By Angela Pirisi
When her two-an-a-half month old Zack woke up with a raging temperature of almost 40°C, his parents were worried. “He started running a high fever and coughing like he was a 50-year-old smoker, so we immediately called our family doctor, who saw him right away,” says his mom, Pamela Barwell-Zega of Hamilton, Ont. After examining Zack, the doctor sent him to the ER where he was diagnosed with RSV, a type of respiratory virus, then sent home the same day. “When your child is young like that and can’t tell you where and what hurts it’s very frightening,” says Barwell-Zega.
Fever ranks pretty high among kids’ health ailments that freak parents out. Some of the concern is well placed. After all, fever, which is an increase in internal body temperature above its normal level, is a sign that the body is fighting off an infection. But the presence of fever isn’t always a sign of impending doom or a trip to the ER. “In the first year of life, the most common cause of fever is a virus, and the vast majority of viral infections are benign. In children three months and younger, there’s a higher risk of becoming severely ill with a bacterial infection,” says Dr. Mark Feldman, chair of the Community Paediatrics Committee for the Canadian Paediatric Society (CPS). A low-grade (mild) fever in infants can also result from overdressing or vaccination.
Taking a temperature
For babies, the most manageable, accurate method is to take a rectal temperature using a digital thermometer. A reading of 38.1ºC or higher constitutes a fever. Dr. Feldman adds that you have to insert the thermometer one inch to get an accurate reading. Use petroleum jelly to lubricate the tip to help the insertion. At this age, the other recommended — but less accurate — method is measuring under the armpit (axillary). Measured under the arm, a reading of 37.3°C or higher is a fever.
How to offer relief
So what do you do with a hot baby? Comfort is key. Offer plenty of fluids and remove extra blankets and clothing. Don’t strip them bare, since the body will cool down too quickly. “A child under two months of age with a fever should always be referred urgently to a physician, so I wouldn’t recommend medication for this age group,” says Laura Bolton-Debusschere, BSP, a staff pharmacist at Lakeview Pharmacy in Saskatoon. For relief, you can give acetaminophen to a child more than two months old, or ibuprofen if more than six months, she suggests.
Fear of febrile seizure
Parents often wonder what happens if a baby develops a seizure because of fever. The truth is, says Dr. Feldman, that they’re a lot more dramatic than they are serious. “Seizures occur between five months and six years of age, and there is no long-term harm or complications.” The CPS recommends calling 9-1-1 if the seizure is longer than three minutes, or if your baby is under six months.
Looking beyond the numbers
Don’t get bogged down by a thermometer reading and ignore the bigger picture – how does your baby look and feel? Is she refusing to feed? Is her skin pale or mottled? Does she seem less alert, sleepy or irritable? Coughing, wheezing and/or the presence of a rash should signal you to seek medical help too.
If you do administer fever meds, just know that they won’t reduce temperature to normal – that’s not the idea. “Rather than looking for a return to a normal temperature, look to provide some symptom relief for your child, such as lowering the fever enough and relieving aches and pains, so the child can sleep, eat, drink or play for a little while,” explains Bolton-Debusschere.
Angela Pirisi is a writer and worrywart mom whose blood pressure spikes along with her daughter’s rising temperature.
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