The first time baby Malinda had fever I was clueless. I had never taken care of sick children in my life. She was warm and fussy, not acting like her cheerful, little self. "How high a temp was too high? How could I help her feel better? When would I know if it was an emergency?"
Dr. Leila Denmark, the world's most experienced pediatrician, helped me learn to diagnose, treat and defeat fevers.
Hi, I’m Madia. I have eleven children and one of the greatest privileges of my life was to know Dr. Leila Denmark. She practiced pediatrics for over 75 years and was my mentor for 32 years.
I can hardly express how much she helped me, both with the children’s medical issues and family life challenges. I would love to share what she taught me with you.
Fever can be frightening, but it's also a blessing. Fever is the body’s alarm system, alerting us to illness. There is hardly a child who never experiences a fever. Every mother needs to know how to diagnose and treat it.
Diagnosing a Fever
When a child is uncharacteristically fussy and warm to the touch, take his temperature with a thermometer. If you don't have a thermometer, pick one up at your local pharmacy. It's best to get a regular digital thermometer that measures oral, rectal and underarm temperature rather than ear or forehead thermometers.
While you are at the pharmacy, it would also be good to purchase a bottle of low dose (81mg) chewable aspirin.Aspirin does not cure a fever, but is a pain and feverreducer and is anti-inflammatory.Every home should be supplied with a thermometer and fever reducer. It helps your child feel better while his body is fighting an illness.
Procedure for Taking Temp
Read the instructions that come with your particular thermometer. Instructions vary slightly. The general procedure is as follows:
Rectal (infants and toddlers)
1. Lay baby over your lap and gently insert the thermometer 1/2 inch into his rectum.
2. Pinch buttocks gently around the thermometer to keep it in place and hold for one minute before reading.
Underarm (young children)
1. Place the end of the thermometer in the child’s armpit.
2. Bring the arm down over the end of the thermometer and hold securely for a minute. Try to keep the armpit airtight.
Oral (For older children and adults)
Place the end of the thermometer under the tongue and instruct the child to keep it there with his mouth closed for one minute.
One degree above the following readings indicates a fever: under arm (97°), oral (98.6°), rectal (99.6°).
Double Check to Be Safe
If your child registers an abnormal temperature, it's probably due to a common illness. There is no need to panic as I did when my first baby, Malinda, was sick. However, as Dr. Denmark instructed me, it's good to first check for meningitis. Most fevers are not an emergency, but meningitis is.
Checking for Meningitis
1. Lay your child on his back.
2. Put a hand under the back of his neck and bend his head forward gently, bringing the chin toward the chest. A fussy child may stiffen his neck to resist examination, so calm and distract him while you check. If the neck is stiff and will not bend, take him to thehospital emergency room.
3. Lay the child on his back.
4. Lift his knee and try to raise the leg at a right angle from body. If legs are very stiff, it also indicates an emergency. A bulging fontanel (soft spot) on a newborn may also indicate meningitis.
Note: Meningitis is always an emergency. If the cause of your child's fever does not become clear and the high temp continues, periodically check for meningitis to be on the safe side. If any symptoms of meningitis are present, go immediately to the hospital.
When meningitis is ruled out, look for the following common symptoms to determine the cause of the fever:
A deep cough
Swollen glands in neck under jaws
A throat redder than the color of his gums
Pulling at ears
A bad headache (the flu often starts with a bad headache)
Fever is caused by infection. Scientists aren’t certain what fever does, but have observed that different germs cause fever with varying characteristics. With a strep infection, the temperature typically runs low in the morning and may even be subnormal before noon. Then it usually begins to rise, peaks at 6:00 p.m., and goes down around 2:00 a.m. Fevers accompanying flu or German measles tend to remain fairly consistent throughout the day. A fever brought on by an abscess usually drops when the abscess is opened.
Continue to observe your child for rising temperature and other symptoms. As time goes on it will become more apparent what kind of infection is causing the fever.
Treat and Defeat
If your child has an intestinal problem or stomach bug, a Denmark enema can work wonders. For instructions on safe, effective enemas refer to "Dr. Denmark Said It!".
Enemas can actually help reduce any high fever by replenishing vital body fluids. Sometimes aspirin may be added to the enema if the child cannot keep it down orally.
If symptoms are mild, inconclusive, and/or indicate an upper respiratory problem, the following are recommended:
A hot bath. Run the shower first so the room will be warm and steamy. Dry him off and dress him in pajamas from another room so his clothing will be dry.
Give him the appropriate dose of aspirin (dosages indicated below).
Bundle the child up. When he starts to perspire, usually around the back of the neck, begin taking layers off. Change wet clothing.
Give him plenty of water to drink and encourage him to rest. Without rest, a mild illness can become more serious. Rest helps the immune system work more effectively.
(Low dose 81mg chewable tablets originally called “baby” or “children’s” aspirin)
1–3 months: Mix one crushed baby aspirin and five teaspoons water; give one teaspoon.
3–5 months: Mix one crushed baby aspirin and four teaspoons water; give one teaspoon.
5–7 months: Mix one crushed baby aspirin and three teaspoons water; give one teaspoon.
7–12 months: Mix one crushed baby aspirin and two teaspoons water; give one teaspoon.
12 months: One whole baby aspirin. If he won’t swallow a tablet, crush it and mix
it with water or honey.
2 yrs to under 3: 1-1/2 baby aspirin tablets
3 yrs to under 4: Two baby aspirin tablets
4 yrs to under 6: Three baby aspirin tablets
6 yrs to under 9: Four baby aspirin tablets
9 yrs to under 11: Four to five baby aspirin tablets
11 yrs to under 12: Four to six baby aspirin tablets
12 yrs to adult: Five to eight baby aspirin tablets
Adult: Use adult aspirin, and consult bottle for dosage
* Aspirin should be administered every four hours as needed.
* Four low dose aspirin equals one 325 mg adult aspirin.
Note: Dr. Denmark was convinced that aspirin is a safe medication for children. It has been used effectively for over a hundred years. We have used it with all of our children for over 38 years with no ill effects. Dr. Denmark did not believe that aspirin causes Reye’s syndrome. However, other fever reducers recommended by your doctor can be used effectively as well.
With a high fever a child has chills. Many infants and toddlers will sit in their mothers' laps for warmth. Applying cool cloths to the child’s forehead or cool baths is not
recommended. Cold baths may cause a seizure. I would often wrap a warm blanket around my baby and cuddle him close until his fever broke. It's a good time for rocking and snuggling.
Every child’s reaction to infection is individual. Some typically run higher temperatures than others. One may have a low fever and be very sick, though another’s temperature may spike with the least illness. Some have a tendency to complain intensely with the least discomfort, while others hardly complain at all, even when they are very sick. Our Leila can spike 105 degrees and still be coherent, while Steven has been delirious at 101 degrees.
You need to evaluate the child’s general behavior to determine the severity of the illness. Observe his appetite, playfulness, and coordination in addition to his temperature, and compare his behavior to what it normally is. Your instincts are often accurate. If you’re worried and not sure what the problem is, consult a physician. Any high or pro-longed fever may indicate a need for antibiotics.
It’s easy to assume a child is well when his temperature is down in the morning. However, temperatures due to staph and strep infections characteristically drop in the morning even before true recovery. Just because he appears well, don’t send him back to school or take him to church. Going into public too soon may prolong illness and infect other children. The child’s white blood cell count may be low, rendering him more susceptible to picking up something else. He should have at least two fever-free evenings before resuming his normal routine.