My Doctor Online The Permanente Medical Group

Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Randy Bergen

Randy Bergen, MD

Pediatrics

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Walnut Creek
Appt/Advice: 925-295-4200

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Overview

Fever is a symptom, not an illness. It is the body's normal response to infections and other illnesses.

Normal body temperature is about 98.6°F (Fahrenheit). It is usually lower in the morning and higher in the late afternoon.  We call it a fever when the body temperature is 100.4°F or above when taken with a digital thermometer or temporal (forehead) scanner.

Each child has a normal temperature range that may be different from any other child. Mild increases to 100.4°F can be caused by exercising, wearing too many clothes, taking a hot bath, or being outside in hot weather.

If your child is running a fever, the temperature reading may not be related to the seriousness of the illness. The way your child looks and acts is a better guide than the thermometer. Most children will be less active when they have a fever.

Most fevers can be safely treated at home. If your child doesn't seem to be very sick, it is fine to wait 48 to 72 hours and let the fever come down on its own.

How to Take Your Child's Temperature

While there are several different methods for taking your child's temperature, we recommend digital thermometers.  This type of thermometer can be used rectally (in the bottom), axillary (in the armpit), or orally (in the mouth), depending on your child's age.

If your child is 3 months or younger, take temperatures rectally (this method is the most reliable in infants). Watch our video “Taking Your Baby’s Temperature” for detailed instructions.

If your child is 4 months to 3 years old, rectal temperatures are still most accurate, but are not essential.  You can also use a digital thermometer in your child’s armpit. Another option is to use a temporal scanner on your child’s forehead.

If your child is 4 years or older, take your child's temperature orally (by mouth). Make sure he or she keeps the thermometer under the tongue until it beeps.

Other ways to measure temperature, such as ear probe thermometers, forehead temperature strips, or pacifier thermometers may not be as reliable or accurate. In addition, glass thermometers are no longer recommended due to the risk of exposure to mercury if the glass breaks.

For more information, see How to Take a Child's Temperature, from the American Academy of Pediatrics.

Additional References:

Symptoms

If you think your child has a fever, it is important to look for other signs that your child may be ill.

Babies with a fever may:

  • Cry or be more irritable than usual
  • Be listless or drowsy or more sleepy than usual
  • Eat poorly (loss of interest or frequent stops during feeding, weak suck)
  • Breathe faster than usual
  • Have mottled skin

Older children may:

  • Complain of body aches or a headache
  • Have difficulty sleeping or sleep more than usual
  • Have a poor appetite
Additional References:

Home Treatment

In most instances, you can safely take care of your child at home. If your child doesn't seem to be very sick, it is fine to wait 48 to 72 hours and let the fever come down on its own.

We know it can be hard to know whether you should call us when your child has a fever, especially during the cold and flu season. If your child is comfortable and alert, eating well, drinking enough fluids, and seems to be improving, home treatment without medicine is usually all that is needed for a fever of 100°F to 103°F.

Tips when your child has a fever:

  • Watch for signs of dehydration. Encourage your child to drink extra fluids or suck on popsicles. Your child should be urinating at least every 6 to 8 hours.
  • Avoid making a room too warm or too cool.
  • Dress your child lightly and do not wrap him or her in blankets. Dressing lightly will help your child's body cool down.
  • Do not sponge-bathe an infant who has a fever. Do not use ice or rubbing alcohol on a child of any age.
  • Baths can cause unnecessary discomfort. If you do decide to give your child a bath, make sure to use only tepid water, bathe for 5 to 10 minutes, and thoroughly dry and dress your child comfortably.
  • Encourage quiet activities and rest, when needed.
Over-the-counter medications

Treating your child's fever can make your child more comfortable but will not make the infection go away any faster.

Ibuprofen and acetaminophen are both fever reducers. You can use either of these over-the-counter pain medications. Make sure you follow the package dosing directions exactly. Download our Pediatric Dosage Guide for more information.

Talk to us before switching back and forth between doses of acetaminophen and ibuprofen to treat a fever. When you switch between two medicines, there is a chance your child will get too much medication.

Safety tips when using nonprescription medicines:

  • Carefully read and follow all labels on the medicine bottle and box.
  • Give, but do not exceed, the maximum recommended doses.
  • Do not give your child a medicine if he or she has had an allergic reaction to it in the past.
  • If your child is less than 2 months old, do not give acetaminophen unless directed.
  • Do not give ibuprofen to infants under 6 months of age.
  • Do not give aspirin to anyone under age 20.
  • Do not give naproxen sodium (such as Aleve) to children younger than age 12 unless we prescribe it for you.

Causes

Common causes of fever in children are:

  • Colds, flu, chickenpox, and other infections that are caused by a virus.
  • Infections of the ear, throat, or urinary tract or other infections caused by bacteria or viruses.
  • Immunizations can also cause children to get a low-grade fever after they have been vaccinated.

Teething does not cause a fever. If your baby is teething and has a fever, look for other signs that your child may be ill.

When your child has a fever, remember the following tips:

  • How your child looks and acts (especially when the fever is down) is much more important than the thermometer reading.
  • Consider your child's other symptoms to help determine whether the illness is mild or more serious.
  • Although it may be scary when your child's temperature goes up, fever will not harm your child.
  • Children tend to run higher fevers than adults. The degree of fever may not indicate how serious your child's illness is.
  • Children with fever may be fussy, play less, or not eat as much as usual.
  • You can usually treat your child's fever safely at home.

When to Call Us

Please call the Appointment and Advice line if your child has a fever of 100.4 or higher and any of the symptoms or signs listed below.

Age of ChildWhen to Call
2 months or youngerCall us right away, even if your child has no other symptoms
3 months to 3 years

Call us if you are concerned that your child is very sick or shows any of the following: Trouble breathing, wheezing or tightness in the chest, a deep cough with lots of mucus, vomiting or diarrhea, signs of being dehydrated (refuses to drink; has a dry mouth or cola colored urine), severe headache, stiff neck, very sore throat or trouble swallowing, skin rash, a bulging soft spot on his or her head, severe ear pain, painful joint with swelling or redness, pain when urinating or urine that has a foul odor, irritable or crying constantly; does not want to be held or comforted, seems confused or extremely sleepy, lacks energy; is limp or listless. Also call if your child is not improving, seems to get better and then gets worse again, or has a fever that doesn't come down after 3 days of home treatment.

3 years and older

Call us if you are concerned that your child is very sick or shows any of the following: Trouble breathing, wheezing or tightness in the chest, a deep cough with lots of mucus, vomiting or diarrhea, signs of being dehydrated (dry mouth, cola colored urine), severe headache, stiff neck, very sore throat or trouble swallowing, skin rash, severe ear pain, painful joint with swelling or redness, pain when urinating or urine that has a foul odor, confused, listless, or has a total lack of energy. Also call if your child is not improving: seems to get better and then gets worse again or has a fever that doesn't come down after 5 days of home treatment.

Related Health Tools:

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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