Fever part 4: The Fever Action Plan
In prior posts, we’ve covered what a fever is, and why the body runs a fever, and how to tell if a fever is something serious to worry about. Putting all of this together in one practical plan has been the goal of this series. We want to keep children healthy and safe, and avoid unnecessary Emergency Room visits—while looking out for occasions when a child might really need evaluation right away. So here it is, what you’ve been waiting for, The Pediatric Insider fever “action plan.” Clip and save, or even better, share this with friends to bring more eyeballs to my blog. You found it here first!
What to do if your child feels like he has a fever
1. If your child looks very ill—he’s unresponsive, having trouble breathing, or has a blue or grayish color—call 911 or bring him to the nearest emergency room.
2. If the child has not reached his four month birthday, measure the fever with a thermometer, rectally. If the number is 100.4 F or higher, call your child’s pediatrician for instructions. Fevers in very young babies are far more likely to be caused by a serious problem, and usually need to be evaluated right away. Even if the measured temperature doesn’t show that your baby has a fever, call your pediatrician if your child seems unwell.
3. If your child has a poor or abnormal immune system, or has a disease that you’ve been told predisposes to serious infections, call your physician. You should also contact your physician if your child has a fever and has not been immunized—these kids are at much higher risk for serious bacterial infections that may need urgent evaluation and therapy.
The remainder of this action plan is only for normal, otherwise healthy and immunized children 4 months of age or older.
4. (Optional) Measure the temperature in an appropriate way with a thermometer. There is no reason to check a rectal temperature on an older child. An axillary (armpit) or temporal artery temperature is a good enough estimate. (I haven’t found ear thermometers, pacifier thermometers, or skin thermometer strips to be accurate) If you don’t have a thermometer handy, it is not essential to measure the temperature; but it can be handy for monitoring to keep track of the temperature trend, especially if the fever lasts more than a day.
5. If you child feels ill (achy, or just “blah”), give a dose of fever-reducing medicine such as acetaminophen or ibuprofen. You’re giving the medicine to help your child feel better—not necessarily to reduce the fever—but it will probably help the fever drop, too.
6. After the fever decreases, see how your child feels. If he’s still feeling ill, contact your physician for instructions or bring him to the doctor. If he’s looking and feeling better, see how he’s doing in the morning and call your pediatrician for a non-emergency appointment within a few days for evaluation if the fever or other symptoms persist.
Fever itself can be an unpleasant symptom, often accompanied by chills and aches. Parents should treat fever with medicine not because the fever itself is harmful, but to help the child feel better. Even if the fever medicine doesn’t reduce the temperature back to normal, it will help how your child feels. It’s also easier and more accurate to judge just how sick a child is after the fever has been brought down.
During a fever, you’ll also want to offer your child extra fluids. It doesn’t matter what Junior drinks, as long as it’s wet. Milk and other dairy products are fine during a fever (even an extremely high fever isn’t nearly warm enough to “curdle” milk.) Jello, applesauce, pudding, ice cream, and Popsicles are all also good choices. For little babies, encourage frequent nursing or offer an extra bottle. If your child doesn’t feel like eating, that’s OK—as long as he’s drinking, he won’t get dehydrated.
“Fever phobia” is an unwarranted fear that fever is really going to harm your child. In the past, fevers could often have been a harbinger of a truly devastating illness. Nowadays, almost all of the serious fever illness are easily prevented with vaccines and simple hygiene. The few serious fever illnesses that still occur are far more easily recognized and managed. Though fever ought to be treated if it makes your child feel bad, it’s nothing to be afraid of. Protect your child with vaccines, look out for the few red flags that we’ve discussed, and help your child stay comfortable when the occasional fever strikes.
Previous posts in this series:
Part 1: What is it?
Part 2: Why?
Part 3: Dispelling fever phobia