The Doctor’s In…Let’s Talk about Fever in Children

Some years ago, when I was first practicing, an article written by a long-time pediatrician came my way regarding Fever in children. It has been invaluable for me to share with families over the years.  Today I will give you a synopsis of what this physician wrote, having treated over 100,000 children in his years of practice.

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What constituents “Normal” body temperature? Everyone’s body temperature moves between 97-100 degrees throughout the day.

Each child’s temperature will shift throughout the day between 97 and 100 degrees.

How does the body produce Heat? The body maintains a fairly constant internal temperature regardless of the outside temperature, through the unseen, internal work going on at a cellular level. That is why, although asleep and apparently doing nothing, a child’s body temperature is still 97-100 degrees. Some is muscles at work; like the heart muscle, which continues to work through the night, even when children are sleeping. Still other work is happening as thousands of chemical reactions are going on in the trillions of body cells. 

All of this work produces in normal children, up to 100 degrees of body heat.

Heat is a by-product of work: With the body maintaining a “Normal” temperature of 97-100 degrees, there must be more heat produced when there is more work being done…and there is.

Fever is a word, which indicates that there is more than the normal amount of internal work going on in the body.

What is the predominant reason for the normal internal work of the body to increase and accelerate?

The answer is almost always – infection.

Why does infection result in more work for the body? When there is an infection somewhere in the body, many body processes are speeded up and many processes which weren’t going on at all before, are set in motion—all in an attempt to return the body to a state of health.

  • White Blood Cells (WBCs) which normally circulate in the blood are increased
  • Cells of the body, like factories, begin to produce antibodies at a faster rate 
  • The Heart beats faster, as propels WBCs & antibodies to where they are needed
  • New blood vessels, built into the area of the infection, bring WBCs & antibodies
  • The rate of breathing increases, to supply the more oxygen for these new activities 
  • Many other known & unknown activities are either initiated or speeded up 

It is easy to see that fever is, in a way, a good thing for it is evidence that the body is able to respond to an infection.

What does responding to an infection indicate? Responding to an infection indicates that the immune system is functioning well, and because the bodies of healthy, young children are in such good condition and are functioning so optimally….

children often get 104 degrees of fever with as minor a condition as a cold.

Common myths about Fever:  Now, after understanding more about fever, which is the result of the body doing the things it needs to do, in order to return to a state of health, do these myths make sense? 

  • A fever can cause brain damage:  

There is essentially no basis in fact to substantiate the myth that fever in & of itself can cause brain damage. This myth likely began, long ago, when less was understood about the relationship between illness & fever. In those days when someone was sick, the fever was looked upon as being the problem, rather than the result of the body reacting to the problem.

There are certain infections, like meningitis & encephalitis, which can result in various degrees of brain damage, if one survives the infection. It seems reasonable to assume that the brain damage, which resulted from such an infection, was blamed on the fever, which was associated with the infection.

  • A fever, if it gets too high, causes convulsions: It is true that there are some children who sometimes, when they are sick & happen to have a fever, do have convulsions. This certainly is far from proof that fever is the cause of the convulsions. If the degree of the fever was the primary factor which caused the convulsions, then one would expect that all or at least a majority of children would have a convulsion when their body temperature reached a certain degree. Just the opposite is true. The vast majority of normal children never have convulsions, regardless of how high their body temperature gets.
  • A fever left untreated could rise indefinitely:  The body’s temperature is a reflection of the amount of internal work going on in the body. Therefore, the degree to which the body’s temperature can rise is limited by the amount of internal work that the body can do, which is governed by the laws of physics & chemistry. 
  • It is important to lower a high fever: There is no scientific evidence to indicate that it is ether necessary or good to attempt to lower the body’s temperature. Since fever is not the problem, but is only the result of the body responding to the problem, it makes  no sense to try and lower the body’s temperature.
  • A high fever must indicate a serious infection:  A child is not more likely to have something serious if the temperature is 104, compared to a temperature of 101. A child’s temperature fluctuates when sick, & it may be 102 in the afternoon and 104 at night, as temperatures do seem to be higher at night. If a child’s temperature was 102 at its highest yesterday and has gotten as high as 104 today, it doesn’t mean that the body’s defenses are not adequately dealing with the infection.
  • Temperatures of 104 are too high and not common: In fact, Temperatures of 104 are extremely common, & they are commonly associated with the most harmless types of infections…colds and flus.
  • It is important to take the temperature regularly:  While you may choose to take your child’s temperature, knowing the exact degree, gives very little, if any, useful information about how the child is doing. If you don’t take your child’s temperature (with the understanding of course of why you are not), you will not be doing your child any harm and in all likelihood your child will appreciate not being bothered.

Remember…Knowledge is Power. As parents and caregivers, it is so important to work from a foundation of knowledge and set the myths aside.  

Mahalo nui loa!

Peace & Blessings,

Dr. Patricia

This information does not apply to infants less than three months old. They should be examined by a physician if they have a rectal temperature greater than 100 degrees and are acting sick.

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