A fever is a symptom indicating the body’s immune system is fighting an infection, typically viral or bacterial. It involves an elevation in core body temperature, generally defined as 100.4°F (38°C) or higher. For infants, the primary goal of managing a fever is to maintain comfort while preventing overheating or chilling. Since babies cannot regulate their temperature as effectively as adults, careful attention to their clothing and surroundings is important.
Dressing for Comfort and Heat Regulation
When an infant has a fever, the focus shifts to facilitating natural heat dissipation through the skin. Parents should dress the baby in only a single layer of lightweight clothing, such as a cotton onesie or a light sleep sack. Using breathable fabrics like cotton or muslin is recommended because these materials allow air circulation and reduce the likelihood of excessive sweating.
The common practice of adding an extra layer of clothing should be disregarded when a baby is feverish. Excessive clothing or bundling traps body heat, preventing the fever from coming down and increasing discomfort. Parents should check the baby’s temperature by feeling the chest or back, as hands and feet are unreliable indicators of core warmth. If the baby has been sweating, change any damp clothing to prevent the skin from cooling too quickly once the fever begins to drop.
Environmental Management
The surrounding environment plays a significant role in helping a baby manage an elevated temperature. Experts recommend keeping the room temperature in a moderate range, typically between 68°F and 72°F (20°C and 22°C). This range supports the body’s effort to cool itself without causing the baby to shiver.
A gentle circulation of air can be helpful, but the baby should be placed away from direct drafts or strong air currents. For sleep, use only a light sheet or blanket, or none at all, ensuring the crib remains clear of heavy covers. Maintaining a cool sleeping environment helps reduce the risk of overheating, which is linked to Sudden Infant Death Syndrome (SIDS).
Common Mistakes and What to Avoid
A common misconception is that a fever needs to be “sweated out” by bundling the child in extra clothes and blankets. This practice is dangerous because it prevents heat from escaping, causing the fever to rise and potentially leading to hyperthermia. Infants, especially those under one year old, are susceptible to overheating because their body temperature regulation system is less developed.
Parents should also avoid extreme cooling methods, such as using ice baths or cold water, which can cause the baby to shiver. Shivering is a reflex that generates internal heat, causing the core body temperature to increase. Using rubbing alcohol for cooling is unsafe, as it can be absorbed through the skin and is toxic to infants.
When to Seek Medical Attention
While many fevers resolve on their own, certain signs warrant immediate medical attention. Any fever of 100.4°F (38°C) or higher in an infant younger than three months old requires an immediate call to a healthcare provider or a trip to the emergency department. Fever in very young infants can indicate a serious infection that requires prompt evaluation.
For babies older than three months, seek medical advice if the fever reaches 102.2°F (39°C) or higher, or if it lasts for more than 24 hours without an apparent cause. Urgent warning signs include:
- Lethargy or difficulty waking the baby.
- Difficulty breathing or a stiff neck.
- Refusal to drink fluids for a prolonged period.
- Skin or lips appearing blue, purple, or gray, or inconsolable crying.