Fever has been recognized as being around for thousands of years. And yet it’s never gone away. We’ve just not evolved it away. Which must mean it benefits us, right?

The process of a fever, simplified/Dr. Diane-ified:

1. A germ (virus or bacteria) enters your body. One of your immune cells floating around notices it. It freaks out. It makes a whole bunch of chemicals to freak everybody else out. HIGH ALERT, EVERYONE!

2. The chemicals reach your brain (the hypothalamus, in particular). The hypothalamus says OK GUYS, GET THE ARMY OUT THERE, STAT. DO YOUR THANG. I'LL MAKE THIS PLACE REAL HOT TO HELP OUT!

3. The brain thermostat is set at a new number. Instead of 98 F, he’s now gonna re-set at 102 F.

4. Heart rate speeds up. Breathing speeds up. Blood vessels open, flush. The body is physically pushing the blood around faster, to get the white blood cells there quicker.

5. Muscles shiver, generating heat. You start making more immune cells. They travel around faster. They talk to each other more effectively. They “stick” to the bad guys better.

6. You feel cold, because your new “set” thermostat wants you to be 102F. You're not there yet, so your body is trying to get you there. You shiver. Your muscles ache.

7. Soon, the germ can’t replicate as much as it wants to. It can't divide and conquer. Maybe even its protective coating starts to break down a little bit.

After a few days of fever, you beat the germ! Thank you, glorious fever and fabulous immune system!

Studies have shown (in rats and iguanas) that there is even a higher success rate at overcoming a virus or bacteria if a fever is allowed to burn rather than when they're given medications to bring it down.

Oh my gosh. Aren’t our bodies amazing? And are you feeling a teeny bit better about that number on the thermometer?

Most of the time, fever is just a sign that the body is fighting something, and you just need to try to keep your kiddo hydrated and comfortable.

You do not have to run to the ER, or my office, at the very first sign of a fever if your child is over age 3 months.

But sometimes, fever isn't OK.

My son once woke up with a fever of 105.7F. I remember the day clearly. I totally freaked out, just like you do. Then I asked myself – what do I tell my patient families to do?

Once I tried a few different thermometers and they all read the same number, I gave him a dose of ibuprofen and put him in a warm bath (NOT cold – warm) and let him play.

I watched him closely. I made sure he was breathing OK, and able to drink. He seemed fine, just super grumpy.

After about 45 minutes, I re-checked his temp. It was 102F. He was sitting on the couch, drinking water and talking comfortably. I was OK with this. And he did fine. He had a fever for three days, and a runny nose and a little cough, and it went away. He had a virus, and his body took care of it.

6 Types of Thermometers:

1. Thermometer forehead “strips”, pacifier thermometers, and wearable thermometers - don’t buy them. Save your money. 

2. Forehead “temporal” thermometers – they’re OK. We use this kind in the office. Good days and bad days, and I think they’re usually as accurate as the ear ones.

3. Tympanic (ear) ones – easy to use. Pretty accurate. Don't use under 6 months, ear canals too tiny.

4. Rectal - most accurate (good luck)

5. Oral - second most accurate, if they can hold their mouths shut

6. Armpit - least accurate

Yes, you add one degree to the armpit temp measurements. Although again, I dislike the math.

But what I want to drive home is: if the child looks fine otherwise, the number often doesn’t matter too much to me.

Febrile seizures:

Something like 2-4 percent of kids between the ages of 6 months and 5 years have febrile seizures. This means they may have a seizure when they have a high fever spike. They usually stop by age 5.

These are super scary, but actually don’t cause any brain damage. The child should be rolled onto his side, and watched closely. Don’t stick anything into his mouth.

VERY rarely, unrelenting and long febrile seizures may indicate a bigger problem like something neurologic or genetic going on. But again, this is super rare.

Febrile seizures may run in families. If the seizure lasts longer than 5 minutes, call an ambulance. Again, these are rare, and usually very benign.

Whew. OK. I hope this helps you understand fevers better!

Education is empowerment in your child's health! The more you know, the better you feel!

Want even more on beautiful science of fever? It's all laid out here, with lots of big words and acronyms.

Have a great day, friends!

Dr. Diane

Once people have heard my reasoning, they can get on board that fever isn’t as big of a deal as they once thought except for one MAJOR question:

What about febrile seizures?

The bottom line is that febrile seizures for the most part have to do with genetics and other uncontrollable issues. It has very little to do with the parent’s treating or not treating fever. Basically some kids are simply more likely to have them than others. You might just consider it a bit of bad luck.

On that note, here are 13 facts about febrile seizures:

1. Seizures can only be classified as febrile seizure if they happen when the child has fever.
2. Most febrile seizures occur on the first day of illness (often before the family knows the child has a fever).
3. The child cannot have a history of seizures or an infection that causes inflammation of the brain (like meningitis).
4. Febrile seizures occur between the ages of 6 months to 6 years (most commonly 12-18 months).
5. Boys are slightly more likely to have febrile seizures.
6. About 1/3 of all kids who have a febrile seizure will have another febrile seizure in their lifetime.
7. Kids with febrile seizures are only slightly more likely to have non-febrile seizures (only 1-2 percent).
8. Febrile seizures involve whole body shaking. If it’s just one sided or one body part, other causes should be considered.
9. Most febrile seizures are less than five minutes.
10. Head imaging (CT or MRI) and EEG (which look at brain activity) are not necessary with febrile seizures.
11. Treatment at the time of a febrile seizure is not necessary if less than 5 minutes.
12. Children with febrile seizures do not need to be admitted to the hospital unless the underlying cause of the fever makes it necessary.
13. Trying to prevent febrile seizures by treating fever aggressively has not been shown to be effective.

These are the 13 facts that I walk through with all of my families who have experienced a febrile seizure.

Hopefully knowing the facts will decrease some of the fear and relieve some of the guilt that has been placed on them for not preventing febrile seizures by catching fever in time.

About the author

Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Ft. Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in the fall of 2016.