Fever

Fever is a body temperature that is higher than normal.

What’s normal for your child may be a little higher or lower than the average normal temperature of 37℃.

Most body temperatures vary a little bit during the course of the day: It’s usually a little lower in the morning and a little higher in the evening and can vary as kids run around and play.

How do I tell if the baby has fever?

Placing a hand lightly over the child’s skin or a gentle kiss over the forehead may be the first hint that your child has a fever. However, this method of taking a temperature is often unreliable and will not give you an accurate measurement.

Use a reliable digital thermometer to confirm a fever.

The most accurate way to take a temperature is with a thermometer inserted into the anus or rectum (rectal temperature) in babies and children under 3 years of age OR

placed in the mouth (oral temperature) in older children able to hold the thermometer in their mouth long enough

Other methods of measuring temperature may sometimes be useful but less accurate.

These methods include using a thermometer in the armpit (axillary temperature) OR an ear thermometer (tympanic temperature)

As a general rule, in children a temperature over 38°C is a fever.

What is causing my child’s fever?

It’s important to remember that fever by itself  is not a disease or illness itself but a signal that something out of the ordinary is going on in your child’s body. How your child looks and acts are more important than how high the fever is.

A fever most commonly a sign that your child’s body is fighting off an infection.It’s part of the body’s natural way of defending itself against infections.The high body temperature makes it more difficult for the bacteria and viruses that cause infections to survive.

Infants, especially newborns, may get fevers if they’re overdressed or in a hot environment because they don’t regulate their body temperature as well as older kids. But because fevers in newborns can indicate a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

A child may get a low-grade fever after getting vaccinated.

Teething may cause a slight rise in body temperature but most often not high enough to be considered a fever.If your baby has a fever, do not assume it is due to teething

Some medications such as antibiotics and those used to treat convulsions or high blood pressure may cause fever.

Very high environmental temperature such as hot weather or inside a car parked with windows closed can cause heat exhaustion and a rise in body temperature.

Some non-infectious illnesses and inflammatory conditions can cause recurrent or persistent fevers.

Sometimes the cause of a fever can’t be identified. If you have a fever and your doctor isn’t able to find the cause after extensive evaluation, the diagnosis may be fever of unknown origin.

Is fever a sign of something serious?

Remember:

Fever is the body’s natural response to infection, and not necessarily a sign that something serious is taking place.

If your child is active, smiling and making good eye contact, drinking fluids well and looks comfortable when the fever comes down it’s usually not a serious problem.

Fever alone cannot be used to reliably tell whether the illness is serious or just a passing cloud. In fact, a mild viral infection like a simple common cold can cause high fever; some children, especially infants, with serious and perhaps life-threatening illnesses may not have fever or even lower than normal body temperature.

You will need to visit the doctor immediately if your child has a fever and any of the following:

  • your child is limp, unresponsive or won’t make eye contact.
  • Your child is crying a lot for long and is very difficult to console.
  • Your child is vomiting and has a headache or a stiff neck or bright light hurts the eyes.
  • Your child is not able to keep down any fluids, is not peeing and appears dehydrated.
  • Your child develops a rash that looks like small purple dots that do not go away when you apply pressure with your fingers
  • Your child has a seizure
  • Your child is having difficulty in breathing

Contact your doctor urgently if your child:

  • is under three months old and has a temperature of 38C above.
  • is between three and six months old and has a temperature of 39C or above.
  • is above six months old and has had a high fever which has lasted more than 24 hours.

How long will the fever last in my child?

The type of infection causing the fever usually determines how often the fever recurs and how long the fever lasts.

Fevers due to viruses can last for as little as two to three days and sometime as long as two weeks.

A fever caused by a bacterial infection may continue until the child is treated with an antibiotic. However, once the correct treatment is given it may take two to three days before the fever goes away.

Fevers may also cycle up and down on their own.

Will fever cause a seizure in my child?

Approximately 1 out of every 20  children between the ages of six months and six years may have seizures when their body temperature rises rapidly. These are called febrile seizures.

When it happens you may notice jerking movements, rolling of the eyes, twitching or frothing through the mouth.

Your child is susceptible if febrile seizures run in your family or if he’s had one within the past year.

Febrile seizures are disturbing to watch but rarely harm a child and don’t predispose him to epilepsy.

You should take your child to see a doctor after a febrile seizure, but febrile seizures are generally not dangerous.

If your child has one, keep him on the floor and away from sharp objects, and turn his head sideways so that his tongue doesn’t obstruct his breathing.

Call the doctor urgently if it lasts longer than five minutes.

Treating the fever will not prevent febrile seizures and you should not use medications for this purpose.

Do fevers cause brain damage?

No, they don’t!

Most fevers associated with infections are less than 42℃. These fevers do not cause brain damage.

Only a persistent body temperature greater than 44℃.can cause brain damage. These body temperatures are more likely to occur with heat stroke or after exposure to certain street drugs or medications,such as those used for anesthesia and for treating some mental illnesses. They do not occur with the usual infections that children can have.

Will antibiotics make fever go away faster?

This is a common belief that is not true. Antibiotics are only useful in treating bacterial infections. The antibiotic will start working to fight the bacteria as soon as your child takes it, but it may take two to three days before the fever goes away. Antibiotics have no effect on viral infections. Since most infections in children are caused by viruses, an antibiotic will not help bring down the fever or cure the illness.

How can you help your child feel better?

Remember:
Not all fevers will need to be treated. If your child doesn’t seem distressed, there’s no need to give them medicine to lower their temperature.

In most cases, you should give medicine for fever only if the fever is making your child uncomfortable.

Look at your child to see if he or she is uncomfortable.

You may notice that he is fussy or crying a little more than usual or he may not be playing as much as you are used to.

Other signs of discomfort associated with fever include body aches, headache, shivering, sweating and lack of energy

Here are some ways to ease the discomfort that often accompany a fever:

You could give a dose of paracetamol or ibuprofen.

If you don’t know the recommended dose for your child’s age or weight, call a doctor or a pharmacist to find out how much to give.

Remember: These medications help make children feel more comfortable but may only reduce the fever by 1℃ to 2℃ and may not bring the temperature down to normal. Sometimes a fever continues even after giving ibuprofen or paracetamol.

DO NOT  give aspirin to a child to manage a fever unless your doctor has specifically told you to do so because it might cause a rare but potentially life threatening condition called Reye’s syndome. You may need to check the label of other medication or ask your pharmacist to make sure that they do not contain aspirin.

If your child is younger than 2 months you should not give any medicine until the child has been checked by a doctor.

If your child has any medical problems, check with the doctor to see which medicine is best to use.

Keep your child lightly dressed. Most body heat is lost through the skin, so overdressing or bundling your child may result in a higher fever and can make your child more uncomfortable.If your child is having chills or shivers, give them a light blanket.

Keep the room temperature at a level that is comfortable for you, when lightly dressed.

You may have been advised,on a previous occasion, to sponge your child with lukewarm water to help bring down the body temperature.It is also called sponge baths or tepid sponging. Sponging may just cool the outside of your child’s body and cause them to shiver without really affecting the internal body temperature.In fact tepid sponging is likely to make your child more uncomfortable. Only use sponging in an emergency, such as heat stroke.

DO NOT rub the skin with alcohol or methylated spirit or bathe the child with cold water. They can cause chills that can raise body temperature.

Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids more rapidly than usual. Water and soup are good choices.

Avoid drinks with caffeine, including coffee and tea, because they can make dehydration worse by making the child urinate more frequently.

Whether you give your child cold or warm drinks does not matter. However, cool water or drinks may help your child feel more comfortable.

Make sure your child gets plenty of rest. It is not necessary that an unwell child stays in bed the whole day but let he or she take it easy.

It’s best to keep a child with a fever home from school or childcare. Most doctors feel that it’s safe to return when the temperature has been normal for 24 hours.

Let’s recap!

Fever is usually a sign that the body is fighting an infection.

A temperature of 38℃ or higher means a fever.

See your doctor right away if your child has a temperature and looks sick or if your child has a temperature and is less than 3 months old.

Pay attention to how your child looks and acts. Keep a record of the number of days of fever.

To keep your child comfortable, dress your child lightly. Give your child lots of fluids to drink.

Give paracetamol or ibuprofen if your child is uncomfortable or distressed.

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