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Dr. Sri Explains It All: When to Worry About a Fever

By Dr. Sri Narayanan

Fevers can be scary. Your child has all the energy knocked out of him, he’s panting and sweaty and clammy and fussy all at the safeverme time. As dangerous as they may seem, fevers are simply the body’s way to rev up the immune system and kill the viruses or bacteria that are causing an infection – with the side effect of making you feel lousy. Thankfully, most children with fevers have viruses that just need to run their course, and they can be managed at home without needing to see a doctor for further testing.

Most doctors define fever as a temperature over 100.4 degrees Fahrenheit (38 degrees Celsius), measured rectally in infants and under the armpit or tongue in older children. We see a lot of kids in the Emergency Department for fever, and our advice is usually the same:

  • Give them plenty of fluids
  • Let them rest
  • Try some acetaminophen or ibuprofen if they cannot get comfortable

Here are a couple of situations where you may want to seek medical attention:

  • Fever in an infant under 2 months of age. Little babies with a cold start off the same way as little babies with severe infections, so we recommend that any infant under 2 months with a fever gets an evaluation in the Emergency Department.
  • Fever for more than five days. Some viruses like influenza and EBV (the virus that causes mono) can cause fever for a week, but an illness that lasts this long is unusual enough that you should see your pediatrician.
  • Fever and vomiting / abdominal pain. If the pain is bad enough that the usual over-the-counter medicine is not helping, or if your child cannot even keep down sips of fluids, they are at high risk for dehydration and should be seen by a physician.
  • Fever and difficulty breathing. As I wrote about in last month’s blog post, bronchiolitis season is here, and we saw several kids with the flu. Rapid breathing or pulling in at the neck/ribs is a reason to get checked out sooner rather than later.

Contrary to what you may hear, fevers do not cause brain damage, no matter how high the temperature gets. In a small percentage of kids under age six, fevers can cause seizures, but these almost always stop on their own and have no long-term effects. If your child is seen in our Emergency Department for a febrile seizure, we have an informative video all about seizure facts and first aid.

Fevers are a natural part of healing and are the sign of a strong immune system. They can certainly be uncomfortable, but they are rarely dangerous. Follow the tips above to help your child recover as quickly as possible, and to know when it’s important to seek medical attention.

Winter Safety and Kids

By Rachel Olis

At this time of year, even in Alabama, we can expect some low temperatures. Cold weather does not necessarily mean you need to keep your kids cooped up inside- However; it’s important to remember some general safety tips this winter, regardless of whether your family stays inside or ventures out.

Many kids don’t like the idea of wearing a heavy coat and may claim they aren’t cold. According to Christina Fettig, pediatrician at Children’s of Alabama, children are just as susceptible to the cold as adults are.

“The American Academy of Pediatrics recommends several layers,” she said. “The best rule of thumbs is to dress your children in one more layer than we as adults wear.”

Help keep your kids safe indoors and outdoors with these tips:

  • “Just like in the summer, dehydration can still occur,” Fettig said. She recommends drinking water as the best way to keep kids hydrated while outdoors.
  •  Instead of heavy materials, choose lighter, cold-weather fabrics like polyester fleece that are easier for children to move around in. This allows kids to take off layers when they get warm and add additional layers when they get cold.
  •  Make sure kids cover exposed areas like hands, ears and heads.
  •  Snow can reflect up to 85 percent of the sun’s ultraviolet rays, so sunscreen is still important even in winter weather.
  •  Fettig advises being cautious with space heaters in the home.“The Centers for Disease Control and Prevention show carbon monoxide poisoning is highest in January.” She added that only one-third of homes have a carbon monoxide detector.
  •   To keep children’s skin from drying out from the cold air, Fettig advises not bathing young children every day. “We recommend if a child is less than one, don’t bathe them more than 2-3 times per week.” For older children who spend more time outdoors, she recommends a gentle, perfume-free moisturizer.