Wednesday, November 13, 2013

Fever Tales

Before I had kids I never really thought about fevers.  In fact, I don't think I had really had a fever in about a decade.  There just comes a time in one's adult life where fevers are a rarity.  Isn't that nice?

But then come children.  And with that, fevers.  

Fever Tale #1
After I had Braden, my first child, I took him to his first doctor's appointment and returned home armed with "Guidelines for the Newborn Infant."  In it was a chart with medicine and dosing instructions, in the event that Braden ever got a fever.  I stocked my medicine cabinet with acetaminophen and ibuprofen, and never really thought much of it.  

At the age of 7 months, Braden got his first fever.  I could tell he was warm, but I was a novice.  I took his temperature (rectally - it takes a while to get used to that), and it was 101.  I FREAKED THE HELL OUT.  As in, called the on-call pediatrician at 2am freaked out.  I look back at this now and am humiliated, but hey, I was a first time mom.  This was a first time fever.  The doctor called me back asking what the emergency was, and I told her my son has some kind of infection or ailment or disease!  HE HAS A FEVER!  She instructed me to (drum roll please).... give him some medicine.  I did.  He got better.  Onto the next.  

Fever Tale #2
By the time my second son, Casey, entered the picture, fevers were old hat.  They happened.  A lot.  I gave medicine, I waited them out, and I didn't freak.  But there was one thing I was fearful of.... the pre-six week old infant fever.  

Why?  Because if a baby is younger than six weeks old and gets a fever, that means automatic hospitalization.  At that age, they can't be sure it's not meningitis or pneumococcus or any of those other really scary diseases, so they hospitalize the baby for a couple of days, take a spinal tap, give antibiotics just in case, and run lots of tests.  I had had a few friends go through this with their newborns, and it didn't seem fun (luckily their newborns turned out to be fine - just run of the mill fevers).  

So when Casey was 5 weeks old and came down with a temperature of 100.5, I knew what the deal was going to be.  Off to the hospital we went.  Spinal tap.  Antibiotics.  Admission for two nights.  The diagnosis after all that?  The common cold.  I totally get why we had to go through the motions, and I was grateful that it was nothing serious.  But still, compared to Braden's first fever, this one was a doozy.  

Fever Tale #3
After two kids and countless fevers, I have to admit that I started to get a bit laxadasical about the whole thing.  My lips have actually become my thermometer - I can kiss the kids' foreheads and predict the temperature with remarkable accuracy.  When I realize the kids have a fever, I don't panic - I simply break out the medicine, keep them home from school, and life goes on.  No big deal.  

Then, a few months ago, I got sick.  I actually got a fever.  It was the first fever I had had in years, and it was awful.  Horrible.  So horrible, that I felt a deep guilt for not feeling more sympathy for my kids when they have fevers.  For drugging them and expecting them to carry on and eat and not throw tantrums and sleep normally.  Because when I had this fever, I was a big baby.  I wanted to be served. Massaged.  Taken care of.  I couldn't eat, I couldn't sleep, and spent hours moaning (a la Billy Crystal, When Harry Met Sally style).  I took tylenol around the clock and eventually recovered, but the whole experience put these fevers in perspective.  They suck.  

Everyone has their own fever tales, and they are never fun.  But no matter how seasoned we get with fevers, it's always good to have some reminders how to treat them, particularly with regard to kids.  Here are some great tips from OTC Safety:

- Two over the counter medicines that can be used in children to treat fevers are acetaminophen and ibuprofen.

- You can use both medicines simultaneously, but it is absolutely vital that you maintain six hours in between the use of the same medicine, while alternating between medicines every three to four hours.  For example, if you give your child acetaminophen at noon, you can give him ibuprofen at 3pm, adn then acetaminophen again at 6pm, and ibuprofen again at 9pm.  Neither medicine should be used for more than 24 hours without consulting a physician.  (Please see the OTC Link here for more details).

- Note that there have been some recent changes to acetaminophen dosing.  There used to be two concentrations: one for infants 0-3 years of age, and one for children 2-12 years of age.  Now both infants' and children's liquid acetaminophen are made in the same strength to make it easier for parents and caregivers to avoid common dosing errors.    (Please see the OTC Link here for more details).

- Acetaminophen and ibuprofen products come with age-appropriate dosing devices, such as plastic syringes or measuring cups.
     * Before giving your child any medicines, make sure you know your child's weights.  Dosing is              most accurate when it is based on weight, not age.
     *Make sure to read the package label very carefully for proper dosing.
     *Acetaminophen is most commonly administered at a dose of 10mg/kg to 15 mg/kg every four              hours; whereas, ibuprofen is usually administered at a dose of 10 mg/kg every six hours.
     *Always use the measuring device that comes with the medicine.  Do not mix and match dosing           devices.

Below is a helpful info-graphic that outlines some of these reminders.  

And lastly, a call to action:

As many of us parents know, acetaminophen products don't have dosing instructions for children six months to two years old.  Instead, it simply says:  "Ask a doctor."  I don't know about you, but at 2am when I am bleary eyed and trying to figure out how much medicine to give my child, it's not the most opportune time to ask said doctor (or to try and dig out that pamphlet my doctor gave me 5+ years ago - no idea what ever happened to that).  

Though this information is readily available on the internet, or in literature from your doctor, for years the manufacturers of pediatric acetaminophen have been asking the FDA to let them include this dosing information on the product itself.  If you are interested in supporting this effort, then you can view the citizen petition that has been submitted to the FDA, and submit your comments here.


  1. Maybe I'm weird but I like getting fevers. Well, I guess I prefer not to have them. But if I have to get sick, I always hope it is a fever rather than something else. I'm not puking. I don't have to go to work. I have an excuse to lay in bed all day. I'm not too sick that I can't watch TV or read a book. I can cuddle under a blankie until my body is so hot it feels like I'll explode. Ok, I'm just weird.

  2. Helpful information. Thank you! I bet I'll refer back to this in the future.

  3. Helpful information. Thank you! I bet I'll refer back to this in the future.


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