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Ask Dr. Sears: Easing a Fever

Q. My 18-month-old gets a lot of fevers. When should I be concerned, and is there anything I can do to help her feel better?

A. A fever is not an illness in itself—it's the symptom of an underlying problem (usually an infection), just as a car's engine light acts as an alarm signal. And not every one is necessarily serious.

A higher fever doesn't always indicate a sicker child. Minor viral illnesses may produce a high temperature (104°F to 105°F), while some serious bacterial infections—like meningitis—may cause a lower one (101°F to 102°F). Also, a fever that spikes high but subsides quickly is usually less of a worry than a mild fever that doesn't come down easily.

The best way to know when to be concerned: Watch your child, not the thermometer, for increasing signs of illness. (One exception: If an infant 3 months or younger has a rectal temperature above 100.5°F for more than eight hours, you should call the doctor right away, whether or not she shows any other signs of illness.) Get to know the typical progression of her fevers, and pay attention to any deviation from their typical course. For example, if your child never runs high fevers and then one day does, that's much more serious than if her temperature usually reaches 104°F with a normal cold.

Most fevers will go down within a few days, but in the meantime, here are some ways to help your child feel more comfortable:

  • Give her fever-lowering medicine, such as acetaminophen or ibuprofen.
  • Dress her in light, breathable clothing, to let the heat radiate out of her body. Don't bundle her in heavy blankets or cover her head.
  • Don't believe the age-old saying Starve a fever, feed a cold. It's important that sick children get plenty of nutrients to help them recover. When our kids had fevers, my wife, Martha, and I would often feed them smoothies made of fruit and yogurt. Also, give your little one plenty of fluids—such as water and juice—so that she doesn't dehydrate.
  • Keep your child calm, since too much activity and fussing can raise her body temperature. Make sure she gets a good night's sleep too.

And, of course, if your child's temperature continues to rise over a few days and she gets progressively sicker, call your pediatrician.