Children's Services

Commonly Heard Terms

FEVER

Fever is very common in childhood and occurs when the body temperature is elevated above the normal range of 36^oC to 37^oC (98.6^oF and 100^oF). Body temperature varies throughout the day with the highest in the late afternoon and lowest between 2:00 and 4:00 a.m. Fever is a warning sign and is an important defense that helps the body fight infection.

Parents can check for fever by taking their child's rectal, oral, or tympanic the ear temperature. Ask your doctor which method he/she prefers to use. Your child has a fever when the rectal temperature is 38.5^oC (101.4^oF) or higher, when the oral temperature is 38^oC (100.4^oF) or higher. Axillary temperatures are generally not accurate and not usually used.

If your child has a fever higher than 39^oC (102^oF), it is important to contact your physician. When a child has a fever, medication is not always needed to reduce the temperature. In fact, the best reason for giving your child medication is not to reduce the fever but to relieve the associated aches and pains.

Acetaminophen (Tylenol, Tempra, Panadol and others) is the best medication to give for a fever. Unless your physician says otherwise, parents can give the dose recommended on the package every four hours until the child's temperature has come down. The temperature usually comes down in 1 1/2 to 2 hours and then rises again; in which case the medication may have to be repeated.

A child or teenager with a fever should not be given aspirin (acetylsalicylic acid [ASA]) or any products that contain ASA. If the fever is due to chicken pox, influenza, or certain other viral infections, taking aspirin can increase the risk of Reye's Syndrome. This is a very serious condition that can damage the liver and brain. If your child has a fever, make sure the child is comfortable. Remove extra blankets and clothing so heat can leave the child's body and help lower the body temperature. Do not take off all of your child's clothes because the child may become too cold and start shivering, which produces more body heat, causing the temperature to rise again. Although sponging the child with tepid (lukewarm) water may help reduce the fever, it can make the child feel uncomfortable. Alcohol baths and rubs are not recommended.

In general, a child's behaviour will tell more abut the severity of illness rather than a fever. If your child is droopy, eating poorly, has diarrhea or vomiting, ignoring toys, uninterested in surroundings, inconsolable crying, pale/ashen colour, problems with urination, dry lips, no tears, or unresponsive he/she must be seen by a physician.

FOOD ALLERGIES

The top food allergens are milk, egg, wheat, soy, peanuts, nuts, fish, and shellfish. The risk of an infant developing food allergies is largely related to family history and the age at which the food is introduced, with the age of sensitization greatest in the first year of life. Signs and symptoms of food allergies include swelling of skin, skin rashes, nasal congestion, breathing difficulty, vomiting, and diarrhea. For infants at increased risk of food allergy because of a family history of allergies, exclusive breastfeeding for at least four months is beneficial.

When introducing new foods to infants, it is important to introduce one food at a time, several days apart. This way if a reaction occurs you will be able to identify which food caused it. If you suspect an allergy, talk to your physician. Treatment of food allergy involves avoidance of foods proven to cause symptoms. Food allergies in infants tend to disappear with age. Your physician or allergist may recommend rechallenging the offending food at certain ages. Allergies to peanuts, nuts, wheat, fish, and shellfish are the most severe and may be lifelong. In the case of one or more food allergies, ask your physician for a referral to a dietitian to ensure that your child is meeting all of his/her nutrient requirements for growth.