How High Is Too High?

Think about this question...

What would you do if you took your child's temperature at 3 in the morning and it was 104.7 degrees?

This happened to me last night and it was scary! Mostly because I didn't know what I was supposed to do. I had already been doing the the alternating between Tylenol and Motrin and she had a lukewarm bath before bed. My doctor's nurse had told me the other day that if it goes above 103.5 then I might go ahead and give them a call back. But I didn't get the specifics of- "Does that apply to paging and waking the doctor at 3AM?" and "At what exact temperature does it turn into an emergency situation?". Therefore, I urge all of you to ask your doctor these questions before you ever get into that situation!

I did call my doctor today and here is the info I got:
By the way, this applies to a 3 year old (and older children). If a baby has ANY kind of fever (100.4 or above) then you should always page your doctor...even in the middle of the night. And, of course, ask YOUR doctor what they recommend. This is just what my doctor says:

A fever only should be treated with Tylenol and/or Motrin if it is causing your child to be uncomfortable (usually at the 102 degree mark). Otherwise you could interfere with the fever's "job" of fighting whatever infection is causing it in the first place. You can treat a high fever by alternating the medicine. The first dose will be a single dose of BOTH at the same time. Then give a single dose of one or the other (alternating them) every fours after the initial dose.

A fever will not cause brain damage until it hits the 107 range. (Can you believe that?) At that point it becomes an emergency situation and requires a 911 call. (Specific answer #1 that I wanted)

Any fever below 107 is acceptable as long as it comes down at least .2 degrees within an hour of a dose of Tylenol or Motrin.

Any fever (in the 102-106 range) that does not respond to Tylenol or Motrin at all requires a call to the doctor- even in the middle of the night. So if your child has a 104.7 fever and it goes down when given medicine, then she's most likely okay. If it does not do anything, or goes up, then call or page the doctor. My doctor told me that usually, as a precaution, she wants you to page her whenever you get a reading of 105- even if it does go down. (This was the other specific answer I was looking for.)

Of course she told me to call them ANYTIME, no matter what the temperature and even in the middle of the night, if I am ever concerned at ALL or have any questions.
And also to call if there are any other symptoms besides just a fever. Here is a list I found on kidshealth.org:

When to Call the Doctor

The exact temperature that should trigger a call to the doctor depends on the age of the child, the illness, and whether the child has other symptoms with the fever.

Call your doctor if you have an:

• infant younger than 3 months with a temperature of 100.4° Fahrenheit (38° Celsius) or higher
• older child with a temperature of higher than 102.2° Fahrenheit (39° Celsius)

Call the doctor if an older child has a fever of less than 102.2° Fahrenheit (39° Celsius) but also:

• refuses fluids or seems too ill to drink adequately
• has persistent diarrhea or repeated vomiting
• has any signs of dehydration (urinating less than usual, not having tears when crying, less alert and less active than usual)
• has a specific complaint (i.e., sore throat or earache)
• still has a fever after 24 hours (in kids younger than 2 years) or 72 hours (in kids 2 years or older)
• has recurrent fevers, even if they only last a few hours each night
• has a chronic medical problem such as heart disease, cancer, lupus, or sickle cell anemia
• has a rash
• has pain with urination

Seek emergency care if your child shows any of the following signs along with a fever:

• inconsolable crying
• extreme irritability
• lethargy and difficulty waking
• rash or purple spots that look like bruises on the skin (that were not there before the child got sick)
• blue lips, tongue, or nails
• infant's soft spot on the head seems to be bulging outward or sunken inwards
• stiff neck
• severe headache
• limpness or refusal to move
• difficulty breathing that doesn't get better when the nose is cleared
• leaning forward and drooling
• seizure
• abdominal pain

Also, ask your child's doctor for his or her specific guidelines on when to call about a fever.

*Other things my doctor (and kidshealth.org) mentioned to do for your child are a lukewarm bath or sponge bath (never cold because it can cause shivering-which will raise your child's temperature), dress the child in lightweight clothing (and only use a lightweight blanket), give plenty of fluids and have the child rest.



So, what I did for Ellie, was give her more Motrin and put ice packs on her. (I now know not to do this.) Her temperature went back down to the 103 range (where it's been hovering since Tuesday) and she was able to go back to sleep. I was very worried, though, and wish I had known the answers to my questions BEFORE this happened.
So everyone, if you don't know what your doctor recommends about fevers, then call and ask! Get the very specifics. It'll save you a lot of worry in the middle of the night...


By the way, I went ahead and took Ellie to the doctor just to make SURE it was nothing more than this virus going around and it's not. I can expect 1-4 more days of this yuckiness...