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| |    Fever: 3 to 12 Years by Laura Jana, M.D., F.A.A.P. reviewed and revised by Lynn Cates, M.D., F.A.A.P. Not every child who feels warm has a fever Healthy children have normal changes in their body temperature over the course of a day. They can feel warm to the touch after simply running around and playing, or if they are dressed particularly warmly. When to take fever seriously Fever often serves a useful purpose in helping your child's body fight an infection. Rather than just paying attention to whether your child has a fever, it's more important to assess how long the fever lasts, how high it goes, and, most importantly, how sick your child seems. How high a fever goes doesn't necessarily predict how serious your child's illness will be. If in doubt, ask your child's healthcare provider: "At what temperature should I call again?" Often when children have temperatures above 101.5 degrees F (38.6 degrees C) or so, they tend to appear very sick. If you are unable to get the fever down with medication, or if your child still appears to be very ill, seek medical attention. Fevers often help in following the course of an infection, so many health professionals want to be informed if fevers continue more than a certain number of days without resolving. (I generally use five days as a rough rule of thumb). Also see: What's fever and what isn't? Don't depend on fever as your only sign of infection Even without a fever, you should watch for other signs of more serious illness such as severe headache or abdominal pain, lethargy, or difficulty breathing. Don't assume that a fever has to be present before seeking medical attention if you have concerns about your child's health. Common causes The most common causes of fever in children are generally the same as for you or me, viral illnesses. If your child has symptoms of a common cold, especially if she has been exposed to others with the same symptoms, but she's generally acting OK, there is less reason for concern. Typically, your child will get a fever at the beginning of a cold if she is going to develop one, and this is when she will be most contagious. The best approach is to limit her direct exposure to other people who are fairly sick, especially people with fevers. At this age, however, it is very impractical for your child to try to avoid anyone with a runny nose or cough. Teach your child to wash her hands frequently and avoid sharing cups and utensils with others. These simple measures are effective in reducing the spread of germs that cause colds. How fever affects your child's eating Children with fevers are often disinterested in food. I'm convinced it's a universal trait of parents to worry about how little food their children eat (of which I too am guilty). However, you shouldn't worry if your child does not eat during the course of a routine cold. You may find that your child is more interested in eating when her fever has come down, although I commonly find that it may take up to a week or so for a child's appetite to return to normal after an illness. Instead of focusing on food, direct your attention toward making sure that she gets enough to drink and doesn't become dehydrated. Keeping track of your child's fluid intake is much more important when she has a fever. Pay attention to how much and how often your child is drinking compared to her normal intake. Fever, as well as vomiting and diarrhea, can lead to dehydration. Children this age don't tend to become dehydrated quickly unless they drink very little, have persistent fevers over several days, or are losing fluids in the form of vomiting or diarrhea, or both. Offering small amounts of liquids more frequently is a good way to get your child to drink more fluids. Be creative in your attempts to keep her hydrated by offering items such as popsicles, ice cream, and Jell-O. Be sure to discuss with your child's healthcare provider any concerns you may have. Taking your child's temperature Getting an accurate temperature reading can be important, especially if your child has a high fever. If you have questions about which type of thermometer to use, don't hesitate to ask your child's healthcare provider because some types are more accurate than others. Needless to say, using rectal thermometers at this age is generally out of the question, and only recommended in rare instances. Also see: Thermometers and Techniques Treating your child's fever Some healthcare providers may feel that using medicine to treat a fever is unnecessary in a child who otherwise appears well (she's eating and sleeping well and behaving normally). However, if your child has a higher fever or is uncomfortable, then medication can be very useful when used correctly. Although providers have slightly varying approaches to managing fever, there are a few accepted rules to follow. Types of medication Acetaminophen (found in Tylenol®, Panadol®, Tempra®, etc.) is available in liquid, chewable, and suppository forms, as well as pills to swallow. It should not be given more often than every four to six hours. Ibuprofen (found in Motrin®, Advil®) is available in liquid and chewable forms, as well as pills to swallow. It should not be given more often than every six to eight hours and can sometimes cause stomach upset or irritation, especially if given repeatedly and on an empty stomach. Do NOT use aspirin for fever in children. Dosing If you are giving your child a liquid form of acetaminophen, be sure you know exactly what type of liquid form you have, because there are many types available and the strength of medication will vary. Dosing is based on your child's weight, so be sure to ask your child's provider for an appropriate dose. It can change as your child grows. It's best to think in terms of how many milligrams of fever medicine your child should take, since you will then be able to determine how much to give of any form, (whether it be liquid or chewable, etc.) with less chance of giving an incorrect dose. Read all labels of medications carefully. Giving your child the medicine At this age, most children will voice a preference for either liquid or chewable medication. Older children may or may not be able to swallow pills. No one form is better than the other, so help your child determine which form is easiest for her to take. Never tell your child that medications are candy in an attempt to get her to take it. From as early as the toddler years, teach your child that medication should be taken only when she is sick and when given to her by an adult. Check with your pharmacist or your child's provider about the possibility of mixing or crushing medicine in with foods or drink. Never assume it's OK, since certain mixtures may make the medicine ineffective. Suppositories are not generally used at this age. However, when children are very sick, vomiting, or refuse other forms of medication, this can be an alternative if it's absolutely necessary to bring a fever down with medication.
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