PUBLISHED: 10:06 AM on Wednesday, December 27, 2006
A guide to take care of your feverish child
It's 3 a.m. and your 2-year-old daughter's fever has hit 103.5 degrees.

What do you do?

A) Give her a cold bath. B) Take her to the emergency room. C) Use over-the-counter medicine to keep the fever down through the night and call your doctor in the morning.

That's actually a trick question.

No two fevers are exactly the same, and parents need to consider more than temperature.

With flu season here, parents might need a crash course in basic home health care. And don't always trust those old wise tales and folk remedies your grandmother taught you.

"As long as the child is acting fairly well, it's not an absolute emergency if a child has a temperature of 103.5," said Dr. Jeremy Franklin, a pediatrician.

Children can tolerate higher fevers than adults, so parents shouldn't panic when their child's fever hits 103 or 104 degrees, Franklin said.

At the same time, a fever of 101 degrees in a child can be very serious.

Understanding fever

• Most pediatricians consider any thermometer reading above 100.4 degrees a sign of a fever.

• Fevers are generally harmless and help your child fight infection. Except in the case of heat stroke, fever itself is not an illness - only a symptom of one.

• Many conditions, such as an ear infection, a common cold, the flu, a urinary tract infection or pneumonia, may cause a child to develop a fever.

Source: American Academy of Pediatrics

"It's not how high the fever goes; it's how the child looks," said Dr. Lesley Motheral, a second-year medical resident at the Health Sciences Center who works many evenings answering the after-hours phone line as the on-call doctor.

There are a few telltale signs to look for that could mean a fever needs immediate attention.

"Dehydration, rapid or stressed breathing or severe lethargy - those are all serious signs," said Dr. Andy John Gray, who operates a family practice.

Severe vomiting and or diarrhea also can lead to dehydration, which can be treated by giving children teaspoon-sized sips of Pedialyte or another oral electrolyte replenisher every 10 or 20 minutes.

So your child has a fever and the doctor's office is closed. But the fever isn't high enough to take your child to the emergency room.

You could be in for a long night, but most parents should be able to handle the situation.

"One of the secrets to fighting a cold or fever is staying well hydrated, taking in a lot of fluid," said Dr. Richard Lampe, chairman of the department of pediatrics at the Health Sciences Center.

In most cases, an over-the-counter medicine such as Children's Tylenol or Motrin will lower a child's fever. Always follow the directions on the label, and when in doubt of the proper dose, call your doctor.

If over-the-counter medicine isn't working, that could signify a more serious condition.

"If you get a fever that's not responding to appropriate doses of medicine, it's time to go in and be seen," Gray said.

What about all those folk remedies Granny used?

Most doctors don't have a lot of faith in them.

"We always hear about chicken soup," Franklin said. "There's not any definitive data out there that supports any of these home remedies. There are some home remedies that can be dangerous."

The old advice to rub alcohol over the skin to the reduce fever isn't recommended anymore.

"That's a big no-no," Lampe said, adding that alcohol can be absorbed through a child's skin and cause adverse reactions.

Another folk remedy for fever that doctors say people need to stop doing is attempting to cool off the patient with cold water.

"It's worse, because it causes them to shiver and will increase their temperature," Lampe said.

Some parents tend to bundle their children too much when they have colds or fevers.

"If you're comfortable in the room, your child doesn't need to be bundled," Gray said.

To help reduce the fever, doctors say children should be lightly clothed in loosely fitting garments that allow heat to escape the body.