Fever without fear: what the number does and does not tell you
Fever is a response, not a disease
Raising body temperature is one of the immune system's tools. It is unpleasant, and it makes children miserable, but the fever itself is rarely the thing doing harm. It is the sign that a response is under way.
This is why we rarely chase a number down for its own sake. We are far more interested in what is causing it and in how the child is coping.
Look at the child, not the thermometer
A child at 39C who is drinking, complaining, and irritated by the thermometer is usually in better shape than a child at 38C who has gone quiet, floppy, and uninterested in anything.
The questions we ask ourselves are simple. Are they drinking? Are they making wet nappies or going to the toilet? Do they respond and engage when you talk to them? Can they be roused easily? Those answers tell us more than any single reading.
The situations that change the plan
There is one hard rule: any fever in a baby under three months old is a same-day call, every time, even if the baby seems fine. Their immune systems and their ability to show us they are unwell are both still immature.
Otherwise, call the same day for breathing that looks like effort, for signs of dehydration, for a fever lasting more than three days, for a rash that does not fade when pressed, for a stiff neck, or for a child who is much harder to wake than usual.
Treating discomfort rather than numbers
Paracetamol and ibuprofen are for comfort. If your child has a temperature of 38.5C and is playing happily, there is no obligation to medicate. If they are wretched at 38C, treating them is entirely reasonable.
Dose by weight rather than age where you can, and write down what you gave and when. In the middle of a bad night that note is worth a great deal, especially if two adults are taking turns.
Febrile seizures, briefly
They are frightening to witness and much less dangerous than they look. They happen in a small minority of young children, usually as the temperature rises quickly, and most last under a few minutes.
Keep the child safe on their side, do not put anything in their mouth, and time it. A first seizure always warrants being seen, and anything lasting more than five minutes is a 911 call.
This is general information, not advice about your own child. If something here raises a question, ask us at your next visit or call the office. That conversation is what we are for.