Fevers are common and the misconceptions about the dangers of fevers are common. Unwarranted fears because of these myths result in lost sleep and unnecessary stress for many parents and other caregivers. Here are some facts to give you some perspective on fevers in children.
Some people call temperatures from 98.7 to 100 degrees a “low-grade” fever. Actually, that’s a normal body temperature. Our body temperature fluctuates throughout the day, and the 98.6 degree body temperature is the average of all of the fluctuations. A temperature of about 100 to 102 degrees is what I would call a low-grade fever, with 103 to 104 degrees a mid-grade fever, and 105 to 106 degrees a high-grade fever.
Many people believe that any fever is bad for children. Fevers are simply a nonspecific response to an infection that boosts the immune system to fight the infection. Most fevers between 100 and 104 degrees are good for sick children because they help. For instance, bacteria grow and move more slowly when your body is outside their preferred temperature range, which is usually about normal body temperature. The exception is for babies less than 3 months old. They should be seen by a health care provider right away for any fever.
Some people think fevers cause brain damage or that fevers over 104 degrees are dangerous. Fevers themselves don’t cause brain damage. Only body temperatures over 108 degrees can cause brain damage. This only happens with extreme environmental temperatures, called heat stroke (for example, the tragic stories you read about every summer of children confined in a closed car in hot weather). There is also a misconception that without treatment, fevers will keep going higher. That’s incorrect, because the brain has a thermostat, just like the heater and air conditioner in your house and fevers usually top out at 103 to 104 degrees.
Another misconception is that any child can get a seizure from any fever. Only 4 percent of children have febrile (fever) seizures, and most of them have a family history of a relative that had febrile seizures. While scary to watch, they usually stop within five minutes. They cause no permanent harm, and children who suffer them do not have any greater risk of developmental delays, learning disabilities or developing non-febrile seizures.
Some people think all fevers need to be treated with fever reducing medicines. Actually, fevers only need to be treated if they cause discomfort, typically for fevers over 102 degrees, but this can vary. Fever-reducers usually only drop the temperature by 2 to 3 degrees. For example, a temperature of 104 degrees might still be 101 to 102 degrees after treatment and that is normal. Fevers usually last for two or three days with most viral infections. When the fever medicine wears off (usually in four to six hours) the fever will return and need to be treated again. The fever usually goes away and doesn’t return once your body overpowers the virus, which usually takes about four days.
Also, many people think that if the fever is high that the cause is serious. However, it may or may not be. I’ve seen mild infections produce 104-degree fevers in some children, and serious infections produce only 101-degree fevers in others. How the child looks is more important than the actual temperature. If your child looks very sick, the cause is more likely to be serious.
Finally, some people also think that if the fever doesn’t come down with medicine then the cause is serious. Fevers that don’t respond to fever reducers can be caused by viruses or bacteria. Whether the medicine works or not doesn’t relate to how serious the infection is. How your child looks is the more important factor to pay attention to when your child is sick.
I hope this helps reduce the urgency you feel when your child gets a fever and helps you focus on what’s important: How your child looks when they are sick. If they are still playing with a mid-grade fever then you can be reassured that they are probably fine. However, please bring them to a doctor if they look very sick.
Dr. Gregory Kostur is Health West’s new pediatrician. After working in the US Air Force as a pediatrician until 2008, he worked in private practice near San Antonio, Texas, until March of this year.