Fever in Children: When to Worry

Seeing your child with a fever can be very frightening. You may worry; does my child have a serious infection? Will the fever cause him to have a seizure? Will the fever damage her brain? Many questions may run through your mind as you sit at your child’s bedside, feeling worried and helpless.

But are fevers actually dangerous?

First of all, what is a fever?

A normal body temperature is between 97 and 100.4° F (36 to 38° C). If your child’s temperature is above this range, he has a fever.

A fever is usually caused by infections from either:

viruses, the most common cause (such as a cold or the flu) or
bacteria (such as strep throat or some ear infections).

Are fevers dangerous?

What most parents don’t realize is that, alhamdulillah, fever is just a natural part of many illnesses and can actually benefit your child. By itself, fever is not a disease. Usually it is a positive sign that your child’s body is fighting infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading viruses and bacteria.

The American Academy of Pediatrics states,

“Fever is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child’s overall comfort rather than focus on the normalization of body temperature.”

In other words, your child’s fever is actually important in helping him fight the infection.

So rather than worrying about the number on the thermometer, focus on how your child looks and acts. Make sure your child is drinking enough fluids and not becoming dehydrated. Keep him comfortable with these natural ways to reduce a fever (article coming soon inshAllah). And to help support your child’s immune system, read here about natural remedies for cold and flu.

Should I give my child fever-reducers?

Only treat your child’s fever with medication if the fever is making him miserable. And PLEASE! Don’t wake up your child in order to give him a fever-reducer. He needs sleep more than he needs medication to lower his fever.

Unfortunately, especially here in the Middle East, a trip to the doctor will often mean coming home with a bag full of pharmaceuticals, many of which are unnecessary are have harmful side effects. For example, a child with a viral infection (like a cold or flu) will not benefit from antibiotics. Antibiotics are only effective against bacterial infections, and do absolutely nothing to combat a viral infection. In such a situation the antibiotics actually do more harm than good. Antibiotics destroy the “good bacteria” found in our intestines which are crucial to our health and the functioning of our immune systems (Read more here about the importance of these “good bacteria”). So by taking antibiotics, the child’s immune system will weaken and he will be more susceptible to infection in the future. This becomes a vicious cycle for many children, who seem to be ill the entire winter.

Of course, there are situations in which antibiotics are necessary. But in the majority of cases of fever in children, time, rest, and loving care are all that’s needed.

So when should I be worried?

Here are situations in which your child should be taken to see a doctor:

Any infant younger than 6 weeks of age with a temperature of 100.4°F (38.0°C) or higher. This child should be seen by a doctor immediately.
Fever lasting more than 5 days.
Fever rising above 104°F (40°C) repeatedly for a child of any age.
If your child is having difficulty breathing (he is working very hard to breath or is breathing very fast).
There is no clear cause for the child’s fever (no cough, runny nose, throat pain, ear pain, diarrhea, etc) and the fever has lasted for two to three days.
If your child is not drinking enough liquids. Babies who are not wetting at least four diapers per day and older children who are not urinating every eight to 12 hours may become dehydrated. This is especially dangerous for small babies.
Your child has any of the following symptoms: stiff neck or pain in the back of the neck, severe headache, severe sore throat, severe ear pain, severe abdominal pain, pain with urination, or repeated vomiting or diarrhea without tolerating fluids.
If your child has had a seizure.
If your child is lethargic- this means that your child is limp, lifeless, difficult to awaken, unresponsive or won’t make eye contact.
Your child cries for hours, won’t talk to you, and is almost impossible to comfort.

Do high fevers cause brain damage?

Fevers due to infection do not cause brain damage. Only body temperatures above 108° F (42° C) can cause brain damage, and these high temperatures are only seen under extreme conditions (for example, if a child is kept in a closed car in hot weather). Fevers caused by infection will rarely go over 105°F (40.5° C).

What if my child has a seizure?

A febrile seizure can occur during a quick spike in temperature. They affect children 6 months to 6 years old, and are most common in children 12–18 months old. The seizures usually last for a few minutes. A child is prone to febrile seizures if they run in his family or if he’s had one within the past year.

Although they can be terrifying for the parents to watch, febrile seizures do not cause brain damage or affect intelligence. And evidence shows that treating a child’s fever with acetaminophen or ibuprofen does not prevent febrile seizures.

Parents who witness their child’s febrile seizure should:

Try to stay calm (I know…easier said than done)
Make sure the child is on a safe surface and position him on his side to prevent choking.
Do not try to stop his movement or convulsions.
Do not put anything in the child’s mouth.
Remove hard or sharp objects nearby.
Time the seizure. If it lasts for more than 5 minutes, the child needs emergency medical assistance. If the seizure lasts less than 5 minutes the child should be evaluated by a doctor, but in most cases no further treatment is needed.

In Summary:

Fever itself is not dangerous and can actually benefit your child. It is usually a positive sign that your child’s body is fighting infection.
Rather than worrying about the number on the thermometer, focus on how your child looks and acts, and his level of hydration.
Try to treat your child’s fever with natural remedies, and only give fever-reducers if the fever is making him miserable.
The fever itself, due to infection, does not cause brain damage.
Febrile seizures do not cause brain damage or affect intelligence. And evidence shows that treating a child’s fever with acetaminophen or ibuprofen does not prevent febrile seizures.