Video transcription

Hi, I'm Dr. David Hill, and today we're going to talk about how to break a fever in an infant. And that brings us to the question of fevers in infants in general because some of them can be signs of very dangerous disease. So, let's talk about that for a second. Any infant up to three months of age really should not develop a fever under normal circumstances especially in the first month of life, but also to some extent in the next two months of life. A temperature over one hundred point four degrees taken in the rectum could suggest a serious life threatening illness. So, that's a baby that you want to bring to medical care immediately. There's a good chance that baby's going to require hospitalization for a day or two while the doctors make sure that he or she does not have a serious life threatening illness. The next thing to know that any fever in an infant, that's a child under twelve months of age, any fever in an infant that does not have an explanation is always concerning to us. Commonly that can be anything from a virus which maybe very mild and unimportant to urinary tract infection which can be dangerous to the kidneys. So, if your child has a fever before twelve months of age and it's not clear why, then, you still need to bring that child to medical attention so the doctor can try and figure out where the fever is coming from. Let's look at the third case. We have a child who is over three months old and has an obvious source for a fever, usually a cold, runny nose, cough, goopy eyes, there might have a little bit of vomiting or diarrhea mild; what you're going to do about that? Well, it depends how high the fever is. If the fever is over a hundred five degrees, you really want a medical provider to see that child immediately. Why? Not because the fever is going to hurt them. There's this belief that some people have that fever will fry the brain or cause permanent brain damage. It will not. It just can't happen. However, you do want to find out what the source of a high fever. Is it maybe a very serious infection? So, you just want to get that child to appropriate medical care. Between a hundred and four and a hundred and five degrees, we're little more relax, but we'd like to know we'd like to know within twenty four hours and get that child seen if it's you know, during the night, get him seen the next day so we can again look and figure out what the cause of the fever is. For fevers over a hundred point four degrees rectal to a hundred four degrees rectal, it's a little bit less urgent as long as we know what the cause of the fever is. Again, the fever is not going to damage the child. A child up to age six months may have Acetaminophen which is what's in Tylenol. Infants six months to twelve months may have either Acetaminophen or Ibuprofen. Now, back in the day, we used to recommend this regimen of alternating to Acetaminophen and then four hours later, do Ibuprofen, then go back to Acetaminophen; back and forth. We found that in the middle of the night, it's really easy to give the same thing twice and potentially causing an overdose. It also does really work much better than just giving one of the other. So, we changed our advice. Take one that works okay for your child whether it's the Ibuprofen or the Acetaminophen and stick with that whenever six to eight hours. There is really no benefit in combining them. Now, if you need to use the other one, it's fine; just switch them up. That's not a problem either. But, don't get yourself in some sort or regimen that's going to require you to keep a chart by the child's bed to figure out what you last gave; it's not worth it. You can use a tepid bath. You don't want to pour the child in a bath full of ice water. Again, the fever is not going to harm the child. So, you don't want to make the child desperately uncomfortable trying to get rid of the fever. But, a sort of a lukewarm, coolish bath may help the baby feel better and may bring the fever down a little bit and get everybody a little bit of more rest. So, talking about treating fever in an infant, I'm Dr. David Hill.