Fever in Children. What are the key points to know?

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Dr. Sandro Cantoni. Updated: 20 September 2021

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What is a fever?

Fever is not a disease, but it is an ally to help your child fight it.

In fact, it helps the body to eliminate the virus or bacteria responsible for the infection that causes the fever.

How? Fever in children retards the growth and reproduction of the microorganisms responsible for the infection. It also increases the production of the body’s defense cells.

Why does the temperature rise?

If your child has a fever, it is because his or her “internal thermostat” regulates the temperature above the normal level of 98.5-99.5°F (37-37.5°C).

During an infection, your baby’s “thermostat” adjusts the temperature to a higher level, perhaps around 101.5 – 102.5°F (38.5-39°C). The reason seems to be that if the body temperature is higher, the body more effectively fights off germs.

But why does my baby or child have a fever? What are the most common causes of fever in children?

In most cases, fever is caused by an infection, such as pharyngitis or bronchitis, and others. Usually these are viral infections, that is, due to viruses, and the child heals on his own without specific therapy.

Instead, more rarely, the fever is caused by bacteria.  For example, the child may have streptococcal pharyngitis or bacterial pneumonia.

What temperature is considered a fever?

The normal temperature value depends on the method of measurement you use. If you use a rectal, or ear thermometer, the normal temperature ranges from 97-100.4°F (36 to 38°C) or so.

If you measure your temperature with an axillary or oral thermometer, the normal value is about 96-99°F (35.5 to 37.5°C).

Above these values, your baby has a fever.

What method do I use to take my temperature?

The method of measurement depends on your baby’s age, whether they’re a few months old or older.

What I recommend to the parents of my patients is:

Up to 12 months of age = rectal temperature

12 months to 4 years = rectal or ear temperature

4 years and older = axillary, oral or ear temperature.

My baby has a high fever: what do I do? How can I help him?

First thing to do. He needs to drink often.

One of the most important things to remember is that when your baby or child has a fever, you need to give him more to drink than usual to prevent him from becoming dehydrated.

It’s best not to give him plain water, but, for example, milk, diluted fruit juices. Or even a glucosaline solution (with glucose and mineral salts) that you can find in drugstores.

How to lower a fever in children?

You should not try to lower the fever at all costs, but only if it causes discomfort in your child.

Remember that a slightly higher temperature helps your baby to recover.

What are the natural remedies to bring down a fever in children?

Dress him as lightly as possible, without him being cold or shivering. Also try to leave areas of skin uncovered so heat can evaporate.

Give him cool drinks to drink, such as fresh juices, yogurt, cool water. This way you reduce the temperature from the inside and keep him hydrated.

You can also do sponge baths, that is, make the skin moist with a sponge soaked in room temperature water. This helps the evaporation of heat from the body and lowers the temperature.

What medications are available to bring down a fever?

Your goal is not to reduce the fever at all costs, but it is to make him feel better. That is why it is okay to give acetaminophen or ibuprofen if your child has a fever and is not well.

If your child has a fever, but is playing, running around the room, smiling, you don’t need medicine to bring the fever down.

The two medicines that are used are acetaminophen and ibuprofen.

Can I alternate between the two medications if my baby’s fever doesn’t go down?

Research shows that alternating use of acetaminophen and ibuprofen seems to help keep the temperature down for a longer time.

But there is no data regarding the safety of this approach, in part because using two medications increases the risk of dosage errors.

Fever. When to call the pediatrician?

In any of the following situations, it is best to contact your doctor or take your baby to the hospital.

– Your baby is less than three months old and has a fever of 38°C or higher

Other warning signs: call your doctor, or take your child to the hospital, if your child, of any age, has any of these symptoms:

– Fever for more than 5 days

– Fever over 40 that doesn’t get better 2 hours after taking acetaminophen or ibuprofen

– Difficulty breathing, with noises while breathing, or pauses while breathing

– Vomiting (especially if green or dark in color)

– Does not drink and has not had a drink in over 6 hours. Has not urinated in the past 8 hours.

– Does not seem interested in anything, is apathetic, confused.

– The child is irritable, or drowsy.

– Looks very sick, doesn’t play, is sad, weak cry. 

– Has pain in the back of his neck and a stiff neck (can’t touch his chest with his chin).

or

– Cries continuously , or cries when touched.

– Has discomfort or cries when urinating.

– You feel like your baby looks, or acts, very sick.

When to go immediately to the emergency room or call the ambulance?

You should call the ambulance immediately if your child with fever has even one of these associated signs or symptoms:

– Blue, or cold and very pale, or marbled skin.

– He is difficult to wake up or is lethargic (a marked state of stupor)

– Unresponsive, not waking up.

– Very fast and difficult breathing, has blue lips.

– Red spots on the body that do not disappear when you press them (e.g. with the edge of a glass)

– Convulsions

Even just one of these signs can be a sign of very serious infection. A visit is needed right away.

Conclusion.

With time you will notice that when your child has a fever, your concern will decrease, because you will have already seen that after a few days he gets better.

But in some conditions, especially if it seems to you that his general state is not as good as the other times, better to hear the opinion of your doctor.

In any case, the instincts of you parents are often a useful diagnostic tool, so if you feel restless or worried about the health of your child, call the doctor.


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