Fever – Bloem Mom Doc

Little Nina has been battling a fever since yesterday, so I thought I’d repost this.

Fever is probably one of the things that causes the most panic in moms. Fever is a natural way for the body to fight infection and inflammation and should not be feared. Every child will eventually experience a fever, no matter how careful you are.

What causes fever?

Chemicals, called cytokines, are produced by the body in response to an invasion from a microorganism (bacteria or viruses), malignancy (cancers), or another intruder. Germs don’t function well in high temperatures, so the body’s fighting mechanism keeps them at bay.

The body is making more cells that go to combat when intruders are present in the body (macrophages). These cells actually “eat up” the invading organism.

The body is trying to produce natural antibodies to fight the infection.

Many bacteria are enclosed in a membrane. When disrupted or broken, the contents that escape can be toxic to the body and raise the temperature.

Why does my child have a fever?

The most common cause of fever is an infection.

Either viral or bacterial. See my post on viral and bacterial infections here: https://www.facebook.com/1442008255941830/posts/1458483034294352/?d=n

But fevers do not always occur just due to infections. Some other conditions can cause a fever, including heatstroke, blood transfusions, cancers, and autoimmune diseases.

Although teething may cause a slight rise in body temperature, it’s probably not the cause if a child’s temperature is above 38°C. 

One can also get a low-grade fever after vaccination, as the body may show an immune response by developing antibodies.

What are the symptoms of fever?

Children with fevers may become more uncomfortable as their temperature rises. The child may not be as active or talkative as usual. They may seem fussier, less hungry, and thirstier. Your child may feel warm or hot.

What is the best way to take a temperature?

Touching a child to determine if you should check their temperature is valid, but skin temperature can vary based on what the child has been doing and is not an accurate measure.

The most accurate is a digital thermometer in the mouth, rectum, or under the arm.

Other thermometers that can be used on the forehead or ear (never trust them below 6 months, as the ear canals are too small) should be double-checked with a digital underarm thermometer. I have found they can sometimes be inaccurate. Thermometer forehead “strips,” dummy thermometers, and non-contact thermometers are not always accurate, as the ambient temperature can increase or decrease the skin temperature.

What temperature is regarded as fever?

Low-grade fever is a temperature of 37.3-38.4ºC.

High-grade fever is a temperature of 38.5ºC and higher.

Can a person have a unique temperature to them that is considered a fever for them?

No. A common misconception is that every child has their own level of temperature that is considered a fever. If you take your healthy child’s temperature, it varies during the day according to the level of activity, ambient temperature, and the clothes they are wearing. A fever is considered when the temperature is above the levels stated before, and it applies to everyone.

Is a fever worse the higher the temperature is?

The severity of a fever does not indicate that something more dangerous is going on. Still, it does alert you that something is happening that you should keep an eye out for.

When should you treat a fever?

In healthy kids, not all fevers need to be treated. In children, only a fever that is making them uncomfortable should be treated. Treating your child’s fever will not help the body get rid of the infection any faster; it will only relieve discomfort associated with fever. Some children can develop seizures from fever, called febrile seizures; therefore, do not leave a high fever untreated. See my post on febrile seizures here: https://www.facebook.com/1442008255941830/posts/1462689130540409/?d=n

If your child has a fever and is uncomfortable, don’t leave them miserable until you go to the doctor because you are scared, the doctor won’t believe you. We trust you if you say your child has a fever. If you’re worried your doctor won’t trust you, take a picture of the thermometer.

Never treat a fever in a child younger than 3 months old before taking your child to the doctor.

What can I do to decrease fever?

Never wake a sleeping or playing baby to treat their fever. If they were uncomfortable, they wouldn’t be sleeping or playing soundly. Treat fever based on the child’s comfort; it’s fine to let the child have a fever if they are comfortable.

Always start with these methods before giving medication:

Remove excess clothing as it can trap body heat and cause the temperature to rise.

Encourage your child to drink plenty of fluids.

Give your child a lukewarm bath, not a cold bath. Shivering from a cold bath can raise the body temperature.

Place cold washcloths over areas of the body where the blood vessels are close to the skin’s surface, such as the forehead, wrists, and groin.

If the above methods do not reduce your child’s temperature, administer an anti-fever medication.

Always start with Paracetamol. 

If your child does not respond to the paracetamol, you can add Ibuprofen if the child is above 6 months old. Do not give your child Ibuprofen if the child has the risk of being dehydrated or not taking enough fluids, as this may cause kidney damage.

By combining Paracetamol and Ibuprofen, you have a good combination that potentiates (makes better) each other and fights the fever better. 

Remember, oral medication works just as well as suppositories. Suppositories should be used as a backup when your child is not keeping anything down.

Remember to continue to give the medication over at least 24 hours, or the fever will usually return.

Do not give your child aspirin, as it has been linked to a severe, potentially fatal disease called Reye syndrome.

When should I take my child to the doctor?

Call your paediatrician immediately if your child is younger than 3 months old and they have a fever.

If your child is older than 3 months with a fever, call your doctor right away or go to the emergency room if:

Your child is crying inconsolably.

Your child is very sleepy and difficult to awaken.

Your child has been in a very hot place for an extended period, such as inside a hot car.

Your child has a seizure (convulsion).

Your child has other symptoms, such as a severe headache, stiff neck, or an unexplained rash.

Your child has cancer.

The fever repeatedly rises to 40ºC or higher.

Your child has severe vomiting or diarrhoea.

Your child does not pass urine as often as you are used to.

You can wait until the following day to phone your doctor if:

Your child is 2 years or younger, and the fever persists for more than 24 hours.

Your child is older than 2 years and has had a fever for more than 72 hours.

Your child seems to be getting worse when the fever comes down.

You should not be afraid of fever. Fever is just another symptom a child can have when they are sick. Watch the child closely, but resist the urge to panic. But if you’re ever in doubt about what to do or what a fever might mean, or if your child is acting ill in a way that concerns you, even if there’s no fever, always call your doctor for advice.

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