Dr. Zibners.com

How to know if your child's illness or injury is really an emergency

articles

Update: Week of February 15

This Week’s Hot Topic
Oh my goodness, are we really to Myth #1? I’m going to have to find a new list of topics to write about. But I won’t put this one off any longer, since we did start way back in September with our Top 10 Worst Myths about kids and their health. And really, Myth #1 is very appropriate today. Zoe is 4 weeks old today. 28 days. And for a pediatrician, this is a huge milestone because it means that if she gets a fever, I can be a lot less worried. And that is Myth #1: Fever is dangerous.

When your body gets sick, the immune system kicks in to start fighting the infection and runs a messenger up to the brain’s temperature center telling it to jack up the heat and help get rid of the bad guys. Therefore, when a fever is the result of being ill (as opposed to being locked in a hot car or some other outside cause of fever), it is the body’s own doing. And the body is not going to do anything to harm itself. Therefore, you should think of fever as a symptom, not a bad thing in and of itself. But parents often lose sight of this and focus on the fever, growing more and more fearful as the numbers grow higher. Pediatricians call this fear of the thermometer “Fever Phobia.”

Fever is a worry for certain groups of kids. If your child has other health problems that affect the immune system, such as cancer, then a fever with no other symptoms would prompt a call to the doctor. A baby under 3 months with a temperature of 100.4 F or higher also gets seen by the doc, and babies under 28 days usually have to spend a couple days in the hospital to make sure there isn’t a serious infection. But for kids over 3 months who are otherwise healthy, the presence of a fever is not nearly as important to me as how the kid is otherwise acting. I don’t worry about 104 F, I worry about how a kid is breathing, whether she is drinking enough to stay hydrated, if she’s showing any interest in the TV or playing games. Kids who are working to breathe, are very irritable or very lethargic or who have other worrisome symptoms need to be seen, regardless of whether their fever is 100 or 106.

Of course, fever makes us feel cruddy and a high temperature can make a kid breathe funny or be very irritable. While some doctors argue that you shouldn’t treat fever because fever can be beneficial to the immune system, I would say that if your kid acts like the fever is making him uncomfortable, go ahead and treat him with an age and weight-appropriate dose of an over-the-counter fever reducer such as ibuprofen or acetaminophen. (Aspirin is not appropriate for treating fever or pain in kids). Then if he is still acting really ill once he’s more comfortable, that is the time to put in a call to the pediatrician.

I’ll just end it here because I could go on and on and on. I did a whole chapter on fever and probably could write a whole book about why fever is scarier than it ought to be. We’ll address some more of this in the weeks to come because I’ve just got bunches on this one.

Dr. Lara Zibners, Feb 19, 2010

• Permanent Link »
• Leave a Comment »

Page 1 of 1 pages