Treating fever in a three-year-old

In My Humble Opinion (IMHO)
#1

Late Thursday night (really Friday morning), my three year old daughter woke up vomiting, had a fever of 102.7. I cleaned her up and gave her a fever reducer/antihistmine, and she went back to bed. No vomiting since then (it’s now Sunday), but she has had coughing, sneezing, congestion, runny nose, and has continued to run a fever around 101. I’ve been treating the fever intermittently with Children’s Motrin, and the other symptoms at bedtime with a multi-symptom flu medicine. This morning, her temp was 101.4, and she’s congested. But her mood seems fine. She’s playing and running around like normal. So, here are my questions: If her mood seems fine and she’s active, do I even need to treat the fever? Also, how long should I let this fever go on before I take her to the doctor? (Hubby thinks we should call doc if fever continues through Monday). I’d call her ped with these questions, but it’s so hard to get hold of her on weekends!

Thanks for any advice you have to offer!

#2

Current medical thinking is that, in most cases, fever is neither friend nor foe. So whether to treat it or not depends on how the feverish person is feeling. I personally wouldn’t give totnak medicine for his fever if he was playing happily as you say your daughter is. The medicine would upset him more than the fever!

On the other hand, I think three days is about as long as I’d let a fever go, even an “innocent” one, without checking in with the doctor. So yeah, I’d call Monday morning if she’s still feverish. It’s probably nothing serious, of course, but it’s good to know.

Hope you little one is feeling better soon!

#3

Fever is the body’s way of fighting off an infection. The best reasons to treat are for patient discomfort, and if it goes too high. I tend to recommend using acetaminophen or ibuprofen on children if their temperature goes up over 102.5 F. I don’t worry about the fever (after I’ve examined them and ruled out the bad causes of fever) unless it goes over 104, and doesn’t respond to medications. Once one’s temperature pushes towards 105, febrile seizures are a possibility. Said seizures are minimally dangerous in the vast majority of cases, but they are frightening. Tho more to the parent than the child.

So if the kid’s eating and drinking, and playing, or at least not overtly uncomfortable, and they’ve got classic cold/respiratory symptoms like runny nose and cough and a temp of 102.0, I recommend holding off on treating. But if they don’t seem to feel so well, I’ve a low threshold for giving the first dose of fever reducer. A parent should consult their own comfort level too, and if they’re going to withold medication but check the kid’s temp every 10 minutes, they may want to reconsider giving meds.

And of course if things deteriorate or one has unanswered questions, a call to the doctor’s office is a good idea.

QtM, MD

#4

And as long as a patient is taking fluids well and their behavior is relatively normal, one can follow a fever for 4 or 5 days.

#5

Thanks, Qadgop! You’re the only doc I can find that will answer questions on weekends! :slight_smile:

#6

IANAD, but Infant’s (not Children’s) Advil seemed to do the trick for our not-quite-three-year-old a couple months ago. He was running about a 103 temperature at the time.

#7

(Father of 6)
If the medication isn’t making the faver complelty go away, there could be something to be concerned about.
Fluids and rest are the best things of course. And most improtant, the parent can tell if the something is reaaly wrong with the child.
All the doc can do is perscribe antibiotics, which may be good.
But I wouldn’t go in on a monday morning without and appointment. You know the waiting room is a hive of illness.
IMHO, if the fever is stioll there Monday, make an appointment.
Do what you think is right.

#8

Yes, this is my concern, too. The medication hasn’t been making the fever go away completely. Temp will be about 101.7, then an hour after dosing with ibuprofen, will drop to about 99.6, or something like that.

No, I’m not planning on going without appt. If she still is feverish in the morning, I’ll call the doc’s office, and they will advise me further.

Thanks!

#9

My kids had something that sounds remarkably like this a few weeks ago. My younger daughter (almost 10) ran a fever for four days solid, and the older one had it for three. I tended to give acetominophen at bedtime so they would sleep well, but I held off during the day unless they were whiny. The kids liked to take their own temperatures, and we were making a game out of it by Day 3 of the mutual illness. Younger Daughter won, with a temp of 104.1 (and that’s when I not only gave her acetominophen but also put her into a 100-degree bath). Her fever was down the next morning, or I’d have taken her in.

Good luck!

#10

InternetLegend, this kind of advice is, no doubt, why you are a Legend:slight_smile:

#11

Thank you for not pointing out that it’s essentially what Quadgop said. :wink:

BTW, the high temp was at 10 p.m. on a Monday. My pediatrician had given me the advice about the warm (not cool) bath some years earlier and I just didn’t want to pack both kids up to sit in an E.R. (the urgent cares close at 10) if it wasn’t necessary. Had her temperature not come down, I’d have gotten in touch with the doctor on call and followed his or her advice.

And the “Legend” thing is a joke with a long, long set-up.

#12

Well, perhaps iit is essentially what Qadgop said, but there’s a big difference between knowing something as a physician, and knowing something as a parent, if you follow me. Not to denegrate QtM’s advice, but, you know. . .

I probably would have already tried the bath (heaven knows she’s filthy enough:)), were it not for our strange bath tub situation. You see, we own both halves of a duplex, and no one lives in the other side. In our side, we have a shower, but not a tub. The other side has a tub but no shower. It’s been mighty cold lately, and I’m hesitant to take her outside to take her next door for a “tubby”. So, we’ve been spot-cleaning with baby wipes for a few days now.

#13

Maybe DSeid will pop by and give some pointers too. I’ve kinda gotten out of the “caring for kids” routine at work since I changed to prison practice. The youngest inmate I’ve seen is 16! And a quarter of my patients used to be pre-adolescents. I miss the buggers. Sometimes. I don’t miss some of the parents, tho.

Hope your kid’s better, norinew. Cumberland is in Garrett Co, right?

#14

Qadgop, can you give a basic, all purpose overview of the progress and function of fever, and when to be alarmed? I’d be grateful for a clear explaination.

#15

I have to confess that I can’t remember the last time I took my son’s temperature. I’d have to dig to find a thermometer. I tend to go by how he’s acting, an approach that seems to be encouraged by my family practice. If he feels a little warm but is not acting lethargic, then I don’t sweat it and don’t even bother to get a reading. I used to go by the recommendations in the parenting books (certain temperature over a certain period of time) but I started feeling like an idiot taking him in when he seemed otherwise fine. So now I go by mom instinct. That said, if your mom instinct says there’s something wrong, then by all means take her in. Even if her fever is mild. You know your child, and don’t let any doctor make you feel differently!

For a stubborn fever, it is okay to alternate ibuprofen and Motrin, even though in doing so it feels like you are “doubling up.” One dose of each is not the same as a double dose of a single one (which would not be recommended).

#16

** no no no no!!** Ibuprofen and motrin are the same thing! Don’t double up on them! You risk and overdose!!

You’re thinking of alternating ibuprofen and acetaminophen to fight fever. That approach is acceptable.

Bad Cranky! Go buy a thermometer!

#17

Well, no. Cumberland is in Allegany Co. Garrett Co. is about 30 miles west of here. But you were close.

#18

Ooops! Absolutely right, Qadgop. Very naughty of me not to proofread. I meant, as you surmised, that you can alternate ibuprofin (advil, motrin, etc) and acetaminophen (tylenol) to fight fever.

#19

Well, this morning when she got up, my little Mousegirl’s fever was down to 99.9. I re-took it later, so I could call the doc’s office and give them the latest info. Her temp was 98.6. So doc’s nurse said to keep monitoring her temp, and if it comes back, or if the chest congestion isn’t significantly better by Wednesday to call for an appt. to bring her in.

#20

That;s good to hear, she’s probably through the worst of it. And you’re a wiser mom from the experence. We all learn by this. The days will come when you will be the giver of advice about children.