My anti-vaxer niece just let me know her 3 year old has a 102 temp

[3catwoman3]

36. Pediatric nurse practitioner here, with 43 years.

..in the trenches. I will offer you what I call my “Fever 101” lecture (pun intended). I have given this information to worried parents more times than I can count in my now lengthy career.

First point - fever, in and of itself, is seldom dangerous. The 2 times that it is are not related to infection, which is quite fascinating. Those 2 times are heat stroke and malignant hyperthermia, which is a bad reaction to an anaesthetic gases. There are dangerous illnesses accompanied by fever, but it is the illneses that are dangerous, not the fever.

Second point - fever has benefits. It slows down germ growth and speeds up white blood cell production. There is thinking among immunologists and infectious disease docs that over-management of fever may result in illnesses lasting longer because we are interfering with the body’s attempt to heal itself.

Third point - the goal of fever management is to bring the temp down enough to feel more comfortable, but not necessarily down to normal. We want the fever to do its work, but not to feel miserable while it does.

Fourth point - 102 is NOT high in a young child. 104 is. Someone above gave the excellent information that her pediatrician said behavior is always a huge factor. That is absolutely correct. If kids are what I call “hot and happy,” it is perfectly OK to just watch. Intervene when they get cranky. Fever reducers usually start Wednesday raking in abut 30 minutes.

Fifth point - Tylenol can be dosed at 4-6 hour intervals, and Motrin at 6-8. I would not recommend giving Motrin every 4 hours. The using both approach has rather fallen out of favor as there is potential for overdosing, and advising the use of two agents adds to fever phobia, making the situation sound so dire that a single medication is not enough. It is sometimes still recommended for fever of 105 or for kids prone to febrile seizures. Not for 102. Febrile seizures occur in about 4% of kids, and are scary but, happily, usually do not cause harm.

Sixth point - if a child perks up on either Tylenol or Motrin, that is very reassuring. If there is a serious diagnosis like meningitis, over-thecounter fever reducers ain’t gonna do it.

Your niece’s situation sounds well within typical illness patterns. Fevers can lead up to 5 days before peds folks start to worry that we need to do a lot of investigating, as long as the child continues to perk up when the fever reducer is given. count 24 hour periods from onset of symptoms, not the names of the days of the week. A child who develops a fever at 10 PM on a Monday night has not had a fever for 3 days at noon on Wednesday - not yet 48 hours. It is important to count properly, so as not to worry too soon that something has lasted too long.