Fever in children

FEVER IN a child can be worrying to parents and is one of the most common reasons parents seek medical care. Because of the normal variation in body temperature, there is no single value that is defined as fever, but in general, a fever means a temperature above 100.4ºF (38ºC). Fever is not an illness, rather, it is a sign or symptom of sickness and is usually a positive sign that the body is fighting infection.

Infection is the most common cause of fever in children. Common viral and bacterial illnesses like colds, gastroenteritis, ear and throat infections and urinary tract infections are some of the more common illnesses that cause fever in children. Nearly every child develops a fever at some point in their lives. The challenge for parents is to know when to be concerned.

Medical attention should be

sought as soon as possible if your child:

Looks very ill, is unusually drowsy, or very irritable.

Has symptoms, such as a stiff neck, severe headache or belly pain, severe sore throat or ear pain, an unexplained rash, or repeated vomiting and/or diarrhoea.

Has difficulty breathing or is drooling.

Is not eating/drinking or looks dehydrated.

Still ‘acts sick’ once his fever is brought down.

Has immune system problems such as sickle cell disease or cancer.

Has had a seizure.

Has swelling of the joints. Has worsening symptoms.

Also, call your doctor if your child:

Is over three months old and has a temperature of 100.4ºF (38.0ºC) or higher.

Is over two years old and has a fever for more than 24 hours.

Is two years old or older and is having fever for more than three days.

Repeatedly has a fever above 104ºF (40ºC).

Also, parents should seek medical care at any point of discomfort during the course of their child’s fever.

The main reason for treating a child’s fever is to make him or her more comfortable. Controlling the temperature will not alter the course of the illness. The most effective way of treating a fever is to use acetaminophen at an appropriate dose and schedule.

ADMINISTERING NSAIDS

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac are also effective in treating fever, but medical attention should be sought before administering them. There have been several recent cases of dengue fever, and administering NSAIDs in a child who has dengue may have detrimental effects, such as severe bleeding.

Aspirin should NEVER be used in persons less than 18 years old as it may cause Reye’s syndrome, a disorder that may damage the liver and brain and may cause death.

Tepid sponging can also help in reducing fever. This should be done with water that is lukewarm (just slightly warm), for at least 30 minutes. Cold or ice water should NOT be used as this may cause shivering, which can raise the body temperature and worsen the fever. Additionally, children should NOT be sponged with alcohol. Alcohol may be absorbed through the skin into the blood stream and cause serious side effects.

Rest and hydration are also important for a febrile child. Fever can contribute to dehydration and, therefore, they should be encouraged to drink plenty of fluids.

Parents should NOT overdress their children while they are having a fever as this may increase the body temperature and worsen the fever.

It is also important for parents to know that antibiotics are used to treat the infection causing the fever. Antibiotics, however, only work to treat bacterial infections and DO NOT work for infections caused by viruses such as the common cold. DR HALL-PARKINSON, Paediatrician at The Paediatric Place