Fever in Children
What is Fever?
Fever is the body's natural response to infections and illnesses. It's characterized by a temporary increase in body temperature. A baby is considered to have a fever when their rectal temperature exceeds 100.4°F (38°C), oral temperature exceeds 100°F (37.8°C), or ear temperature exceeds 100.4°F (38°C).
What Are the Common Causes of Fever in Children?
Fever can result from both infectious and non-infectious factors. Infections, particularly viral, bacterial, fungal, and parasitic, are the most prevalent causes of fever in children. Examples of viral infections include flu (influenza) and the common cold, while bacterial infections encompass respiratory tract and urinary tract infections. Parasitic infections, such as dengue and malaria, are also notable contributors. Additionally, other potential causes may exist. Teething, though debated, is occasionally linked by some parents to low-grade fever. Furthermore, vaccinations can induce mild fever as a response in some children.
Color
- Normal color of skin, lips & tongue
Activity
- Responds Properly
- Looks comfortable
- Active and completely conscious
Circulation & Hydration
- Normal skin and eyes
- Mouth is moist and hydrated
- Passing urine normally
Other
- No intermediate or high risk factors present
Age
- Age < 3-6 years with temperature > 39°C
Color
- Pale skin, lips and tongue
Activity
- Slow responses
- Looks physically uncomfortable
- Inactive and lethargic
- Sudden drop in appetite
Respiratory
- Swelling of nostrils
- Wheezing sound
Circulation & Hydration
- Dry mucous and dehydration
- Passing urine after abnormally long intervals
Other
- Fever > 5 days
- Shivers
- Swelling of a joint or limb
Age
- Age < 3 years with temperature > 38°C
Color
- Pale / blue skin, lips or tongue
Activity
- Extremely Unresponsive
- Cannot stay awake for too long.
- Weak high pitched crying
Respiratory
- Grunting
- Moderate to severe pulling in of the chest.
Circulation & Hydration
- Reduced skin moisture and extreme dehydration
Other
- Non blanching rash
- Neck stiffness
- Focal seizures
What are the common DO’S and DON'TS that all parents must know?
Encourage the child to drink fluids regularly (Infants should be breastfed for at least the first six months)
Ensure medication is given in the right dose at the right time.
Seek further medical advice if the fever does not improve or if the child's condition worsens.
DON’TS
Overdress or underdress the child or wrap the child in heavy blankets.
Allow the children to drink medicines straight from the bottle - because you could easily overdose your child this way. Use labeled cups to measure the medicine properly.
Administer another dose of medications used to reduce fever immediately if the temperature does not decrease after one dose. Wait for the appropriate dosing interval to pass and only give another dose at the correct time.
Give antipyretic medicine to the child for longer than 2 days without consulting a doctor.
How to Take Your Child's Temperature: A Simple Guide
Where to Measure
- To check your baby’s temperature, you can use a thermometer under their armpit or in their ear (if they're older than 4 weeks). It's better not to use a thermometer in their mouth or bottom.
Tips for Armpit Measurement
- Do not measure right after bathing.Ensure the child's armpit is dry.
- If using a glass thermometer, shake it until the liquid is at or below the 96°F line.
- Place the thermometer in the armpit, press the child's elbow against the chest, and read the temperature after 4 minutes (glass thermometer) or when the digital thermometer beeps.
Non-Contact Infrared Thermometers
- It's usually not recommended to use these in children with fever.
- They may be okay for non-febrile kids as a screening tool (e.g., measuring forehead temperature).
- However, in feverish children, they may be unreliable and not as accurate as armpit or ear measurements.
- Proper measurement is essential, and readings may vary based on the child's distress level, distance from the device, and the number of readings taken.
Is Fever Associated with Pain in Children?
Fever in children can be associated with discomfort and pain. The underlying illness causing the fever may result in body aches and irritability. Addressing this discomfort with pain-relieving measures, as advised by a healthcare professional, can improve the child’s well-being.
Why is it Important to Control Fever in Children?
Controlling fever in children is crucial. It enhances the baby's comfort, reduces the risk of febrile seizures (which are brief, fever-related convulsions that can happen in some children), prevents dehydration, and promotes faster recovery from the underlying illness. Always seek guidance from a healthcare provider on when and how to manage your child’s fever.
Two Ways to Control Fever
Non-Pharmacotherapy
Non-pharmacological approaches are essential for managing fever in children. These may include ensuring a comfortable room temperature, offering ample fluids to prevent dehydration, and encouraging rest.
Sponging with lukewarm water can help lower a child’s body temperature. However, it should be done carefully and under supervision.
Pharmacotherapy
Pharmacotherapy involves the use of fever-reducing medications. The appropriate dosage should be determined by a healthcare professional, considering the child’s age and weight. Always consult your doctor whenever in doubt!
Things to be CAUTIOUS of, while treating your child with fever
While it's important to manage fever, there are potential pitfalls in actively controlling it:
Overmedication
Excessive use of fever-reducing medications can lead to adverse effects.
Masking Underlying Conditions
Overuse of fever-reducing drugs may mask the symptoms of a more serious underlying illness. It's vital to consult a healthcare provider to assess the root cause of fever.
In what conditions one should call for an Immediate Doctor’s Visit
These are just a few instances that call for immediate medical attention
Child is younger than 3 months of age.
Child is not eating or drinking normally.
Fever has been present for longer than 2 days (48 hours).
Temperature higher than 104°F.
Persistent vomiting.
Abnormal breathing.
Seizures.
Non-blanching rash.
Urine is very dark in color, and/or the child cries when passing urine.
Swelling of a limb or joint.
Child looks very ill or has signs of dehydration or shock:
- Dry mouth
- Absence of tears
- Sunken eyes
- Poor overall appearance.
Child is not behaving normally, e.g.
- Nonresponsive
- Lethargic
- Persistent, inconsolable crying, or cries when touched.
