医疗新知

A fever means the body temperature is above normal. Your child has a fever if his/her: 

• Rectal temperature is over 100.4°F (38.0°C). 
• Oral temperature is over 99.5°F (37.5°C). 
• Axillary (armpit) temperature is over 99.0°F (37.2°C). 
• Ear (tympanic) temperature is over 100.4°F (38°C). (This measuring method is not 
• reliable for babies under 6 months old.) 
• Pacifier temperature is over 100°F (37.8°C). (The pacifier thermometer works well for babies over 3 months old.) 

The body's average temperature when it is measured orally is 98.6°F (37°C), but it normally fluctuates during the day. Mildly increased temperature (100.4 to 101.3°F, or 38 to 38.5°C) can be caused by exercise, excessive clothing, a hot bath, or hot weather. Warm food or drink can also raise the oral temperature. If you suspect such an effect on the temperature of your child, take his temperature again in a half hour. 

Fever is a symptom, not a disease. It is the body's normal response to infections. Fever helps fight infections by turning on the body's immune system. The usual fevers (100 to 104°F, or 37.8 to 40°C), which all children get, are not harmful. Most are caused by viral illnesses; some are caused by bacterial illnesses. Teething does not cause fever. 

Most fevers with viral illnesses range from 101°F to 104°F (38.3°C to 40°C) and last for 2 to 3 days. In general, the height of the fever doesn't relate to the seriousness of the illness. How sick your child acts is what counts. Fevers cause no permanent harm. Brain damage occurs only if the body temperature is over 108°F (42°C). Fortunately, the brain's thermostat keeps untreated fevers well below this level. 

While all children get fevers, only 4% develop a brief convulsion from the fever. Since this type of seizure is generally harmless, it is not worth worrying about excessively. If your child has had high fevers without seizures, your child is probably safe. 

• Extra fluids and less clothing: Encourage your child to drink extra fluids, but do not force him to drink. Popsicles and iced drinks are helpful. Body fluids are lost during fevers because of sweating. Bundling can be dangerous. Clothing should be kept to a minimum because most heat is lost through the skin. Do not bundle up your child; it will cause a higher fever. During the time your child feels cold or is shivering (the chills), give him a light blanket. 
• Medicines to reduce fever: Remember that fever helps your child fight the infection. Use drugs only if the fever is over 102°F (39°C) and preferably only if your child is also uncomfortable. Two hours after they are given, these drugs will reduce the fever 2°F to 3°F (1°C to 2°C). Medicines do not bring the temperature down to normal unless the temperature was not very elevated before the medicine was given. Repeated dosages of the drugs will be necessary because the fever will go up and down until the illness runs its course. 

  CAUTION: Avoid aspirin: Doctors recommend that children (through age 21 years) not take aspirin if they have any symptoms of a cold or viral infection, such as a fever, cough, or sore throat. Aspirin taken during a viral infection, such as chickenpox or flu, has been linked to a severe illness called Reye's syndrome.

• Sponging is usually not necessary to reduce fever. Never sponge your child without giving him acetaminophen first. Sponge immediately only in emergencies such as heatstroke, delirium, a seizure from fever, or any fever over 106°F (41.1°C). In other cases sponge your child only if the fever is over 104°F (40°C), the fever stays that high when you take the temperature again 30 minutes after your child has taken acetaminophen or ibuprofen, and your child is uncomfortable. Don't add rubbing alcohol to the water; it can be breathed in and cause a coma. 

Call IMMEDIATELY if: 

• Your child is less than 3 months old. 
• The fever is over 105°F (40.6°C). 
• Your child looks or acts very sick.

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