What is fever?
Fever is the elevation of body temperature as a result of the release of certain mediators in response to an infection, injury or insult. In children, fever often comes with sweating, a feeling of being unwell, lack of interest in play and loss of appetite. Because fever is the body’s natural fight against an “enemy,” fevers under 101°F (38.3°C) generally do not need to be treated unless a child is uncomfortable, has nausea and vomiting, or has a history of febrile convulsions.
Is fever dangerous?
Even higher temperatures are not in themselves dangerous or significant unless a child has a history of convulsions or a chronic disease. It is more important to watch how a child is behaving. If he is eating and sleeping well and has periods of playfulness, he probably doesn’t need any management. If the fever bothers him, it can be managed with medication and sponging.
What causes fever?
By itself, fever is not an illness — it is usually a symptom of an underlying problem. Most fevers are caused by infection; fever helps the body fight infections by stimulating its natural defence mechanisms. Infants, especially newborns, may also run warm simply from being over-bundled or in a hot environment, because they can’t yet regulate their body temperature. Babies and children sometimes get a low-grade fever after vaccination. Teething may cause a slight rise, but is probably not the cause if the temperature is above 100°F (37.8°C).
Taking the temperature — by age
- Under 3 months: a digital thermometer, rectally, gives the most reliable reading. Ear thermometers aren’t recommended at this age — the ear canal is too small.
- 3 months – 4 years: digital thermometer rectally, or an electronic ear thermometer. An armpit (axillary) reading also works, though it is less accurate.
- 4 years and older: an oral reading with a digital thermometer, if your child will cooperate; otherwise ear or armpit.
Never take the temperature right after a bath or after your child has been bundled up — and never leave a child unattended with a thermometer. Whichever method you use, note the reading and the time of day.
Fever medicine
The safest fever medicines are paracetamol (acetaminophen) and ibuprofen; both are equally effective at reducing fever. Never give aspirin to a child under 12 — it can cause stomach upset, intestinal bleeding and Reye syndrome, a rare but potentially fatal disease. Ibuprofen may be given from 6 months of age, but never to a child who is dehydrated or vomiting continuously. The dose should be based on your child’s weight, not age — please consult Kopila before starting any fever medicine.
Sponging
Tepid (lukewarm) sponging is a time-honoured way of bringing a high temperature down quickly; it should be combined with paracetamol or ibuprofen for a longer effect. Use water that feels just slightly warm (85–90°F / 29–32°C) — never cold or ice water, which causes shivering and can actually raise the core temperature, and never add alcohol to the water, which can be absorbed or inhaled and is dangerous. Seat your child in 1–2 inches of water and spread a film of water over the trunk, arms and legs; sponging usually brings the fever down in thirty to forty-five minutes. If your child resists and gets upset, take him out — comfort matters more.
A few useful tips
- Keep the room comfortably cool, dress your child lightly, and cover with only a light sheet — over-bundling traps heat.
- Offer plenty of fluids — water, soup, diluted juice. Avoid caffeinated drinks and plain glucose water.
- Let your child eat what he wants in reasonable amounts; don’t force food. Normal milk is fine.
- Your child doesn’t have to stay in bed — being up and about the house is fine, but no running around.
- If the fever comes with a highly contagious illness (chickenpox, measles), keep your child away from other children and the elderly.
Worried right now? The Kopila phone line answers 24/7: (+977-1-) 5442767 — or book a telemedicine call.