Prolonged fever in a toddler

November 6, 2009 8:15 AM

My toddler (just turned 2) has had a fever for almost a month. Would you be concerned? His pediatrician isn't.

So I waited a while to bring him. He had a cold so I about a month ago so I took his temp (with an ear thermometer - the exact same that his doctor has). It was about 99.4-99.6 for thos few days. I have read you add almost a degree to that.

He's been acting completed normal so he may have had the fever before his cold but I would really have no reason to take his temp. He had it for about a week. Then I took his temp and it was normal. Didn't think about it again. Then he had to get his flu shot a week later so I took it... the temp was still there. He had this temp on and off (out of 2 weeks I took his temp every day once or twice and prob 2 times he didn't have a temp).

So I bring him to the doctor and the doctor says he seems fine (checked for an ear infection and listened to his lungs) and said to just stop taking his temp. When he went to the office and didnt have a temp (with the same ear type thermometer). I asked the nurse to take it a second time but she wouldn't. It has been consistantly about 99.5.

How long should I wait before I attempt to go see a doctor again?
What serious things should I be concerned that it could be?
What would you do??

(He does have a low normal temp- just under 98 normally)

posted by beccaj to health & fitness (40 answers total)

Have you tried a different thermometer? Since he didn't have a temp, maybe the thermometer is off. When you take your own temp with this thermometer does it seem high? Have you tried taking an anal temp?

I would explore all these issues before I would worry about it.
posted by wrnealis at 8:21 AM on November 6, 2009

I have taken my temp over and over again with it. My is always fine.
I think I will try to go take an anal temp now.
posted by beccaj at 8:26 AM on November 6, 2009

Your son is occasionally running a very low-grade temperature. He seems fine otherwise. In the absense of identifying another symptom or characteristic that is triggering your mom spidey-sense*, I'd let it go. You sound like you're torturing yourself with this, and that's not good for either one of you.

*If you can identify something else that is also part of the picture -- fatigue, sleeping badly, behavior changes -- that's a different story.
posted by chesty_a_arthur at 8:27 AM on November 6, 2009

Also: stop taking his temperature. You don't need to take it all the time in the absence of anything else being wrong, and you don't want to start irritating his ears or his butt.
posted by chesty_a_arthur at 8:28 AM on November 6, 2009

IANAD but I've read that body temperature fluctuates significantly (up to 2 degrees) throughout the day--especially in children. These low grade "fevers" may just be normal body temp fluctuations.
posted by reverend cuttle at 8:29 AM on November 6, 2009

arrgh cant do the anal temp- just remembered I gave his tylenol to see if it affects the fever (bout 25 minutes ago).
posted by beccaj at 8:33 AM on November 6, 2009

Maybe that's a normal temp for him seeing he's active, his clothes, etc. If the doc isn't worried, worry less. Otherwise get a 2nd opinion.
posted by stormpooper at 8:35 AM on November 6, 2009

Becca - hopefully you've chilled out by now, but come on, relax. I know how worrisome it can be just to have such a tiny little treasure, but toddlers are forever getting fevers, its a big part of how children fight off illness and disease. Throughout your recap, its clear your kids' temp is going up and down - what are you freaking about?

As I do with my own toddler, I would relax and notice how your toddler is feeling - and ignore the the hidden nightmares an ear thermometer showing slightly high temperatures is giving you. You are going to give the kid a complex.
posted by RajahKing at 8:38 AM on November 6, 2009

This:
So I bring him to the doctor and the doctor says he seems fine (checked for an ear infection and listened to his lungs) and said to just stop taking his temp. When he went to the office and didnt have a temp (with the same ear type thermometer). I asked the nurse to take it a second time but she wouldn't. It has been consistantly about 99.5.

does not rhyme with this:

I gave his tylenol to see if it affects the fever (bout 25 minutes ago).

If your doctor said he's fine, why are you giving him Tylenol? I hope you haven't been giving him fever medication for a month?
posted by NekulturnY at 8:38 AM on November 6, 2009

I have a two friends who both run hotter than 98.6°F at all times and stopped worrying about it years and years ago.

Also, like wrnealis states, it might also be a good idea to try another thermometer. While it might be working well to determine your temperature, maybe his ears run hotter than yours or something like that? I've worked in a couple chemistry labs over the years and usually the first thing you'd do when investigating suspicious results is repeat the process with new equipment.

Also also, I think people get too attached to their doctors now-a-days. If you are really worried you should consider getting a second opinion... especially the nurse isn't taking your concerns seriously. Doctoring is a service profession and a lot of them and their staff forget that. Because of their greater knowledge we as patrons tend to put them on pedestals and forget they can make mistakes like the rest of us.
posted by Gainesvillain at 8:40 AM on November 6, 2009

No-- this is the first time I gave him tylenol.
A doctor friend just suggested it because depending on how the fever reacts could help determine the cause.
And well- I don't have much faith in doctors. Some horrible things have been blown off by doctors in my family (to name a couple 2 cancers, a fibroid the size of a grapefruit and a baby) so just because a doctor says "he's fine" doesn't mean thats the last I'll think of it.
posted by beccaj at 8:47 AM on November 6, 2009

beccaj, Tylenol has to be cleared from the blood by the liver. Giving it to your baby just to see what happens, when the doctor has told you not to worry, is not a good idea.

I can only imagine how difficult it is to be a parent, and I don't want to make judgments based on only a question, but are you sure that the problem here isn't with you? Could your persistence here be a symptom of anxiety, or just an overly-protective attitude? It's important not to freak out over every little fluctuation from normal, especially when you don't really know what normal is, or you'll risk raising a very anxious, hypochondriac kid.
posted by Dasein at 8:48 AM on November 6, 2009

And I guess I know it seems like oh come on...
I brought him to the doctor about a dozen times as an infant who wouldn't eat or sleep and cried all the time. Everyone blew me off as a worried first time mom.
"Some babies are fussy"
Well- he had reflux for over a year untreated. Went from 60% percentile to 10%. I am now dealing with horrible things because of trying not to look like an anxious mom. He still wont eat and drink and we are specialists all the time to try to help.

Before I knew I was pregnant I went to my doctor 3 times in a month. She blew me off each time but I was pregnant and had a large fibroid. We both almost died and now I can't have anymore children.

My mom was blown off about a spot on her nose and the doctor said put vaseline on it and had to have her nose basically carved off last year and my dad had a lump blown off as a fatty deposit fot 5 years. It was lymphoma.

Sorry but if you have come to say - jesus, just chill out, please don't.
posted by beccaj at 8:56 AM on November 6, 2009 [1 favorite]

Apparently, the American Academy of Pediatrics considers "a normal body temperature for a healthy child is between 97 and 100.4 degrees Fahrenheit (36 to 38 degrees Celsius). If your toddler's temperature is above this range, he has a fever."
posted by rtha at 9:00 AM on November 6, 2009 [3 favorites]

If you're truly worried the doctor may have missed something, then take him to a different doctor and get a second opinion. A fever isn't truly a fever unless it's above 100.4 - in children anything below that is just normal fluctuation due to environmental conditions. Do you keep your house warm? Does he run and play a lot? Does he wear warm clothes? Small bodies aren't as good at regulating their temperature as our large bodies, and are prone to more fluctuation due to environment. In general, if he's not acting sick, he's probably fine.
posted by jferg at 9:03 AM on November 6, 2009 [3 favorites]

(Aaaand, on non-preview, rtha beat me to it with citations to back it up. )
posted by jferg at 9:04 AM on November 6, 2009

Just because bad things have happened when you followed the doctor's advice in the past doesn't mean that the doctor's advice will now forever be wrong. If the doctor says it's fine, then your prior should be that everything is fine. I'm not saying not to investigate further - after all the doctor could be wrong - but odds are the child will be fine.

So, let's review what we know. The child has apparently had a fluctuating temperature within the last month. We know that when you measure your temp, it's normal, and when you measure your child's temp, it's high. We also know that when the child's temp was measured in the doctor's office, it was normal.

First thing, I would get a different type of thermometer. I understand that this might be expensive, but I'm concerned that something wacky is happening with your thermometer and I think you should check that before pursuing this any further. It would be far worse to treat your child for an illusory fever than to allow the fever to continue for a few more days.

If there is still a fever, then we should consider other possibilities as well. Is there something aversive about when you're reading the child's temperature that causes his/her temp to increase slightly? Do they sense your concern and respond to it? It's not outside the realm of possibility that something like this is happening. Try having someone else take the temperature and see what happens.

Perhaps measure temps before and after eating, to see if there's any effect there.

If these solutions resolve your fever problems, great, but if the fever remains despite all these tests, then there is likely something internal going on, and you should go back to the doctor with the evidence you've collected. It will lend more credence to your claims and they will take you more seriously.
posted by scrutiny at 9:13 AM on November 6, 2009

Yeah - I know he normal temp this- my stepsons run hotter... his normal is 97 ish.
So this is a consistant 2 degrees warmer than normal. 69 degree house- dresses too cool! He's always half naked (at his insistance!).

I understand everyones concern- I guess from one post difficult to tell what kind of parent I am. I am the one that isn't freaking out about my licking the floor or holding the railing. When other parents are sanitizing their kids I'm not. He's always standing on a table or diving from the back of a couch... but sometimes when something is off- you worry. This IS different than normal.

He has sensory issues and pain doesn't bother him that much. (Ex. he has more than once been running tear up his hands on the pavement falling, and just kept playing. After seeing blood on his arms or dripped on to his pants I stop him and clean him up) Because of these issues I have to be a little more attuned to things (like ear infections) since he gives me little indication.
posted by beccaj at 9:13 AM on November 6, 2009

or the body temp is normal, as seen above
posted by scrutiny at 9:13 AM on November 6, 2009

Thanks scrutiny - I will try a different thermometer than the one I have. The one I use is the 50 dollar Braun one that my doctor uses. I will try one of those little 10 buck drugstore ones if I take it anally.
posted by beccaj at 9:17 AM on November 6, 2009

I totally see where you are coming from. I've had some of the same kinds of things happen with doctors (not doctorist) and you can't be too careful when it is your child. I would insist that they do a urine dip (check for UTI), that is non-invasive and easy. I would ask for a blood workup too but that is me and you may not be comfortable with putting your child through that. If the urine dip is fine and he has no other symptoms, just watch him closely, make sure he stays hydrated and see what happens.
posted by pearlybob at 9:40 AM on November 6, 2009

Just chiming in to say- I, too, have a friend whose normal body temperature is above average. It is perfectly normal. Average means just that, AVERAGE. Some people will be above or below average.

If you are really this worried though, I would recommend taking him for a second opinion with a different doctor. It's safer than randomly giving him Tylenol against medical advice.
posted by showbiz_liz at 9:42 AM on November 6, 2009

I think the only thing that'll put your mind to rest is getting a second opinion.
posted by ignignokt at 9:50 AM on November 6, 2009

I don't think it's been mentioned yet: is he teething? I have heard that can cause low fevers and isn't anything to worry about.
posted by fiercecupcake at 9:53 AM on November 6, 2009 [1 favorite]

When my sister was little, she always had a temperature of about 99. She was fine and healthy. I was always jealous though, because she could sleep in the school nurse's office whenever she wanted because of it.
posted by BusyBusyBusy at 9:53 AM on November 6, 2009

fierce cupcake-
good point. teething. Like i said minor pain doesnt bother him to much so I wouldnt have an indicator whether he was teething or not. I will check his gums.
thanks
posted by beccaj at 9:55 AM on November 6, 2009

Certainly get another opinion if you think something is truly wrong. You're the mom. You probably are right if you think something is off.

But I have a baby whose temp runs hot also, generally depending on the time of day, but unrelated to the temperature of the house or the amount of clothes she is wearing. I used to take her temperature a lot, and was always nervous. Then, after she had actually gotten sick a couple times, I realized that I would know if something was wrong, and it would be because of things other than a fever -- changes in eating, sleeping, attitude, lethargy, what have you.

Trust your instincts as a mom, but try not to worry too much -- it really might just be normal for your kid!
posted by dpx.mfx at 10:12 AM on November 6, 2009

Teething doesn't often produce fevers until the day of eruption, but I still wouldn't worry about a month-long low grade fever. Kids are sick a LOT during this period because their immune systems are fighting off new infections for which adult bodies have long been accommodated. Good for you for waiting this long to administer Tylenol. In the future, hold off on drugs until the fever is in the danger zone (at least 101), and then give him Motrin, which will be easier on his sensitive stomach/reflux issues. Motrin reduces fevers much more effectively; save Tylenol for pain issues. Low grade fevers usually mean his body is working normally, and they shouldn't be reduced via artificial means. 99ish is still in the "good" zone, which means his body is fighting off infections on its own. Kids who get lots of colds and fevers as toddlers are generally much healthier later on than kids who were never sick when they were little.

If you notice anything else unusual, like balance problems/falling down a lot, sleep irregularities, bowel irregularities, or any behavioral oddities, then take your kid to another doctor. Most pediatricians judge the ferocity of a fever based on the individual child's reaction to it--hence, an active and happy kid with a 103-degree fever is less worrisome than a glassy-eyed, limp toddler with a 101-degree fever.
posted by zoomorphic at 10:28 AM on November 6, 2009

He's well within the normal range for temperature. How is he acting? Playing, eating, sleeping; whatever "normal" is for him, is he doing it? If he is, he's probably fine. If he's not, get a second opinion.

He hasn't technically had a fever for a month. He's had a fever off-and-on for a month. That's totally different and most likely totally normal, considering he's a germ factory. All little kids are.

Again, if he's acting normally, he's fine. I won't say "don't worry" because you're a mom. It's what you do.
posted by cooker girl at 10:53 AM on November 6, 2009

I'd strongly suggest taking your child to see an ear, nose & throat specialist. My daughter had a constant, low-grade fever which her doctor dismissed as normal. It turns out that she had an ear infection. As a consequence of her doctor's lack of interest, she has significant delays in here speech and motor skills, even four years after the condition was properly diagnosed and dealt with by a specialist.

Get the second opinion. If both doctors come to the same conclusion you'll be out the cost of the co-pay, but the security of knowing that there's nothing wrong is priceless.

I initially put a sarcastic <Cassandra> tag in this comment, but it's no joke. Since I found out about my daughter's undiagnosed ear infection I've met a number of parents who have the same story. I don't mean in an encounter or therapy group, I mean just random encounters at the playground, school, or store. Personal anecdotes are useless as statistical data points, but I've met far too many parents who wish they'd gotten a second opinion earlier than they did.
posted by lekvar at 11:43 AM on November 6, 2009

Is your baby teething? That will sometimes give babies fevers and make them uncomfortable etc.

Also, if you don't trust your doctor maybe you should find another one. No one here is really going to be able to give you advice better then someone who went to school for a shit load of years just so they would know what is wrong with babies and children.
posted by chunking express at 12:28 PM on November 6, 2009

Although I suspect that everything's fine, I'd have to agree (from experience with my own child) with pearlybob. Babies and toddlers with fevers -- assuming for a moment that we're considering this a "fever" -- should, among other things, be checked for UTIs if they are not exhibiting any other symptoms.
posted by suasponte at 12:39 PM on November 6, 2009

Most commenters are telling you that he is fine, and you refuse to believe them. I think you need to consult another doctor for a second opinion. If he tells you your kid is fine, chill. You are probably stressing your kid out.
posted by pintapicasso at 1:37 PM on November 6, 2009

Get a second opinion. Don't let people who aren't doctors and don't know you or your child tell you that they are sure that nothing's wrong. How could they know?

Good luck.
posted by kathrineg at 1:52 PM on November 6, 2009

Most commenters are telling you that he is fine, and you refuse to believe them. I think you need to consult another doctor for a second opinion. If he tells you your kid is fine, chill. You are probably stressing your kid out.

Most commenters are not doctors, and they don't know her child. "Believing them" is not the right way to go.
posted by kathrineg at 1:53 PM on November 6, 2009

As for stressing him out ... he's 2. Getting his temperature taken is playing with the thermometer and getting to listen to the beep beep in his ear. We don't discuss the likelyhood of lyme disease or anything.
posted by beccaj at 2:37 PM on November 6, 2009

99.6 is not a fever. Your child seems to just be running warm.

If you're truly still worried, get a second opinion from a doctor that someone you trust trusts. If that doctor agrees that it's not a problem, let it go and mentally set your new "base temp" for your kid at 99.6.

I think toddlers are constantly trying to screw with us, even on a subconscious level (says the mother of a toddler).
posted by wallaby at 3:09 PM on November 6, 2009

I learned this the hard way:

You are often the best person to judge if there's something wrong. If you don't like what a doctor is telling you, and you still think something's wrong, go see another doctor. If you don't like what that doctor is telling you, so see a third one. If all three doctors tell you that there's nothing wrong, chances are there's nothing wrong.

Doctors are like mechanics, they can only guess at what's wrong. Some are better than others at doing this. Hopefully your doctor is always right, but be aware and prepared for the fact that doctors are not omniscient.
posted by Simon Barclay at 4:51 PM on November 6, 2009

I would get a second opinion. You are the mom, you know your child.
posted by SuzySmith at 12:11 AM on November 7, 2009

Like others have said, temps less than 38C (100.4F) are not considered fever. That's core temp by the way (rectal), so temps taken from other areas need to be converted.
posted by sero_venientibus_ossa at 12:41 PM on November 7, 2009