When your child wakes up in the middle of the night, you are understandably concerned. The question is when is the right time to take your child to the doctor or the emergency room?

What Temperature constitutes a fever?
Normal temperature – 36 to 37.2 Celcius
Low-grade fever – 37.3 to 38.3 Celcius
Common fever – 38.4 to 39.7 Celcius
High fever – 39.8 Celcius

Remember, fevers are your body’s natural response to infection, and not necessarily a sign that something serious is taking place.

  • Low-grade fevers are generally not serious, are easily treated, and can wait until the morning to be evaluated by your doctor.
  • Common fevers are also generally not serious and can wait until morning to be evaluated, except in certain circumstances.
  • High fevers that come down quickly to 37.8 to 38.3 Celcius with the treatment are also generally not serious and can wait until morning, except in certain circumstances.

Here are some situations that would warrant an urgent call to your doctor:

  • If your baby is 6 weeks or younger, and has a High fever, this is considered a medical emergency. Your doctor should evaluate your baby right away. Do not give any fever-reducing medications in this situation (you don’t want to hide the fever until after a doctor has evaluated your baby).
  • Infants age 7 weeks to three months with a High fever warrant an appointment with your doctor within the next several hours. You generally don’t need to call your doctor in the middle of the night in this situation if the office opens within the next few hours. Treat the fever and call your doctor in the morning. If it is the early evening you should probably call your doctor, since the office won’t be open until the following day.
  • If your child of any age has one or more of the following symptoms, you should probably call your doctor right away:
    High fevers that don’t come down to 38.3 to 38.9 Celcius with the treatment
    Lethargy – this means more than your child just isn’t acting right or laying quietly in your arms. Lethargy actually refers to your child being limp, lifeless, unresponsive, or won’t make eye contact.
    Irritability – this means more than just fussiness. A truly irritable child will cry for hours with minimal verbal interaction, and is almost impossible to console.
    Meningitis – symptoms are high fever, stiff neck or pain in the back of the neck, vomiting, headache, bright light hurts the eyes. Before calling your doctor, you should also look up any other symptoms your child has, such as cough, vomiting, rash, etc and read those guidelines to determine your best course of action.

Are Fevers Dangerous?
No. Many parents have a misconception that fevers are a bad thing and a sign that there is some serious underlying illness. This simply is not true. Fever is a normal and healthy response of the body to an illness. The body’s immune system releases chemicals that raise the body temperature. This is part of the normal infection-fighting process. Low-grade fevers are helpful in fighting off infection. You should only treat a fever when it is making your child miserable. Treat your child, not the fever.

Top 3 Causes

  • Viral infection – this is the most common cause of fever in children. Examples are: Roseola, Colds, Flu, Coxsackie (hand, foot and mouth disease), Chicken Pox, Fifth Disease, and many others. Most viruses are not dangerous. They simply need to run their course over several days. They are not treatable with antibiotics.
  • Bacterial infection – Some examples include ear infection, sinus infection, pneumonia, bladder infection, and strep throat. These are treatable with antibiotics, although treatment can usually wait 12 hours until you can contact you doctor in the morning.
  • Teething– this can cause fevers, though usually not higher than 101.

Measuring your Child’s Temperature

  • Regular glass underarm thermometer– this seemingly “old fashioned” method is still probably the most accurate, although difficult to do with a crying, squirming child. Try to hold in place for 3 minutes, making sure the tip is deep in the soft underarm skin.
  • Ear thermometer – this quick and easy method has become more popular. The accuracy of these thermometers varies, however. One ear may read 38, the other 43. Which do you believe? If it reads close to normal, then it’s probably true.
  • Rectal glass thermometer – this method should only be used for newborns through age 3 months since accuracy is crucial for this age. Gently insert the thermometer approximately ½ inch into the anus and hold in place for 3 minutes.
  • Digital thermometer – these are oral, underarm or rectal. They are much faster than a glass thermometer, although you do lose some accuracy as with the ear thermometer.

Getting through the night…

First step – decide if the fever warrants treatment.

  • Medications such as Paracetamol (Acetaminophen in North America) or Ibuprofen can make babies and children feel more comfortable. Paracetamol is a fever reducer/pain reliever and has been around a long time. It is effective is most cases. It can be given every 4 hours.
  • Ibuprofen– this newer medication is also effective for fever and pain. It often works better for higher fevers, and lasts longer too. It can be given every 6 hours.
  • WARNING – don’t give ASPIRIN to children 12 and under.
  • VomitingIf your child is vomiting and won’t keep down any medication, you can use suppositories available over the counter.
  • Lukewarm bath and cool washcloth – this can help get a fever down fast, especially if it is high, but only use along with, not instead of fever lowing medication.
  • Cool liquids to drink can help cool down a fever and keep your child well hydrated.

Remember, if you have a “gut-feeling” that your child is seriously ill, contact the doctor right away – Mommy Instinct!

For more information go to http://www.askdrsears.com

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