It’s the beginning of cold and flu season. That means a lot of kiddos, big and small, are coming to the office with fever.
As docs, we know that fevers can freak moms and dads out. Kids look pretty awful when their temperature climbs, and it is understandable that parents want to bring them to the office for an evaluation.
In the exam room, I often hear worried parents say something like this: “Dr. Natasha, we gave her some ibuprofen for her fever last night, but we did not give her anything this morning. I wanted you to see what she looks like with no medicine.”
Undoubtedly, my little patient is sitting on her parent’s lap; looking red-cheeked, droopy, and endearingly pathetic. And so the challenge begins. My job to get the correct diagnosis just got harder.
1. A child with a fever is hard to examine. When a child is ill, I need to be able to do a thorough and accurate exam. But fevers make kids feel pretty rotten. They are hot and sweaty, sore and achey. The last thing they want is to be poked and prodded by a stranger with shiny, unfamiliar tools. So I am often left with a crying, protesting, flailing child who is hard to hold, and even harder to examine.
2. Fevers change vital signs. Fever does not only elevate a child’s temperature, it also increases their heart rate and breathing rate. Fever also can change how the skin appears. These appropriate, natural body changes that occur when body temperature rises can be misleading when looking for signs of illness. Subtle clues to significant illness can be overshadowed. For example, a fever can make it less clear if a child’s rapid breathing is due to pneumonia or due to the fever itself.
3. I believe you. Your story matters. If you tell me that your kiddo has had an elevated temperature, I trust what you say. It is much more important to me for you to share when your child’s fever started, if and how you took her temperature, and what fever reducing medication dosages you are using. I don’t need proof.
The bottom line is that fever is a symptom of an illness, not an illness itself. So, I don’t need to see it.
The next time your child has a fever as part of an illness, don’t hesitate to adequately treat them with fever reducer (here is a dosing chart for help) before bringing them to the office. Your child will feel better, our time together will be more effective, and we can work together to return to wellness.
Natasha Burgert is a pediatrician who blogs at KC Kids Doc.