| SPONGING
Although helpful, sponging (artificially cooling the skin surface) is usually not necessary to reduce fever. Never sponge your child without first giving a fever medication. Sponge immediately only in emergencies such as heat stroke, delirium (acting very confused) from fever, a seizure from fever, or any fever greater than 106°F. In other cases, sponge your child only if the fever is over 103°F, the fever has stayed that high when you take the child's temperature 45 minutes after giving medication, or your child is uncomfortable from the fever. Until the medication has taken effect (by resetting the body's thermostat), sponging will only cause shivering, which is the body's attempt to raise the temperature.
If you choose to sponge your child, use lukewarm (85-90°F) water. Sponging works much faster than immersion, so seat your child in about two inches of lukewarm water and wet the skin surface continually over about 20 minutes. If your child shivers, warm the water slightly, or wait for the fever medication to take effect. Your goal should be to reduce the fever by a few degrees, not to eliminate it entirely. Never use rubbing alcohol either alone or in the sponging water. The skin can absorb it, and it can cause coma if inhaled. And please remember never to leave your child unattended in the tub.
EXTRA FLUIDS
Because body fluids are lost due to sweating during fevers, encourage your child to take some extra fluids to replace those losses, but do not force him to drink. Your child may especially prefer popsicles or iced drinks during the fever.
LESS CLOTHING (BUNDLING CAN BE DANGEROUS)
Since most body heat is eliminated through the skin surface, your child's clothing should be kept to a minimum during a fever. Bundling a child can cause a higher fever; be especially careful with infants who cannot shed extra layers if they become overheated. During a fever, dressing the child in a single layer should be adequate. If at any time your child feels cold or develops shivering ("the chills"), offer a light blanket or a warm drink.
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How to Measure Body Temperature
Obtaining an accurate measurement of your child's temperature with a thermometer requires some practice. If you have questions about this procedure, ask your pediatrician or office nurse to demonstrate how it is done and to observe you taking your child's temperature. A rectal measurement is the most desirable and the most accurate, especially in an infant, because it reflects the body's central ("core") temperature. Oral temperatures are also reasonably accurate if performed properly. Axillary (underarm) temperatures are the least accurate, but better than no measurement at all.
TYPES OF THERMOMETERS
1. Digital--These record temperatures with a heat sensor that runs on a small battery. They measure quickly, usually in less than 30 seconds, and can be used for rectal, oral, or axillary readings. They usually "beep" when the measurement is complete, and then display the temperature in numbers on a small screen. These thermometers are inexpensive and are recommended as the most reliable by pediatricians.
2. Glass--These come in two versions, rectal (with a round tip) and oral (with a thinner tip) although they can be used interchangeably if well-cleaned, and can also be used under the arm. They are the least expensive type of thermometer but also the slowest (usually requiring two to three minutes for a measurement) and the most difficult to read. Mercury thermometers should not be used. We encourage parents to remove mercury thermometers from their homes to prevent accidental exposure to this toxin.
3. Ear Thermometers--These are infrared devices that read the temperature of the eardrum, which provides a measurement that is as sensitive as a rectal temperature. Although they are the fastest reading thermometers (less than two seconds), they are expensive and often inaccurate and therefore unreliable.
4. Other thermometers--Liquid crystal strips and temperaturesensitive pacifiers have been found to be inaccurate and unreliable and should be avoided. |
