Infant fever

Fever is not an illness. It is a sign that the body is fighting infection. Children often have high temperatures with infections. Fever may accompany respiratory illnesses, ear infections, flu, severe colds, and sore throats. Not all fevers mean that a child has a serious illness or needs an antibiotic. Usually, an elevated temperature can be managed with acetaminophen. Never give aspirin to a child under 18 years. Refer to the pharmacist, your child's physician, or the package insert to determine the correct dose for your child. The exact weight of your child is the main factor in defining dosage. Normal temperature for a child varies by the time of day and how it is taken.

* Oral temperature over 99.5 F. (37.5 C.) is a fever.

* Rectal temperature over 100.4 F. (38 C.) is a fever.

* Axillary (armpit) temperature over 98.6 F.(37 C.) is a fever.

Notify your child's doctor if your infant is under 3 months of age and has a rectal temperature of 100.4 F. (38 C.) or more; between 3 and 6 months and has a fever of 102 F. (38.9 C.) or more; or older than 6 months and has a fever of 103 F. (39.5 C.) or more.

Generally, a child with a temperature of 102 F. (38.9 C.) or more should be given acetaminophen no more than every four hours. Contact your child's physician if your child has other symptoms such as vomiting, diarrhea, or a severe cough. In most cases, the child will show improvement after a dose of acetaminophen. Do not give acetaminophen to infants under 3 months of age unless directed by a physician. The goal of care for mild fevers is to help your child feel better. Make sure the child drinks extra fluids. Keep the child quiet. Dress the child in light cotton clothes. Keep the room comfortably cool. Add or remove an extra blanket when the child is chilled or too warm.

Symptoms

Although a fever itself is usually a symptom of some other illness or disorder, it can also cause symptoms. A flushed face (rosy cheeks), hot, dry skin, rapid heart rate, rapid breathing, nausea and vomiting, and an increased thirst may all be symptoms of a fever. In infants under six months, it is often difficult to assess when a fever is present because of the absence of these other symptoms. As well, newborns may not have a fever at all, despite of an acute infection. In the young infant, subtle changes in feeding and behaviour may be the only signs of illness. Parents may find their infant refuses feedings or is just cranky and more tired than usual. An infant whose suck is not as strong as usual can also alert parents.

Another sign of illness or infection may be long periods of sleeping with difficulty waking. It is important for parents to communicate their concerns and provide a history to the physician, so that treatment can be started early. The presence of rashes, lumps, coughs and nasal congestion may also provide clues to the infant's health.

Contact your child's doctor immediately if your child has:

* fever with seizures

* fever with a rash

* high fevers of 104 (40 C.) or 105 (40.5 C.)

* fever with unexplained pain,

* temperature that remain elevated for more than 72 hours, or

* if the temperature does not respond to home care measures.

Devices are available that can monitor the ear temperature. Ear thermometers are NOT reliable when used in a child under 12 months of age, because of the small size of their ear canal. Use a digital or mercury thermometer to take the child's temperature. If your child is having diarrhea, or has blood in the bowel movement, a rectal temperature should not be taken.