Feeling Hot, Hot, Hot!!

What exactly is a fever and why does it matter?  Over the years I have had parents come in with kids that were sent home from school for a “fever of 99”.  M’kay….. aaand? and that was it! no other symptoms or complaints. SO! Let’s talk about what a fever actually is and why we care….

Firstly, normal body temperature is 98.6 degrees Fahrenheit (plus or minus one degree) or 37 degrees Celsius.  The accuracy of the temperature will vary depending on where you take the temperature.  Your core temperature is most accurate and that can be taken rectally or orally.  When taking it orally, you need to be sure the probe is all the way under the tongue so that the reading is as accurate as possible which can be difficult in a little squirmy person. Outside of infancy checking the temperature rectally may not be the most comfortable option for both parties involved. So that leaves axillary (armpit), ear or forehead/temple areas.  There are lots of handy dandy electrical thermometers that can get a quick read if you’ve got a moving target like we did with BeBe.  Be mindful that your reading can be off a degree or so if you do check in one of those areas.  The instruction manual for your thermometer should be able to help you determine how much. Either which way once you start reaching 100.3 and above you’re getting into the fever zone. Now! why does that matter?!

A fever is ACTUALLY a part of your immune system’s defense mechanisms.  Most viruses and bacteria are able to thrive and replicate rapidly at your normal body temperature. When your immune system is out patrolling and notices a foreign invader is trying to wreak havoc on your body, it sends out signals to recruit back up. These signals are chemical mediators that beckon more immune cells to mature and differentiate to fight the infection at hand.  These chemical mediators also signal the thermostat in your body to raise the temperature in an attempt to make your body less inhabitable for the infection trying to take over. So mounting a fever in some ways is a good thing.  However, in the very young and very old it may be a cause of concern because often times when you don’t feel well, your appetite may decrease. As a result you may also drink less and dehydration becomes a risk which can be dangerous in the very young and very old.  Also, when you have a fever, you sweat and lose fluid that way. The best time to try to encourage eating or drinking is about 30-45min after reducing the fever as this is when they will feel a bit better and be more willing to eat or drink.

When people ask me what temperature should be cause for alarm, I typically tell them there isn’t really a set number.  We have to look at the whole picture.  I’m likely to be more concerned about the child with a fever of 101 or so that looks like they’ve been hit by a truck versus the kid with a 103 running around and playing.  Having said that once we get to 104 and definitely 105 and/or the temperature (and child) isn’t responding to the appropriate dosing of a fever reducer, then it’s time to take them in to get checked. If there are other symptoms of distress like difficulty breathing, or lethargy, or something “just isn’t right”, you know your kid so take them in to get checked. it’s better to be safe than sorry.

Temperatures typically spike in the afternoon or evening RIGHT when your Doctor’s office is closing. BUT there is always help out there for you. Your insurance card may have a Nurse advice hotline phone number that you can call for advice or recommendations on what to do. Also, your Doctor’s office will have an after hours operator that can direct your call to the Doctor or Nurse on call that night. They give you advice and recommend things that you can do at home to help, and/or recommend that your child be seen and if it’s something that can wait until morning or if it needs to be addressed immediately.

It is typical to have a fever for 3-4 days with a run of the mill viral infection.  AND as I mentioned it’s also typical for it to spike up in the evening or over night but go back down during the day only to pop back up again that evening. Don’t be alarmed unless there are new symptoms or the symptoms seem to be getting worse and not better.  Once we are on day 4 and still dealing with fever, take your child in to get checked.  Even if you went on day 1 and the Doctor said “oh it’s just a virus”, take them back in for a recheck. Viruses can sometimes be a gateway for a secondary infection like an ear infection, for example. Also, things can progress and change literally overnight. I’ve seen it with my own two eyes. Trust your gut. If something doesn’t feel right, it can’t hurt to get it rechecked.

Also be mindful that HYPOthermia (low temperature) can be just as – if not more – significant in the very young and very old. If the temperature is 97 or below, take them in to be seen immediately.  Sometimes in the very young and very old population, their immune systems may respond by DROPPING the temperature so don’t dilly dally and get them checked.

Don’t forget that taking a lukewarm (not cold) bath can also help reduce a fever.  Throwing a little Epsom Salt in the tub will help with any aches and pains that can come along with that fever. Drink plenty of fluids and rest! This too shall pass….


Happy Healthy Living!

Until next time….

Take Home Tidbits

  • Normal body temperature is 98.6F plus or minus a degree.
  • Oral and rectal temperatures are most accurate so adjust according to your thermometer’s instructions if you take the temperature in another location.
  • Fever for 3 days or so is typical with a virus.
  • Fevers tend to spike in the evening and overnight.
  • HYPOthermia (low temperature) is concerning in the very young and very old.
  • Things that you can do to boost the immune system – probiotics, and colostrum.

Questions? Comments? Post them below.

The Doctor is in!