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Bodytree Wellness Studio > News & Blog  > Everything you need to know about Fever in Children

Everything you need to know about Fever in Children

Withย Dr Koyes Ahmed, Medicalย Director of Intercare Health Center and Family Medicine Consultant

Fever is defined as a temperature of 37.5c (99.5F) and above, andย can be caused by a number of different things.ย ย When your child has a fever, it can be anย anxious and worrying time, however it is very common and, inย many cases,ย clears up itself without any specific treatment.


Mechanism of fever

Fever is usually caused by an infection or illness, and it is the bodyโ€™sย response to try and make it more difficult for the bacteria or virus causingย this infection to survive. When the body is attacked by these bacteria orย viruses, specific chemicals calledย โ€œcytokinesโ€ and โ€œmediatorsโ€ are produced inย response, in addition to special cells called โ€œmacrophagesโ€ which try and โ€œeatย upโ€ the invading organism.ย ย Many types ofย bacteria are also enclosed in a membrane, which, when disrupted or broken, canย beย toxic to the body and stimulate the brain to increase the temperatureย further.

The body does however react, by being busy and producing naturalย antibodies, which try and remember the infection and recognise it the next timeย the infection tries to invade.

Causes of fever

Common conditions that can cause fevers include viruses, such as thoseย which cause โ€œUpper Respiratory Tract Infectionsโ€ (a group of conditions whichย includes coughs and colds like the โ€œcommon coldโ€, sore throats and earaches)ย and viruses whichย cause the โ€œfluโ€, diarrhoea and vomiting and viral rashes.

Fever can also be caused by other common (often viral) childhoodย conditions such as chickenpox, but also bacterial conditions such as earย infections, tonsillitis, kidney or urinary tract infections. Another cause โ€“ย which often parents worry about andย understandably so – is meningitis, andย although this condition is very rare, if there is ever any suspicion of thisย (such as a high fever, headache, confusion, stiff neck, inability to look atย lights and a non-blanching rash – a rash which doesnโ€™t disappearย when a glassย is rolled over it), urgent medication attention is crucial.

On another note, children can have raised temperatures during teething,ย following vaccinations or if they overheat due to too much clothing or beddingย โ€“ all of these are common causes too, and often need no medical intervention.

Diagnosing a fever

You may be able to tell your child has a fever if they feel hotter thanย usual when you touch them, if they feel sweaty or clammy, or if they haveย flushed cheeks.ย ย If you then suspect aย fever, the next thing to do would be to check their temperature usingย a digitalย thermometer.

The most accurate way of checking a babyโ€™s temperature is using a rectalย thermometer (especially if they are less than six months old), although inย reality this is not usually practical and not commonly done. For younger babiesย (especially those lessย than 1 month old) and for smaller babies, the bestย method is likely to be an axillary (underarm) thermometer โ€“ these often have toย be held in position for at least 15 seconds (or until a โ€œbeepโ€ is heard), andย are easy to use and inexpensive. However, asย the baby becomes older and larger,ย and for children of all other ages, the tympanic (โ€œin-earโ€) thermometer is theย best device to use, and as long as it is correctly inserted into ear, this is aย very quick and accurate method.

Forehead thermometers and oral thermometers are not recommended for checkingย the temperature however, due to inaccurate results, and the risk associatedย with glass and mercury in oral thermometers.

When to seek medical advice

If your child is under three months old and has a temperature of overย 38c (101F) or is between three and six months and has a temperature of over 39cย (102F), always seek urgent medical advice from a Family Medicine doctor.

In addition, if your child has other signs of being unwell โ€“ such asย refusal to feed, appearing floppy or drowsy, signs of dehydration (for example,ย a dry mouth, no tears, less wet nappies, sunken eyes or a sunken fontanelle โ€“ย the soft spot on a babyโ€™sย head), having a fit (convulsion), persistentย vomiting, persistent or high pitched crying, breathlessness, a productive coughย or signs of meningitis (as mentioned earlier), contact a Family Medicine doctorย urgently.

If you have tried simple measures of treating the fever (as below), yetย it still persists for more than 3-4 days, your childโ€™s health is getting worse,ย or you have any other concerns, again contact a Family Medicine doctor.

If your child has a slightly raised temperature, but is otherwiseย appearing well, e.g. playing, attentive, eating and drinking as normal, then itย is less likely they are seriously ill. If in doubt though, or you just needย advice, itโ€™s best to get in touch with aย healthcare provider.

Treating a fever

If your child has a fever, there are a number of things you can do toย help before speaking to a doctor.ย ย Firstly, it is really important to keep your child well hydrated byย giving them plenty of fluids -either cool water for infants or children, or breastย milk/formula milk for babies.ย ย Try and getย your child to drink small amounts but often, to keep their fluid levels up โ€“ย even if they are not thirsty. In terms of food, only offer them food if theyย want it, and donโ€™t be too alarmed if they have gone a dayย without eating muchย (as long as they have been drinking).

Keeping your child cool if the environment is warm is also veryย important, for example by covering them with lightweight clothes or a thinย sheet (but ensuring they are appropriately dressed for their surroundings), asย well as keeping the room coolย (18c/65F is a good guide temperature). Spongingย your child with cool water or a cool flannel however is not recommended, nor isย completely undressing your child.

In terms of medicines, paracetamol and ibuprofen are both antipyreticsย (fever-reducing medicines) as well as painkillers, so they can be given to tryย and reduce a fever. Please always follow the instructions and doses asย mentioned on the bottle, andย start off with one of these medications, and if itย is not helping, try the other (and not both at the same time, but alternateย both if needed, every 4-6 hours for paracetamol and a maximum four times in aย day, and every 6-8 hours for ibuprofen, at aย maximum three times a day).ย ย Ibuprofen is best given with or after food,ย but seek advice if your child is asthmatic as they may not be able to tolerateย the medication. Also, avoid aspirin in children due to the risk of a rareย condition called Reyeโ€™sย syndrome. The most important message though is that ifย your child has a mild fever, but is otherwise appearing very well and notย distressed, you do not need to give any medications.

Paracetamol can be used to treatย fever if needed, alongside ibuprofen.

Summary

Fever in children is a very common symptom, which can be caused by aย number of different things, but may be a sign of a viral of bacterialย infection.ย ย In many cases, no medicalย input is required, but simple measures can be undertaken at home and ifย needed,ย paracetamol or ibuprofen (or both if necessary) can be given, alternatingย between them if required.ย ย If however theย fever is high, it persists, or there are any other symptoms, especially thoseย which may be more concerning, it is always best toย get your child assessed andย seen by a Family Medicine doctor.

If you have any further questionsย or would like your child assessed, please book an appointment with Dr Koyesย Ahmed or one of the other Family Medicine Consultants at Intercare Healthย Center.

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