O.C. Health: Taking care of a feverish child

So your child has a fever, what do you do? It depends.

It is important to note that a fever is the body's natural response to the presence of an infection, so don't panic. There is evidence to suggest that the body's immune system is enhanced by the presence of the fever. A temperature of 100.4 degrees or more is considered a fever regardless of age.

So now what do you do? First, make your child comfortable with a weight-appropriate dose of acetaminophen and/or ibuprofen. Your local pharmacist will let you know how much to give. And yes, you can give both medications together.

If the child is younger than 3 months old, then take him to your local emergency room. If your child is older than 3 months then give the medication about an hour to work. The desired result is not necessarily the temperature reduced to normal, or even reduced at all, but a happier and more active appearing child.

Additionally, parents should begin to hydrate their child with water or an electrolyte solution, such as Pedialyte, which can be found at any local grocery store.

If you have concerns about the health of your child, particularly if he/she appears dehydrated or does not improve after acetaminophen or ibuprofen, please bring him to your local ER for evaluation. ER physicians are well trained to treat your child.

Children who are younger than 2 months have an increased risk of serious bacterial infection, so those with a fever may require a chest X-ray, blood work, urine sample, nasal swab and spinal tap. A spinal tap involves placing a needle in your child's lower back to obtain the fluid surrounding his brain. A urine test will involve placing a tube through your child's urethra to obtain a sample in the bladder.

A male child older than 3 months with a fever will likely require only a physical exam. A female child older than 3 months but less than 2 years will likely need to provide only a urine sample. Your ER physician may recommend more testing depending on your child's symptoms.

The vast majority of children who develop a fever have an infection due to a virus and only symptomatic treatment is needed, so don't be surprised if your doctor does not recommend any antibiotics. Even if your child is diagnosed with an ear infection, or otitis media, do not be concerned. Most children with an ear infection do not require antibiotics.

In fact, the risk of antibiotics causing diarrhea or bacterial resistance far outweighs any benefit of treating an ear infection that will heal on its own. If your child does complain of ear pain, give them over-the-counter ibuprofen or acetaminophen and wait an hour to see if the pain gets better. If it doesn't, head to the emergency room.

Ninety-nine percent of the parents who take their child to the ER are doing a great job of keeping them hydrated and the fever controlled with medications.

Also, remember to keep your child's vaccinations up to date. As a doctor who has treated children on three continents, I have seen the devastation of disease in unvaccinated children.

The 2012 recommended schedule for childhood immunization has recently been released, so your doctor should have the most up-to-date information.

WILLIAM DODGE is an emergency physician at Mission Hospital Laguna Beach.

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