Fevers are common in children under 12 months of age. A fever is an increase in body temperature above the normal level of 98.6 degrees Fahrenheit or 37 degrees Celsius. Fevers are the body's response to viruses, bacteria or toxins, and they are thought to help interfere with the growth of some infections and to help boost the body's immune system response. Depending upon the age of the infant, fevers may be more severe, requiring medical attention.
Fever in Infants
Infants whose temperatures are lower than 103 degrees F often don't require medication unless they're uncomfortable. There is one important exception to this rule: If you have an infant 3 months or younger with a rectal temperature of 100.4 degrees F (38 degrees C) or higher, call your pediatrician or go to the emergency department immediately. Infants at this age have a difficult time fighting off infection, and even a slight fever can be a sign of a potentially serious infection in very young infants. A physician should evaluate an infant over 3 months with a fever of 103 degrees F or any baby who isn't eating well or looks sick.
Conditions Associated with Fever
Infants with fever are usually irritable and may not sleep or feed well. The irritability and disinterest that fever usually causes worsen the higher the fever gets. Infants with a fever can become dehydrated quickly because they lose large amounts of fluid in proportion to their body weight. Some infants can experience a seizure, called a febrile seizure, with an elevated temperature. These usually are harmless to the child, but a physician should evaluate them.
Viral infections such as a cold, flu, and chicken pox can cause a fever. Such infections usually will get better without any treatment. Fevers also are caused by bacterial infections such as ear infections, urinary tract infections or strep throat. Bacterial infections may require antibiotics. Fevers also can occur following routine vaccinations.
Treating the Fever
For treating a fever in an infant, keep the room temperature comfortable and dress him in loose, lightweight clothing. There is no need to wrap him tightly in blankets. Provide plenty of fluids to keep him hydrated. Do not use ice or cold-water baths to bring the fever down; this will constrict the blood vessels and cause the infant to shiver, which actually can increase the temperature. Administer fever-reducing only with advice from your physician.
Call a Doctor
You should call your pediatrician if an infant younger than 3 months has a temperature at or above 100.4 degrees; if an infant over 3 months has a temperature at or above 103 degrees; if there is a fever with a seizure; or if you have any concerns that your child does show her normal behavior regardless of the degree of temperature.
Fevers and Antibiotics
Your physician may not prescribe an antibiotic. Infections caused by bacteria usually are treated with antibiotics, but physicians need to determine the source of the infection before they will prescribe antibiotics. You may be advised to treat your child with fluids and fever-reducing medications and be asked to return for further evaluation if symptoms worsen within 24 hours.
References
- "Sheey's Manual of Emergency Nursing" 6th ed.; Elesevier Mosby; 2005
- "Emergency Nursing Pediatric Provider Manual" 3rd ed; ENA; 2005
- "Comprehensive Pediatric Emergency Care"; Elesevier Mosby; 2005
