Laurie R. Schnell, M.D.

Some parents automatically consider fevers "bad" for children, thinking of them more like a disease than a symptom. Fevers, in fact, are one of the body's protective mechanisms and turn on the immune system. Believe it or not, Schnell, most fevers are good for children and help the body fight infection.

Body temperature actually fluctuates throughout the day, peaking in the late afternoon and evening. Average temperature, measured orally, is 98.6 degrees F. Mild elevation can be caused by exercise, excessive clothing, a hot bath, hot weather, or warm food or drink. Taking the temperature a half hour after addressing these possible effects will give a more accurate reading.

A child has a fever whenever any of the following apply:

• rectal temperature is over 100.4 degrees F
• oral temperature is over 99.5 degrees F
• armpit temperature is over 99.0 degrees F
• temperature taken in the ear is over 100.4 F degrees, if set in rectal mode, or 99.5 degrees F, if set in oral mode

The fourth method is not reliable, however, if the child is less than 6 months old.

The usual fevers (100 to 104 degrees F) that all children get are not harmful. Most are caused by viral illnesses and last for two to three days. In general the height of the fever doesn't relate to the seriousness of the illness - how sick your child acts and looks is what counts.

Fevers only need to be treated if they cause discomfort, usually when they are 102 degrees or higher. A virus or bacteria could be the cause of a fever that doesn't respond to medicine. It doesn't relate to the seriousness of the infection.

Some parents think any fever over 104 degrees F is dangerous and causes permanent harm. In actuality, only body temperatures over 107 degrees F are truly serious and can cause brain damage. Body temperatures only go this high with high environmental temperatures, such as when confined in a car.

Parents also worry about febrile seizures, but only 4% of children experience them. They can be frightening to watch but usually stop within a few minutes and cause no permanent damage.

All fevers can be treated with extra fluids and less clothing. Bundling up a child will only cause a higher fever. If your child experiences the chills, then a light blanket may be offered. Children older than two months can be given any one of the acetaminophen products. Two hours after they are given, these medicines will reduce the fever 2 to 3 degrees. Seldom will a drug bring a temperature down to normal unless it wasn't very elevated to begin with. Do not, under any circumstances, use the dropper that comes with one product with another brand. Ibuprofen and acetaminophen are similar in their abilities to lower fever. One advantage with ibuprofen, however, is it has a longer-lasting effect, i.e., 6 to 8 hours instead of 4 to 6 hours.

Sometimes parents are instructed by their health care provider to alternate acetaminophen and ibuprofen. If so, they should follow these guidelines. Use both if the fever is over 104 degrees F and not responding to one medicine alone. Give a medicine every 4 hours (acetaminophen every 8 hours and ibuprofen every 8 hours). Only alternate for 24 hours or less; then return to a single product.

Parents to always call their doctor if their child is less than 3 months old, has a fever over 105 degrees F, and looks or acts very sick.