let's just start with the basics. What is a fever?

Dr. Pollock: Well I'm glad that you asked. I think fever is the most miss understood, most feared thing that parents deal with, with their children. Fever is the body's immune response to generally infection and it raises the body temperature by increasing your muscle activity and that's why kids shiver. A lot of times when their temperature is going up and increasing metabolic activity in the liver and other parts of the body.

Margot Kim: So when is a fever a fever? Because, you know, mom's like to test the forehead. But there are certain numbers that are guidelines we should know.

Dr. Pollock: So it depends on the age. In a young baby, a newborn, and up to 3-6 months we consider 100.4 or higher to be a fever. And in a young baby you really want to take the temperature rectally because that's the only way you are going to get a reliable reading. You know, older babies and children a fever is a 101 or higher. So anything less than that 99 or 100 is not a fever and you don't need to worry about it and you don't need to give medicine for that.

Tony Cabrera: And at what point do you take them to the E.R.?

Dr. Pollock: So generally if kids have a high fever every day for 5 days or more. Or if they have a high fever like 105 or 106 or their very ill appearing like lethargic where they won't wake up or irritable or crying for hours on hours on end or a young baby one or two months or younger with a fever 100.4 or higher. Those are kids that should be seen.

Margot Kim: Thank you Dr. Pollock

Dr. Pollock: Thank You.
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