A fever indicates the body’s natural response to illness and is a common symptom in children. While often a normal part of fighting off an infection, fevers can cause concern for parents. Understanding its various causes can provide clarity.
Common Reasons for Fever
Many fevers in children arise from common viral infections. Illnesses such as the common cold, influenza, roseola, and stomach bugs frequently trigger a fever as the immune system activates its defenses. Fever might be the initial symptom, with other signs like a runny nose or cough developing a day or two later. For instance, roseola can cause a fever for several days before a rash appears.
Bacterial infections are another source of fever. These can include conditions like ear infections, strep throat, or urinary tract infections. Unlike viruses, bacterial infections sometimes require specific treatments, such as antibiotics.
Fever can also occur as a temporary reaction to routine childhood vaccinations. This post-vaccination fever indicates the child’s immune system is actively responding to the vaccine, building protection against future illnesses. These fevers typically begin within 12 hours of vaccination and usually resolve within one to two days. In some instances, mild dehydration or even overheating can lead to a slight elevation in body temperature, though these are less frequent causes of fever.
Periodic and Atypical Fever Causes
Beyond common infections, some children experience recurring fevers that do not stem from typical viral or bacterial causes. These are often categorized under periodic fever syndromes, which involve episodes of inflammation not caused by infection. One example is Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA) syndrome. PFAPA is considered the most common periodic fever condition in children, usually starting between ages two and five years.
Children with PFAPA syndrome experience recurrent fever episodes lasting typically three to six days, often accompanied by mouth sores, a sore throat, and swollen lymph nodes in the neck. These episodes tend to recur at regular intervals, sometimes every two to eight weeks, and children are generally healthy between episodes. While the exact cause of PFAPA is not fully understood, it involves an abnormal activation of the immune system.
Other less common underlying conditions, often grouped as autoinflammatory diseases, can also manifest with recurrent fevers. These conditions involve an inappropriate triggering of the body’s inflammatory response, distinct from autoimmune diseases where the immune system mistakenly attacks healthy tissue. Examples include Familial Mediterranean Fever (FMF), Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS), and Mevalonate Kinase Deficiency (MKD). These conditions are typically diagnosed by a medical professional after other common causes of fever have been ruled out.
When to Consult a Doctor
Knowing when to seek medical attention for a child’s fever is important. For infants younger than three months, any rectal temperature of 100.4°F (38°C) or higher warrants immediate medical evaluation, as fevers in this age group can signify a serious infection. For children aged three months or older, a temperature higher than 102.2°F (39°C) should prompt a call to the doctor.
The duration of the fever is also a factor; if a fever persists for more than 24 hours in a child younger than two years, or more than three days (72 hours) in a child two years or older, medical advice should be sought.
Accompanying symptoms are important indicators. These include extreme lethargy, unusual drowsiness, or difficulty waking, which are red flags. Other concerning signs are a rash, difficulty breathing, a stiff neck, severe headache, or persistent vomiting or diarrhea. Signs of dehydration, such as fewer wet diapers, lack of tears when crying, dry mouth or lips, or a sunken soft spot on an infant’s head, also necessitate medical consultation. Trusting parental instinct is also important; if a child “just doesn’t seem right,” a medical professional should be contacted.
Home Care for Fevers
When a child has a fever, the primary goals of home care are to ensure comfort and adequate hydration. Offering plenty of fluids like water, clear soups, or electrolyte solutions helps prevent dehydration, which can be a concern with fever. Small, frequent sips are often more manageable than large quantities.
Dressing the child in lightweight clothing and maintaining a comfortably cool room temperature can also help regulate body temperature and promote comfort. Rest is important for recovery, so encouraging low-key activities is beneficial.
Over-the-counter fever reducers, such as acetaminophen or ibuprofen, can be administered to alleviate discomfort. Acetaminophen can be given every four to six hours, while ibuprofen can be given every six to eight hours, with dosages based on the child’s weight. It is important to avoid giving aspirin to children due to its association with Reye syndrome, a rare but serious illness. The aim of these medications is to improve comfort, not necessarily to bring the temperature down to a specific normal level.