Parents commonly think of fever as the number one enemy when their children get sick.  This leads them to battle fever aggressively wit all the medication and sponge baths they can give.  This is based on the mistaken notion that the fever itself is a disease and can easily harm a child.  Fever is not a disease but rather a symptom, showing that a fight against a disease or infection is going on inside the body.  In that fight, excess heat is generated in the core of the body and is dissipated to the head and limbs, where it radiates off the skin.

 

In general, pediatricians recommend not trying to lower fevers under 101 F taken rectally or by ear and they certainly don’t want parents to consider fevers in and of themselves as threats to the well-being of their children.  It should be said, however, that fevers in infants less than three months old are of much more concern than fevers in older infants.

 

The main reason to treat a fever is to reduce your infant’s discomfort and the risk of dehydration.  When fever is present the body loses more fluid that it does under normal conditions.  You don’t need to treat a fever with medication until your baby’s rectal or ear temperature goes over 101 F and preferably only then if your child seems uncomfortable.  Light clothing, extra fluid and a pleasant cool room are better treatments unless the fever is higher.

Febrile seizures can be frightening for parents.  The condition shows up in 2 to 4 percent of children between the ages of 6 months and 5 years old.  They are not usually the sign of a ongoing problem and won’t mean long term damage for your child.

 

Often times febrile seizures are the result of a sudden change in body temperature.  The culprit may be an infection that the parents aren’t even aware of until the seizure hits.  Most febrile seizures develop very quickly from the sudden rise in body temperature but can also result from body temperature dropping.

 

A child having a seizure may have a high fever (normally over 102 F) and shake his or her arms and legs.  They may lose consciousness during a febrile seizure and roll his or her eyes back in the head.  Other symptoms include trouble breathing, crying or moaning.

 

There are two different classifications of febrile seizures.  The simple febrile seizures are most common and can last anywhere from a few seconds to 15 minutes.  These type stop on their own.  Complex febrile seizures last longer than 15 minutes and may be limited to one side of your child’s body.

 

If your child experiences a febrile seizure, have them evaluated by your doctor as soon as possible.  Even if the seizure only lasts a few second, contact the doctor as soon as it is through with and schedule an appointment.

 

 

Laryngitis is an inflammation of the vocal cords located in the larynx. Laryngitis is usually associated with a weak, hoarse voice, sore throat and sometimes a fever. Coughing and tickling in the back of the throat often occurs.

 

The most common cause of laryngitis is a viral infection. It may hang around after the initial infection is over. You will know the infection is over when the fever and ill feeling are gone.

 

Laryngitis can be quite irritating. People that use their voices a lot are often more susceptible to getting laryngitis. This includes singers, cheerleaders, auctioneers and polititions.  Young children that cry a lot or shout while playing can easily get laryngitis. Smoking and second hand smoke can contribute as well, or cause the irritation to last longer.

 

The treatment of laryngitis is as follows:

• Sucking on cough candies or lozenges
• Quit smoking or do not smoke around your children
• Avoid smoky places
• A humidifier will often help
• Gargle with warm water and salt
• Speak soft and do not whisper
• Try a hot shower
• Drink warm liquids 

Some signs that it is time to see your family doctor:

• If you have a hard time breathing
• If you are hoarse for more than one month
• If you are gasping or drooling
• If you have a deep cough
• If you have a fever over 101 degrees

If you have any questions or concerns about laryngitis consult your family doctor.

A kiss on the forehead, or a hand placed on the skin isn’t enough to tell your if your child has a fever. This method of taking temperature is dependent on the person doing the feeling;  it doesn’t give an accurate reading of the child’s temperature.

By using a thermometer you can tell if the child has a fever or if their temperature is higher that one of the following levels:

• 100.4 degrees fehrenheight measured rectally
• 99.5 degrees fehrenheight measured orally
• 99 degrees fehrenheight measured under the arm (axillary)

Whatever kind of thermometer you use, be sure you know how to use it correctly to get an accurate reading. Keep and follow the instructions that come with the thermometer. Digital thermometers provide the fastest most accurate readings. They come in all sorts of shapes and sizes and can be purchased at grocery stores and pharmacies.

Many digital thermometers can be used for these temperature methods:

• Oral (in the mouth)
• Rectal (in the bottom)
• Axillary (under the arm)

Electronic thermometers measure the tympanic temperature inside the ear canal. They are quick, accurate and easy to use in older children. They are not as accurate on younger children as digital thermometers are, and are more expensive. Do not use the ear thermometer on a child less than three months of age. If your child is younger than three months old, you will get the best reading using a digital thermometer to take a rectal temperature. If the child is three months to four years old, you will get an accurate reading using a digital thermometer to take a rectal or axillary temperature. And if the child is four years old or older you can use a digital thermometer to take an oral temperature.

To take an oral temperature, follow these steps

1. Wait 20-30 minutes after a child has eaten or drank anything
2. Place the tip of the thermometer under the tongue and get the child to close lips around it. Tell them not to bite down or talk. Just get them to relax and breath through the nose.
3. Wait until the thermometer beeps the appropriate amount of times. Read and write down the number on the screen, and the time of day.

To take a rectal temperature:

1. Lubricate the thermometer tip with a water soluble jelly
2. Place child face down in your lap, supporting the child’s head. You can also lie the child on a firm flat surface
3. Firmly, but gently place a hand on the child’s back to hold them still
4. With the other hand, insert the thermometer through the anal opening about ½ to 1 inch into rectum. Make sure you stop if you feel any resistance.
5. Make sure you steady the thermometer between your second and third fingers as you put your hands against the child’s bottom. Talk to your child as you hold the thermometer in place.
6. Wait until you hear the right number of beeps. You can keep a record of this if you so decide.

To take an axillary temperature:

1. Remove child’s shirt or undershirt, and put thermometer under the child’s armpit.
2. Fold your child’s arm across their chest to hold thermometer
3. Wait for the appropriate amount of beeps. You can write this temperature down and note the time of day. You should call your family doctor if you have any questions.

The Kawasaki Disease (KD) is a non-specific disease that attacks the mucous membranes, walls of the blood vessels, heart and lymph nodes. The cause of KD hasn’t been determined.

It was first described in Japan, and now it is more frequently noticed in the USA. The risk factors, other than age, are unknown. KD is a disease of young children, with 80 % of affected children younger than five years of age.

This disease is poorly understood. It appears to be an autoimmune vasculitis, which is an autoimmune disorder. This disorder affects the heart, lymph nodes, walls of the blood vessels and the mucous membranes. The cardiac complications are the most important part of the disease. KD can cause vasculitis in the coronary arteries and it can also cause coronary artery aneurysms. Aneurysms can lead to a heart attack even in children, but are very rare.

This disease often begins with a high fever that isn’t very responsive to normal doses of acetaminophen or ibuprofen. The fever may last up to two to three weeks. Children develop red eyes, red cracked lips, strawberry tongue, and swollen lymph nodes. The child may get skin rashes or flaky peeling skin in the genital area, hands and feet.

The following are some symptoms of Kawasaki Disease:

• Fever that is higher than 102 degrees ferenheight and after 104 degrees fehrenheight that remains high for more than three days
• Fever that doesn’t respond to fever-reducing medications
• Bloodshot or red eyes
• Red chapped, or cracked lips
• Strawberry tongue, white coating or red bumps on the tongue
• Swollen hands and feet
• Peeling palms and sloes
• Rashes, non-blister like
• Swollen lymph nodes
• Joint pain

A physical examination will demonstrate many of the symptoms listed above.  A child with KD will be hospitalized. They will be put under the care of pediatric, cardiology and infectious disease doctors. It is important that treatment is started as soon as possible to prevent damage to the coronary arteries and heart.

 

Intravenous gamma globulin is the standard treatment for this disease and is given in high doses. Usually improvement is noticed within 24 hours of treatment. Patients with this disease should have an echocardiogram every 1-2 years. Call your doctor if the symptoms of KD develop. Your doctor should evaluate a high-grade fever that is unresponsive to fever-reducing medication and lasts more than 24 hours. There are no known measures that will prevent this disease.

Croup is a respiratory viral infection that causes inflammation of the trachea and larynx. The air passage becomes swollen, which leads to blockage due to excessive amounts of mucous production. During the child’s respiration process, the air passage partially collapses, causing difficulty in breathing.

It is the partial collapse of the air passage that causes the child to have the “barking ” cough that is characteristic of croup.

Croup will usually last five to six days, and is usually more common in the winter months and in the early spring.  Usually children five years old and younger are more susceptible to croup.  Premature children are also more susceptible. 

If you are unsure if your child has croup, some of the most common symptoms are:

•  hoarseness
•  fever
•  hacking, ‘barking’ cough 

The infection may also cause a crowing noise (called Stridor) as the child breathes in through a narrow windpipe.  The symptoms of croup tend to affect children from ages one to three years old more severely, and can be worse at night.

Some other causes of croup include rhinovirus, influenza, adenovirus, Para influenza, RSV, and the measles.  Usually children with mild croup can be treated at home.  When a child has a croupy cough, you want to increase the amount of liquids that they intake.  Cough medicines are not usually recommended. However, you can give your child Children’s Tylenol or Infant Tylenol; this will help with chest discomfort or fever.

If your child’s croup symptoms are severe and don’t seem to be responding to home treatment, call your family physician.  The doctor may prescribe a medication to aid in reducing the swelling in the child’s air passage.  Watch the child closely and phone your family physician if:

• Your child starts drooling
• Has difficulty swallowing
• If the child’s lips and skin are bluish
• If the child’s breathing becomes difficult

If you have any concerns about croup, or you think your child may have these symptoms, consult your family physician.

 

A febrile seizure is a convulsion triggered by a fever in children. These convulsions happen without any underlying spinal cord or brain infections, or any other neurological reason.

Around 3-5 % of healthy children between nine months and five years old will have a seizure caused by a fever.  Toddlers are usually the most affected.  There are tendencies indicate that  these seizures can run in families.

Mostly, febrile seizures are caused by a rapid rise in the bodies temperature over 102.2 F. Most occur within 24 hours of an illness.  The seizure is usually the first sign of a fever.

The febrile seizure is very frightening for parents.  Parents are often afraid that the seizure will cause death or brain damage; they feel helpless; or even guilty.  It is important to understand that simple febrile seizures are harmless. There are no statistics that show the febrile seizures will cause epilepsy, mental retardation, death, brain damage, learning difficulties or decreased IQ in later life.

Most of the time febrile seizures are caused by fever associated with viral respiratory infections, roseola, or ear infections. Something that should always be considered is that meningitis causes less than 0.1 % of febrile seizures, especially in children under a year old. Meningitis could also be suspected in children that still look sick when the fever comes down.  A febrile seizure stops itself anywhere between a few seconds, up to ten minutes after onset. This is usually followed by a drowsiness or confused state.  Generally an anticonvulsant drug is not needed. 

The complex febrile seizure lasts longer than fifteen minutes.  This occurs in an isolated part of the body, or is a recurrence during the same illness. One third of children who have had a febrile seizure will have another with a fever. Of the children that do, about half of them will have a third seizure. Very few children have more than three of these seizures in their lives. Febrile seizures can be as mild as the child’s limbs stiffening or eyes rolling.  Often a fever triggers full body convulsions.  Febrile seizures may begin with contractions of the muscles on both sides of the child’s body. This usually happens to the muscles of the face, legs, arms and trunk. The child usually lets out a cry or a moan; this is caused by muscle contractions.  The contractions continue for seconds, or tens of seconds. The child will fall, if standing, and may pass urine.  They may vomit, or bite their tongue. The child could stop breathing and may start turning blue.  This is understandably a terrifying ordeal for parents.

During the seizure, leave the child on the floor.  You may slide a blanket under them if the floor is hard, to protect their head.  Only move the child if the area it they are in is dangerous. Loosen any tight clothing, especially around the neck area. If you can, remove clothing from the waist up.  If your child vomits, or if there is a build up of saliva or mucous, turn the child onto their side or stomach.

Do not force anything into the mouth to prevent biting on the tongue, and do not try to restrain the child.  Apply cool washcloths to neck and facial area to help bring fever down.  You can sponge the rest of the child’s body with warm (not cold) water.  Cold water can increase the fever.  When the seizure is over and the child is awake, administer the normal dose of ibuprofen or acetaminophen.  If the seizure lasts for several minutes call 911, and have the child taken to the hospital by ambulance. 

Children should see a doctor as soon as possible after their first febrile seizure. Until you speak with a doctor, you cannot be sure thta your child has experienced this harmless type of seizure.  A child should see a doctor if the seizures keep reoccurring during the same illness, or if it looks like a different type of seizure. Consult your family doctor if you have any questions or concerns about febrile seizures.

Every parent must be ready for his or her child to wake up with a fever in the late night hours. The most important thing to remember is not to panic. Fever is the body’s natural way to fight off infections. Do not rush in and give medication for the fever such as acetaminophen or ibuprofen, not all fevers need medication.

There are different things can cause a fever besides the bodies need to fight infection; the child could be dressed too warmly, immunizations and teething. Low-grade fevers do not need medication unless it is associated with pain such as teething or immunizations. You can then give a fever reducer more for the relief of pain than anything else.

Most of the time doctors will not recommend giving any fever reducer unless the child’s temperature is 102 or over orally and 100.4 rectally in infants. If the temperature is this high then you should go the emergency room to ensure that there is nothing else going on with your child. Normally if your child is still playing, eating, drinking, alert, smiling, and their skin is of normal color the illness is probably not serious and could be no more than a common cold.

Choosing a thermometer may be a very hard decision for some parents. You can choose from digital thermometers, electronic ear thermometers, plastic strip thermometers, forehead thermometers, pacifier thermometers, and glass mercury thermometers. The most important thing to remember is how to use the thermometer properly. Each one has there own features and it will be your choice as to which one works better for you and your household.

After you have taken your child temperature and you are sure there is nothing else medical wrong the best you can do is make your child feel better. If you can tell they are in pain and you wish to make them more comfortable so they can get some rest you can give them acetaminophen or ibuprofen. Be sure to give only what is necessary for their weight or age. If the child is under two consult your doctor before giving any medication. A lukewarm bath can also aid in lower the fever and making your child feel better. Do not use rubbing alcohol or ice packs. Alcohol can cause poisoning when it is absorbed into the skin and ice packs can cause chills that can in fact raise the body temperature. Do not overdress your child while they have a fever. Make sure the temperature in their room is neither too hot nor too cold. Give them plenty of liquids to ensure they do not become dehydrated, however do not give them colas or any drinks with caffeine.