Quick help needed: 2 year old with 104.4 fever

[Amila]

I am usually in the "leave the fever alone" camp, but DH is freaking me out.

I am on the tail end of a bad cold, had a mild fever, sore throat, cough, stuffy nose, etc.

DD woke up today and felt warm- got progressively warmer. Took a super early nap, and just a few minutes ago fell asleep on the couch by herself (which she has NEVER done before). Last time I took her temp it was 104.4 (underarm)

She has been drinking tea, had some oranges and pears, a little bagel, some chicken noodle soup. Definitely lethargic- basically just acting sick, laying down watching cartoons, clingy.

Should I try to get the fever down? Give her a lukewarm bath? Dh wants me to break out the tylenol asap.

Thoughts?

We WERE exposed to Fifth's Disease a week and a half ago, but I don't think this is that.

[alegna]

That's around the range I usually do a warm bath (NOT lukewarm...)

Remember that the fever itself is not dangerous.

Hope she feels better soon!

-Angela

[A&A]

It's up to you. (I'm half-way between the "give Tylenol" and "let the fever ride out" camps.)

At 107 for several hours, brain damage could be sustained. (But my children have had many fevers at 104.) And some people say that the body has built-in mechanisms to not let the fever get to brain-damaging levels.

My worry tends to be how they are feeling--I've personally also had a fever that high, and felt like dying. Medication made me feel much better.

The underarm is kind of unreliable--do you have an ear thermometer? I hate to freak you out, but the fever could actually be higher than that if you only checked with an underarm thermometer.

Dehydration is also a real concern--that fever is burning off fluids in the body, too. Keep your dd hydrated--even little frequent sips of water.

[abomgardner417]

Calcium will bring a fever down. I usually grate one of my calcium supplements in some water and have dc drink that. My cutoff is 105 or if dc is extrememely uncomfortable...then we break out the Tylenol.

[Ruthla]

She's been taking in some fluids so I don't think dehydration is a concern at this point. I'd keep on offering fluids and fluid-rich foods (broth, oranges, etc), and not worry just yet. The fever is likely to break within the next 12-24 hours on its own. Being lethargic for a day or so (as long as the child isn't geting dehydrated) isn't going to cause any long term harm.

If it were my 2yo, I'd just keep offering fluids and enjoy the snuggle day.

[Taryn237]

I start to give tylenol at 104 personally... Just because by then DS is miserable without it. He had a 102-104 fever for 3 days 2 weeks ago and then for 2 days last week. I know a few other kids who've been sick with a fever as the only symptom these last couple of weeks too. I guess maybe something is going around.

[monkeybum]

I have gone through this same dilemma, God I hate fevers. They freak me out, but I am a worrier!

DS had several fevers last winter and I got the same advice each time from my family doc, chiropractor, walk-in docs, emergency room pediatrician and our government nurse-line:

Under 102: Low grade fever, let it run it's course.
102-104: Mid-grade fever, treat with Tylenol for comfort.
104 - 105: High-fever, still not dangerous, treat with Tylenol for comfort and to prevent from getting overheated. May justify a visit to the doc if continues at this level.

Rectal temps are most accurate; others (ear, armpit, etc.) can be off by as much as a degree so I've been told not to even use them.

Advice was always the same:
1. Dress loosely in light clothing, (you want to prevent a chill, but also to prevent overheating).
2. Fevers in themselves are not dangerous. Brain damage can occur once you are up around 107 or 108, but the body will not go to this level on it's own from a virus/illness, (i.e. it may in conjunction with overbundling, warm bath, external heat, etc.).
3. NEVER give a bath - too much chance of overheating or making illness worse if baby gets a chill if you don't get the water temp exactly right.
4. What is more important than a fever is how the baby is acting and the fever's response to fever-reducers. For example, a fever of 103 that isn't brought down by Tylenol (after 1/2 hour or so) may indicate a bacterial infection (i.e. ear infection) and would warrant a visit to the doc. A fever of 99, but where the babe is very lethargic, unresponsive, glazed eyes, refusing to eat/drink etc. would warrant a visit to a doc.

My guy was 6 months at the time and had a fever of 104.8 for 5 days straight. Of course, I went every day to a new doc/walk-in, even tried Emerg convinced they were all missing something...The docs around here (I'm near Toronto, Canada) don't even take temps anymore when you go to the walk-in or Emergency room. If the babe is acting fine, (which mine always is when I go panicking to the doc with a fever), they always look at him, and send me home with the above advice.

From the sounds of it, I would just give Tylenol for comfort, ensure the fever does reduce, let her sleep as much as she wants, don't dress her too warmly or let her get a chill, lots of fluids, and just ride it out. She'll be fine. It is great that she is eating/drinking. She doesn't sound too sick, just like a little girl with a fever.

[Sileree]

Off-topic a bit, but...

Comfort wise, whenever I have a high temp and feel achy and sick, taking a hot bath for 10-20 minutes makes me feel better almost immediately and makes the cold go away within a few hours. I guess its aiding the body's efforts?

I got the idea from Native Americans using steam lodges for sick white captives. They thought they were torturing them when they were really sick but then wondered at how much better they felt. Its amazing how well it works. Could be different for children, though.

[monkeybum]

I would really recommend against a hot or even warm bath for a babe/child with a fever. They can get overheated. I was told by several docs not to do this, as a child/babes body can't regulate it's temp the same way we can and they also can't tell us when they are too hot, etc.

As an adult, we're much more aware of whether we're too hot (get out and cool down) or too cool and getting a chill, (dry off, get warm). I understand that this recommendation (the bath thing) was changed to "recommend you don't do this", at least in our province, b/c there is a risk of making the illness / fever worse if not done exactly right.

I have always found that dressing my babe in just a diaper shirt (under shirt) and laying just a loose receiving blanket across their legs allows the heat to escape. If you live in a hot climate and they aren't cooling down with light clothing, you could try a sponge bath, or cool damp cloth if they don't mind it, (but don't make them miserable!).

Just my advice...

[Amila]

Thanks. She was so miserable that I did give her some Tylenol around 4 pm, which brought the fever down a bit. She was her normal self for a few hours.

Then after she fell asleep her fever climbed to 105 again and she kept waking up and saying weird things/singing the ABC's- but it was almost like she was delerious or something. So we gave her another dose to help her sleep and are keeping an eye on her. If I hadn't JUST been sick (still am really) I would be worried, like what the heck is wrong? But I am sure she just has the bad cold from me. Poor baby

If she was acting normal and not so sickly and out of sorts i would have avoided the tylenol, but I think it was warranted.

[momofmine]

I feel better not giving fever reducing Tylenol or Motrin, because I would rather really know what is going on and allow the body to fight whatever it is they are fighting. If it were me, I would try other things to bring the fever down if they were delirious or super miserable from the fever, like a homeopathic remedy or the warming wet socks treatment. If they are acting normal when the fever is down, that is a good sign. Then you know it is just the fever that is making them feel so lethargic and miserable. Giving Tylenol for the fever is scarier to me than letting the body fight it, because it can prolong the illness or mask other things or cause other problems. This is only my opinion, not telling you what to do.
My first child tended to run higher fevers too, and it was scary, until I had been told a thousand times by many different doctors and people that the only reason to treat a high fever is for comfort. If I can make him comfortable by other measures, then why risk giving medicine unneccessarily. Plus, they are sick, and I think that sometimes our bodies just need to be sick, there is a reason, our bodies are repairing and working. They should be resting and healing, not up and running around.

[nevaehsmommy]

Under arm temp you also are spossed to add 1 degree up oF

so 104oF Would be 105oF

[monkeybum]

I agree Tylenol is for comfort, and I HATE giving meds at all.

But, that said, when I have had a fever, I find I sleep 100 times better when I finally give in and take Tylenol, which means I sleep better = my body heals better/fights the infection. I know that sounds counterintuitive b/c the fever is supposedly helping to fight the infection, but personally, I get better faster when I take Tylenol. I also find my babes sleep better when I give them Tylenol, so I usually do give it for comfort once they are acting miserable.

It's a hard call!! Good luck!!

[sbgrace]

I would think she'd be uncomfortable given that high of temperature..especially for sleeping. I would give meds for pain. At that high of temp you might think about underlying things (like ears).

[Amila]

She is doing much better Ran a 102-103ish fever all day, but was acting much better. Right now she is sleeping and is warm, but its low-grade. i think she will be much better tomorrow. Thanks for all your help.