FEVER GUIDE

Paediatrician Dr Paul Sinclair says the more you know about fever, the less there is to fear

FEVERS ARE COMPLETELY healthy and normal, despite the depths of panic they send you into when your baby’s thermometer reading is “sky high”. Simply put, fevers are a way for your baby’s body to let you know that something is going on. So the key in treating fever is treating what is actually causing it in the first place. A fever is simply a rise in core body temperature in response to different factors. The body responds in different ways from individual to individual, and the response to infection is no different, and will depend on your baby’s age, immunity, what’s infecting her, and other environmental issues.

WHAT DO FEVERS DO? The benefit of this rise in body temperature is two-fold:

✓ Viruses, bacteria and other “nasties” – just like their hosts, you and your baby – function, grow and live best within a small temperature range. So when under infectious attack, the body tries to inhibit the infectious agent from thriving and, most importantly, from breeding by changing the temperature to one in which it simply cannot succeed. ✓ Equally, there are quiet cells in the body that may cause damage internally if they are too active on a day-to-day basis, when all is well. A fever actually works to “wake them up”. For example, the T lymphocytes (a type of white blood cell that plays a key role in immunity) and other disease-killer cells need a rise in temperature to activate them. So in a situation where the body needs aggressive cells to attack a foreign invader (such as a virus or bacterium), temperature is crucial.

HOW DO FEVERS WORK?

A fever’s process is initiated by the immune system producing many active immune chemicals to fight off invading bodies. The hypothalamus, which is situated in your baby’s brain, is considered the body’s centre for homeostatic control, which means that it adjusts the set temperature of your baby’s body by pushing up the metabolic burn rate when under immune attack.

WHAT SHOULD I DO?

A temperature of up to 39°C in a wellhydrated child isn’t usually cause for major concern. However, any temperature higher than 39°C – and especially if your baby is sick or carries risk factors for febrile convulsions (a young age or a family history of these) – starting treatment to bring the temperature down is essential using two groups of measure: ✓ Environmental: Remove your baby’s clothing, sponge him down in a tepid (not cold) bath, and dab a cool cloth over his large arteries. ✓ Medication: In increasing strength from paracetamol, mefenamic acid, ibuprofen and diclofenac acid (these are all available as oral, suppository and even IV options) and beyond onto other in-hospital options.

When dealing with your baby’s temperature, it is also important to look to your baby’s age. Often in the first three months of life a low temperature is experienced and a “cold and clammy” child, and this can be an early indicator of infection. The basic rule of thumb is that a temperature that is high points to an infection and, though less common, fevers can also be a response to an abnormal immune reaction or even an allergic reaction.

Try and see a fever as your friend – it is a marker of a sick child with some physiological benefits. Always know what your child’s “normal temperature” is (his average healthy temperature) so that you can more easily recognise a fever in him and have a plan of what to do and what to use if you need to bring the temperature down. YB