After posting my last blog post on Tylenol (a fever reducer) being a culprit to childhood seizures, I was reminded by a friend about the danger of high fevers causing brain damage.  Since I believe in being armed with knowledge to handle future problems, here’s some information on how to evaluate and treat a child’s fever.  It comes from A Guide To Child Health by Michaela Glocker, but I’ve condensed it and changed some phrases to be more simply understood.

• Tempuratures up to 99.5 degrees farenheight are considered normal.

• Temperature between 99.5 and 100.5 is elevated (considered a low grade fever)

• Temperature 100.5 or higher is considered a fever

• If child’s skin is cool but fever is over 104 or if he has a seizure, call your doctor immediately.  If you cannot reach a doctor, administer a fever-reducing suppository containing an age appropriate does of paracetamol/acetaminophen and take the child to the hospital

• A child’s temperature can become elevated from wearing too much clothing.  In infants, this type of temperature disappears quickly by removing a hat and leggings

• Vigorous movement can cause body temperatures to rise.  Check again after baby has been lying still for a half hour

How high a temperature is safe?

There is no hard-and-fast rule.  Any newborn with a temperature over 100.5 degrees for several hours should be seen by a doctor.  Do not delay if the baby is not drinking or seems unwell. A fever that is higher than 105 degrees or fluctuates by more than 2.5 degrees should be evaluated by a physician.

** With all other cases, the decision of whether or not to consult a doctor should be based on factors other than the fever itself.

Signs of fever/Treating fevers

If your child seems different or you “don’t like how she looks”, it’s time for more detailed observation.  How is she moving?  Is she imitating others as she normally does?  Check her eyes nostrils and breathing; feel the warmth on her forehead, neck, torso and limbs.  Touch her stomach and notice any signs of pain.  Take her temperature.  If you are unfamiliar or concerned with the symptoms you observe, call your doctor who will ask you more questions about her appetite, bowel movements, vomiting, etc.

If the skin on her arms and legs feels cool and temperature is approximately 101.5

You can be sure that her temperature will continue to rise because her body has not yet given off heat through the extremities.  Her calves and feet will feel hot only when the fever has stopped rising and the body is actively attempting to eliminate excess heat. Do NOT under and circumstances apply cool compresses to her calves during the initial chill stage, but applying hot compresses made with arnica essence to the wrists and ankles is helpful.  In addition, cover the child warmly and give her some hot herb tea (chamomile is soothing and calming).  (Note that some children may be allergic to arnica.)

If her skin feels hot all the way to the calves

Apply leg compresses if her temperature is over 102 degrees.  Cool sponging can also be used, but only if it feels comfortable to the child.  These measures support the body’s effort to eliminate excess heat through the skin.  At this stage in a fever, it is important not to obstruct the escape of heat.  In cooler climates, keep your child covered, but not as warmly as when the fever was rising.  Non-chemical fever suppositories such as Weleda Chamomilla comp., Wala Aconit/China comp., or Heel Vibrurcol will help your child feel better and can be used if her extremities are not yet hot.

If your child has a febrile seizure and his skin is hot

Cool him down by wrapping him in a damp towel (water should be at room temperature)

A child with a rising fever

Feels unwell and vomits readily.  She may have a headache or stomach ache that will lessen when the fever peaks.  Do not force her to eat, but give her warm herb tea if she asks for something to drink.

Feeding a child with a high fever, but no diarrhea

Give her plenty of fluids (Slightly sweetend herb tea or milk diluted with the same amount of water, or cool luke warm diluted fruit juice (cherry, blackcurrent, pear or lemon).  A bland diet is required with no potatoes and little fat or protein; no nuts, chocolate, etc.  Do not try to maintain weight in a child with a fever; she will quickly gain it back after the illness is over.

Clothing and bedding

Must be carefully adapted to the temperature of the room and the stage of the child’s fever.  Here are some general guidelines: Fresh air, but no drafts.  In cooler climates, if the window is open, your child should stay well covered and wear a hat and a sweater if needed.  Even in the heat of summer, keep him covered, at least with a sheet.  Your child’s limbs should stay warm and he should feel comfortable.

A restless child

May refuse to stay covered and want to get up and run around in spite of a fever.  He needs the calming presence of an adult who will sing, hum, tell stories or engage in some other quiet activity.

It’s useful to have a portable cot to move around the house so that the child can be near you as you work.