There is a popular fallacy which sets forth that the higher the fever. the sicker the child. It is also believed that fever is a child’s enemy, that it should be fought and the temperature brought to normal. The fact Is that children past early infancy tend to develop high fevers with little provocation. Relatively harmless illnesses like roseola often cause temperatures as high as 106-F, whereas many lethal diseases, such as leukemia and polio, may cause slight or no temperature deviations at all.
A child is as seriously sick as the illness warrants, not as a thermometer registers. A child with pneumonia or meningitis and a fever of 104″F is still as ill after the temperature is artificially reduced to normal. A child with a sore throat and 101°F fever is no less threatened than the same child with a sore throat and a temperature of 104″F. Prostration, disorientation, difficulty in breathing, and other symptoms are means to decide the illness’s severity, not the degree of fever.
Fever: friend and foe.
You should first regard a fever as a child’s friend rather than an enemy. A fever is an early warning signal that a child is ill and that you must look to find a cause. It is also a helpful barometer to judge, together with other symptoms, when an illness is ending. The course of a fever indicates whether or not an antibiotic is working effectively. It speeds up the body’s metabolic processes (possibly including its immunizing mechanisms) and in some instances may help the body’s defenses overcome an illness. Finally, the pattern of daily fluctuations in a fever may be characteristic of particular illnesses and aid the parent or doctor in making a correct diagnosis.
A high fever does have disadvantages, however. It makes a child feel bad and, as it develops, causes chills. If a fever continues for days, it will debilitate a child and cause weakness and the need for a longer recuperation period. In susceptible younger children a fever may precipitate convulsions. For all these reasons, it is sensible to reduce a fever. But it is important not to confuse treating the fever with treating the illness and not to panic as a fever rises or to harm the child in your anxiety to fight the fever.
A matter of degree.
At any given moment, different parts of the body are at different temperatures. Moreover, normal temperatures vary as much as two to three degrees Fahrenheit over the course of a day even when a child is healthy. A rectal temperature of 99.8°F or less, an oral temperature of 98.6°F or below, and an armpit temperature, though the least accurate, of 98°F or less are all considered normal.
Despite these variances, all thermometers are marked to indicate 98.6°F as normal. A rectal thermometer differs from an oral one only in having a more rugged bulb. (The most practical instrument for home use is a stubby bulb thermometer, which can be used to take a child’s temperature in either of the preferred ways.)
Any type of thermometer—rectal, stubby, or oral—can be used to take a rectal temperature. If the oral one is pressed into service, extra care must be taken because of its more pointed and fragile bulb. For the most reliable readings at any age, the rectal thermometer is recommended, although it takes a bit more time for a fever to register.
Taking the Temperature.
Understanding and treating a fever in a child
No one can estimate the degree of a fever by touch; not even a mother. If your child feels warm or appears ill, you must use a thermometer to attain the information you and your doctor need to treat the child. Read the thermometer before inserting it to be certain the mercury column is below 99.8°F and the bulb is intact. Spread the child’s buttocks widely enough with the thumb and forefinger of one hand so the anal opening is clearly visible. Lubricate the bulb and insert it gently into the center of the anus. There should be no pain or discomfort. (Only the bulb portion of the thermometer needs to be inserted for the two to three minutes required to obtain an accurate reading.) You can sufficiently restrain a baby by placing him or her face down on a solid surface and putting the heel of your hand firmly on the lower back. An uncooperative toddler can be firmly clasped between your thighs and bent forward over one leg in a position to expose the target.
Although less reliable, an oral reading will suffice and can be taken in a child who is old enough to hold the bulb of the thermometer under the tongue for three minutes. (If a child accidentally swallows the mercury in the thermometer, don’t fret. Thermometers contain elemental mercury, a nonpoisonous and harmless form of the metal.)
Care of Your Thermometer.
After each use, the thermometer should be shaken down below “normal” and washed with soap and cold water. To sterilize it, you may soak the thermometer in an alcohol solution before storing it in its case. Place it back in the medicine cabinet where it will be handy the next time you need it.
“But my child won’t let me take his temperature,” some parents report. Here’s an opportunity to teach a child one of the important lessons he needs to get along in the world: self-control. Self-control is merely the internalization of the knowledge that one’s actions are capable of being controlled. You demonstrate this to your young child by restraining him from dashing into the path of a truck, taking a hatchet to a peer, or the TV set…and by firmly insisting that he allow you to take his temperature. A calm but determined approach to all of these situations can reassure the child that you are a capable parent upon whose wisdom, strength, and judgment he can depend for guidance and support.
Treatment of Fever.
The most reliable medications for lowering fever are aspirin and paracetamol, a pain reliever found in some over-the-counter preparations. Oral preparations are best, but rectal suppositories are permissible if a child is vomiting or unconscious. Sixty milligrams of either may be given for every 12 pounds of the child’s weight and repeated every four
hours if necessary. This formula works out to one children’s aspirin for every 15 pounds of weight. If the fever does not respond to either aspirin or paracetamol, the drugs may be given together in the same dose. Keep a feverish child lightly clothed or covered to allow the body heat to escape. This, too, will help lower a fever.
Other methods of reducing a fever include placing the child in a cool bath; encasing the nude child in a wet sheet; washing the child down from chin to toe with rubbing alcohol diluted with an equal amount of water; administering a cold enema; and packing ice bags around the child’s body. These methods are seldom necessary, not recommended, and are generally resisted by the child. And none is obligatory unless the temperature goes over 106°F for a sustained period. If the temperature rises that high, the child is better off under the care of a doctor who can employ a thermostatically controlled cooling device to lower the temperature.
Fever is a tool. Learn to use it properly to make your child well again.
Tags: child illness, General Illness, Children's health
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