You may be able to tell if your baby has a fever simply by kissing him on the forehead or laying a hand across his head. If he feels hotter than normal, and he hasn't been running around or jumping more than usual, chances are he has a fever.

You should confirm your guess with a thermometer. According to the American Academy of Family Physicians, your baby has a fever if his temperature is 99.5 degrees Fahrenheit or higher when measured orally (in the mouth) and 100.5 degrees or higher in the rectum.

Most fevers are mild and nothing to worry about. However, if your baby is younger than 3 months and has a fever, call the doctor's office right away.

Even a slight fever can be serious in very young babies. If your baby is older than 3 months, call the doctor if his temperature is above 102 or lasts more than three days. Watch for signs that your baby’s illness is more than a common cold, including:

•Difficulty breathing or wheezing

•Seizures

•Listlessness, whimpering, irritability or other behavior changes

•Stiff neck

•Unusual skin rash

•Constant vomiting

•Diarrhea

•Earache or pulling at ears

•Severe headache

•Dry mouth and other signs of dehydration

•High-pitched crying

•Swelling of the soft spot on the head

•Paleness

•Sore or swollen joints

•Stomach pain

•Sore throat or difficulty swallowing

No one is a better judge of your baby’s health than you are, so if you’re worried or your instinct tells you that something is wrong, call your doctor's office no matter what your baby’s temperature is.

Sometimes heat stroke can be confused with fever. If your baby feels overheated and has been in the sun or in a hot place, remove layers of clothing to help him cool down and call your doctor's office immediately.

Fever is the body’s natural way of fighting infection. But babies under 3 months old don't have a fully developed immune system, so a fever can be a sign of something more serious, and you should always call the doctor. The doctor may want to see the baby or order some tests. At this age, it's better to be safe than sorry.

You can also offer him plenty of fluids to bring his body temperature down and prevent dehydration and remove layers of clothing. If your baby is older than 3 months, and the fever makes him irritable or prevents him from sleeping, you can also give him children's acetaminophen (Tylenol) to lower his temperature. For babies between 4 and 12 months, give 80 milligrams (mg) and for babies between 12 and 24 months, give 120 mg.

These doses can be given every four to six hours, but make sure you follow the directions on the package. The correct dose may vary according to how big the baby is, and usually no more than 4 to 5 doses are given daily, depending on your baby's age. Call your doctor if you have any questions about the right dose for your child. Consult with your doctor regarding the dosage.

Always use the measuring cup or dropper that comes with the medicine to give your baby exactly the right dosage, and don't give any fever-reducing medicine more often than is recommended.

Remember, never give your baby aspirin. It can cause Reye's syndrome, a serious condition that can endanger your child's health.

If your child is too ill or fussy to drink anything, medicine may help him feel better and have more energy to consume liquids that will keep him hydrated.

One time-tested way to reduce a fever is to sponge your baby down with lukewarm water or give him a lukewarm bath. Don’t use cold water, since that can cause chills and shivering, which in turn could raise his fever. Never try to reduce a fever by sponging down your infant with rubbing alcohol, since it can be absorbed into his bloodstream through the skin.

Give your baby lots of breast milk, and other fluids to keep him well-hydrated. Don’t give water to babies under the age of 6 months unless advised to by your doctor.

Although it’s tempting to give your baby over-the-counter cough and cold medications, doctors usually advise against it. Talk to your doctor, however, if persistent coughing disturbs your baby's sleep.

If your baby's temperature spikes suddenly above 102 degrees, he is at risk of having a seizure. In most cases, these "febrile seizures," as doctors call them, are harmless. But they can be scary. You will recognize it as a seizure if your baby’s eyes roll, his legs and arms shake or twitch, and he breathes heavily. If this happens, place your baby on a soft surface such as a carpet or a bed. Make sure he doesn't have anything in his mouth and turn him on his side so he won't choke on saliva. Don't try to restrain his movements during the seizure. Note how long the seizure lasts -- they usually last between a few seconds and ten minutes. After the seizure is over, he'll probably fall into a deep sleep. This is normal and you should let him rest.

If the seizures do not stop after ten minutes or your child becomes difficult to wake, you may need to call 911 or rush your baby to an emergency room.

After the seizure, call your doctor right away. He may suggest trying to lower your baby’s temperature with a lukewarm sponge bath and acetaminophen.

Your baby will run a fever until his body is clear of an infection. This can take several days. The flu, for example, can last from seven to 10 days. Fevers will also rise and fall. When your baby's temperature starts to rise, he may experience chills as his body tries to generate more heat. Likewise, he'll sweat and his temperature will fall as his body releases extra heat.

It can be hard to diagnose a high fever that isn't accompanied by other symptoms such as a runny nose, cough, vomiting, or diarrhea. Some viral infections, such as roseola, cause several days of fever followed by other symptoms, such as a rash. More serious infections, such as bacteremia (bacteria in the bloodstream), may also trigger a high fever without any other symptoms. If your baby has a high fever and no other symptoms, ask your doctor's office if you need to do anything more.

-- Melanie Haiken, M.A., is the former health editor of Parenting magazine and specializes in health, business, and parenting issues. She has served as managing editor of San Francisco magazine and as executive editor of Industry Standard magazine, and has written for Time Inc. Health, The Washington Post, and many other publications.

References

First published December 20, 2005
Copyright © 2005 Consumer Health Interactive

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