FEVER GUIDE

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

Your Baby & Toddler - - The Dossier -

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

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