By Manisha Panchal, M.D.

Infections and fever are a common reason children visit their pediatrician. This is especially true in fall and winter. Infections spread very easily from child to child. Children can get infections from interacting with other children at day care, the grocery store or even at the playground. They can have five to seven infections in a given season without having any immune system abnormalities.

To keep your child healthy, make sure he or she gets plenty of sleep and eats healthy foods. Sleep and a good diet are just as important as medicine in helping your child fight off infections. And remember, the best way to prevent infection is good hand washing.

Treating Fever in Children

Fever in children is defined as a temperature greater than 100.4 degrees Fahrenheit. A fever is not necessarily dangerous to children. Fever is the body’s natural response to infection. It is common in both viral and bacterial infections.

You do not have to treat fever with acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), unless the child is uncomfortable or the temperature rises above 102 degrees Fahrenheit. These drugs are safe and effective when used correctly, but like all drugs, can be dangerous if too much is given.

An overdose of acetaminophen, for example, can cause liver damage, so keep these drugs out of reach in a child-proof cabinet and always follow dosing directions carefully. Use a measuring spoon, dropper or medicinal syringe to be sure you give no more than your doctor recommended. In addition, note down the time you gave the medication and inform all other caregivers to avoid an accidental overdose caused by giving a second dose too close to the first.

In most viral infections, fever lasts three days and resolves in five days. How long the fever lasts is more important than how high the temperature is. If the fever lasts more than three days, your child should be seen by a pediatrician. A long-lasting fever could be a sign of ear infection, sinus infection or pneumonia, which requires treatment. A fever in a baby less than a month old is abnormal and needs prompt evaluation by a pediatrician.

Treating Upper Respiratory Tract Infection (URI) in Children

The most common reason for fever in children is an upper respiratory tract infection (URI). The upper respitory system includes the nose, ears, sinuses and throat. A child with a URI may feel uncomfortable and sound very congested.

The symptoms of a URI include:

• Runny nose
• Cough
• Congestion
• Fatigue
• Decreased appetite
• Irritability
• Difficulty sleeping

Symptoms can last five to seven days. Usually, the first three days are the worst and then symptoms improve. Fever can start in the first few days and should resolve within three to five days. Coughs can take as long as 14 to 18 days to resolve completely.

Treatments for URIs include fluids (such as Pedialyte, Gatorade, water, juice), nasal saline spray and pain medicine (when necessary). It is normal for children to have a decreased appetite for three to five days and then their appetite slowly improves. Humidifiers in the child's bedroom can also be helpful because the steam can help clear the nasal passage. Another way to humidify is to run a hot shower and safely hold the child outside the shower as the child breathes in the steam (the child should not get wet).

If your child's fever persists more than three days or the symptoms are not improving, your child may have an ear infection, pneumonia or a sinus infection. Take your child to a pediatrician for further evaluation.

Visit PAMF's Your Child's Health Web site for more information on colds and fever.

Dr. Panchal is a pediatrician at PAMF's Santa Clara Center. She is currently accepting new patients.