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Fever One of the most common reasons we get called by a parent is that a child has a fever. A fever is considered a body temperature 100.5F or higher. It is important to remember that a fever is a symptom of an infectious or inflammatory process, not an illness itself. If I am treating a child with a fever or some other sign of illness - I would immediately start the supplements listed on the “First Signs of Illness” article on the medical topics section of our webpage. I would review the information in that article that discusses what other symptoms are important to look at when determining if there is a significant illness. There are also other less common, but important, reasons for fever besides infection. These would include: chemical exposure/toxicity, cancer and inflammation (such as colitis). However, in children, fever is most likely due to a virus and secondly by a bacteria. It is important to differentiate between a viral and bacterial infection, since there is no role for antibiotics in a viral infection. If ever a physician were to prescribe an antibiotic for a fever, I would press that physician into explaining why he/she thought this was from a bacteria and not a virus. There are very few situations where a fever actual means something more than a sign that a child is sick. Action must be taken if a documented rectal temperature of 100.5F or higher is seen in a baby less than 8 weeks of age. Newborns are considered immunodeficient and do not have the ability to fight infections like older people. Any fever in a newborn should be considered a medical emergency and the baby should be evaluated by a pediatrician (if after hours, it is important to have a pediatrician, not an adult ER doctor who also sees children, evaluate a newborn). Blood work, urine and possibly even a spinal tap should be performed. The baby is usually given IV antibiotics until it is proven that there is not a bacterial infection. This is standard of care in Pediatrics and I would act in the same manner as other pediatricians. In my professional opinion, there is no “wiggle room” in these youngest of children. In general, the height of a fever is not overly important. Brains do not “fry” from a high fever (at least for a fever under 107F). But a high fever (over 105F) suggests a more serious infection. Also a fever over 104.7 and with NO other symptoms has been associated with a higher likelihood of bacterial infection. Additionally, a fever of 100.5 or greater that lasts more than 5 days should be evaluated for possible bacterial infection unless the fever is trending down towards normal. My general rule of thumb is that I don’t treat a fever with medications like Tylenol or Advil/Motrin. Rather, I treat the comfort level of the patient. A child who is uncomfortable with a fever should be treated so they do not suffer. But if they are playful and in good spirits, there is no need to treat. Studies have shown that symptoms can resolve one day sooner if the fever is left untreated. I theorize that the body creates a fever as part of the infection fighting response, so we should let the body do what it is trying to do. 3405 W. Fletcher Ave Tampa, FL 33618 www.WholisticFamilyCare.com Phone: (813) 9603415 Fax: (813) 9603465 If it is necessary to treat a fever, I recommend the use of Ibuprofen (Advil/Motrin). If the patient does not tolerate Ibuprofen, then I would suggest they take Tylenol/acetaminophen. I have concerns about the effects that acetaminophen has on the liver, and in particular the level of a particularly important antioxidant called glutathione. But if there are no other options and the child is suffering, I would then give the acetaminophen. Ibuprofen can be given every 6 to 8 hours. For each 22 lbs, 100 mg can be given. Acetaminophen can be given every 4-6 hours, and for each 22 lbs 150 mg can be given. These doses are higher than what may be shown on the package label, which discusses the age of a child. But if calculating by weight, which is more accurate, these are the standard doses. Also, if a fever only comes down for a short period of time, acetaminophen and ibuprofen can be alternately given every 3 hours, so that each one individually is given every 6 hours. (ex: 12N Ibuprofen, 3P Acetaminophen, 6P Ibuprofen, 9P Acetaminophen, etc). A child can also be placed in a cool bath, but an ice bath or an alcohol rub should never be used as there are concerns that dropping the fever too quickly can also cause problems. Ultimately, a parent should at first ignore the fever and focus on other signs of serious infection, such as breathing problems, dehydration, or irritability/lethargy. If these more serious signs are present, then the family should contact their primary care provider. 3405 W. Fletcher Ave Tampa, FL 33618 www.WholisticFamilyCare.com Phone: (813) 9603415 Fax: (813) 9603465