Q: My two year old has a fever of 102.3 rectally. He also has a runny nose, slight cough and seems a bit tired and cranky. Should I call his pediatrician right away or wait and see how it goes?

A: Among the zillion responsibilities you have as a parent, knowing what to do when your child gets a fever is among the most important and, therefore, the scariest. Let me break down the issues for you and help you figure out how to approach this common concern:

1. Be certain there is indeed a fever. That usually means a rectal temp (the most accurate) in a young child. Generally any temperature above 100.4 is considered a fever.
   
   
2. Fever = infection. It is not due to teething. It is not due to allergies. It is not due to stress. Your child's fever is almost certainly due to an infection.
   
   
3. Therefore, once a fever has been established, the real question is: what kind of infection is it? A virus? A bacterial infection? Look for clues: are there any symptoms, like a rash, cough, vomiting or diarrhea?
   
   
4. Most important, how sick does your child look? If s/he is happy and playful and living large, then a serious infection is unlikely, no matter what the degree of fever. If, on the other hand, she looks lethargic, unhappy, not alert, not hungry, etc, then a significant infection is more likely, no matter the level of the fever.
   
   
5. Don't be fever-phobic. The fever is unlikely to cause any harm, except to make your child uncomfortable (for more on this see my blog post here.)
   
   
6. For comfort you can give ibuprofen or acetaminophen in the prescribed doses, every four hours or so.
   
   
7. Involve your pedi! Only s/he will be able to diagnose what is going on should your little one need to be seen. Let him/her know what is going on from the beginning, especially if you have concerns.
   
   

The good news is that most infections are self-limited and kids come out of it fine. Odds are that is the case with this current infection. Your job (and mine), however, is to be a little paranoid that perhaps this time, just maybe it's something out of the ordinary, requiring immediate intervention.

Tools to Try

• Check Symptoms
• Treating Fever in Children

Technorati Tags: fever, FAQ, pediatrics, ask the pediatrician

      Q：我两岁的儿子发高烧到39°C左右。而且他还流鼻水，患轻微感冒，看起来有点累，站得不稳。我应该马上叫他的儿科医师来还是等等看将会怎样？

      A：当你的孩子发烧时，知道该怎么做是你作为父母所应付的众多责任中的最重要，也是最让人惊慌的责任之一。现在，让我替你把这些问题分好类，然后帮助你弄清楚怎样处理这些共同的焦虑：

      确定确实是发烧了。那普遍指的是小孩子的直肠温度（最精确的）。通常来说，高于100.4的温度都被认为是发烧。

      发烧=感染。如果这不是由于长牙，不是由于过敏，也不是由于压力引起的，那么你小孩的发烧就毫无疑问地是由一种传染病引发的。

      因此，一旦已经确定是发烧，那么真正的问题是：这是一种什么样的传染病？一种病毒性疾病？一种细菌性感染？查找一些线索：有像疹子，感冒，呕吐腹泻之类的征兆吗

      最重要的是，你的孩子看起来病得怎么样？如果她/他很快乐，很好玩，而且成群结队的，那么，无论（她/他）发烧的程度怎样，都不太可能患严重的感染病。另一方面，如果她看起来是无精打采的，不高兴的，不机灵的，不感觉到饿的，等等，无论发她发烧的程度怎样，都非常有可能患严重的感染。

      不要对发烧有恐惧感。发烧不太有可能引起任何危害，它只是会让你的孩子觉得不舒服（更多有关的信息，请看我这里的博客帖子）。

      你可以在大约每四个小时规定的药量中放入异丁苯丙酸和对乙酰氨基酚，这样会让你的孩子感到舒服一些。

      需要你的精心呵护。你的孩子应该看医生，只有这样她/他才能被诊断出将会发生什么事。尤其在你有焦虑的时候，让他/她知道发生了什么事。

      好的消息是，绝大多数的传染病都是有自己的期限的，孩子会很健康地恢复过来。机率就和现行传染疾病一样。然而，你的工作（和我的）将会变得有点疑神疑鬼的----那就是，也许这个时候，会发生一些不寻常的，需要马上被干预的事。

      尝试的工具

      核实征兆

      处理孩子的发烧问题

      数码英雄标签：发烧，常见问题解答，小儿科，询问儿科医师。