TAMC: Tips if your child has a fever

By Dr. Grace Chen O'Neil Tripler Army Medical Center Department of Emergency MedicineMay 21, 2018

TAMC: Tips if your child has a fever
Nyan Schoeman, left, licensed practical nurse at the Tripler Army Medical Center, TAMC, Pediatric, Adolescent & Young Adult, Pediatric Patient-Centered Medical Home, PCMH, checks vital signs during a physical exam for Matthew Parobek, center, with Sa... (Photo Credit: U.S. Army) VIEW ORIGINAL

HONOLULU (May 18, 2018) - Fevers can be a concerning symptom for parents. Your child may not act like their normal self when they have a fever. They may be more fussy and irritable. They may be more tired than usual, have a poor appetite, and they may experience other symptoms associated with an infection that they are fighting such as a sore throat, stuffy nose, cough, vomiting, diarrhea, or ear pain.

A fever stops the growth of dangerous bacteria and viruses and is usually not dangerous; it is often a symptom of another problem.

Most fevers are of short duration and actually protect the child from infection. It is usually the body's reaction to an infection or other illness. The brain will raise the body's temperature to combat the illness. The fever itself usually does not cause long-term brain damage unless it is over 106 degrees Fahrenheit.

Everyone has their own regular body temperature, which is usually around 98.6 degrees Fahrenheit, plus or minus one degree. Most people have some change in their body temperature during the day. It is generally lower in the morning and higher at night. It can also increase when children run around and exercise.

Smaller infants can get fevers if they are in a hot environment or wearing too much clothing because their temperature regulation is not well developed yet.

Children can also get a fever after getting immunizations, and teething might cause a slight rise in body temperature but likely is not the cause of a temperature higher than 100 degrees Fahrenheit.

A rectal temperature of 100.4 degrees Fahrenheit or more is a fever.

The most important things to do if your child has a fever is to improve your child's comfort by doing several things:

Most people feel better when a fever is treated with medications that reduce the temperature, such as Tylenol or Motrin. (Motrin should only be given to children older than six months of age. Please read instructions on the bottle or ask your doctor for dosing.)

Children will feel the effects of the medication in about 30-60 minutes after administration. Motrin and Tylenol can be given at the same time since they are different types of medications.

More children maintain more relief when both medications are given rather than when one medication is given alone. Motrin is given every six to eight hours, and Tylenol is given every four to six hours. However, there is no need to wake your child up from sleep to administer medication for fever if your child is comfortable sleeping.

Children with a fever usually have a faster than average heart rate and breathe faster than normal. So make sure your child is well-hydrated and getting plenty of fluids to avoid dehydration because a fever will cause more fluid loss.

Reasons to see the doctor right away include:

1. Your child has been in a hot place such as a closed car in the summer.

2. Your child has a sunken soft spot on their head, cannot tolerate fluids, has not made a wet diaper for a long time, or has other symptoms of dehydration.

3. Your child looks very ill, is inconsolable, or unusually sleepy.

4. Your child is taking steroids or has an illness that compromises the immune system such as sickle cell disease or cancer.

5. Your child is younger than three months.

6. Your child has a severe headache and stiff neck, cannot swallow or has a rash.

7. Your child has a seizure.

8. Your child is having difficulty breathing.

Please make an appointment with your child's doctor if your child seems to be getting worse despite the fever being brought down, or if the fever persists more than 24 hours in a child younger than two years old, or persists more than three days in a child older than two years old.

There are multiple ways to schedule an appointment for your child if needed, at your convenience. You can schedule a variety of appointments at any time online by visiting the TRICARE Online Patient Portal at https://www.tricareonline.com, or call the Tripler Appointment Line at 808-433-2778 or 1-800-322-TAMC (8262) to schedule an appointment. The Tripler Appointment Line is open Mon. through Fri. (except holidays), 6:30 a.m. - 4:25 p.m. To reduce unnecessary appointments and stress you can communicate virtually and directly with your health care team by accessing the RelayHealth Patient Portal at https://mil.relayhealth.com.

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