Fever in Children

Dr. Parang Mehta, MD.

Fever is a sign of disease, not a disease by itself. Fever is usually a response of our body to some harmful process going on. The body draws attention to several different diseases of differing types by the fever response.

Many types of diseases cause fever. Some are dangerous. Fever should not be taken lightly, especially in children less than a year old. At this age, serious infections are more common, and diseases progress rapidly.

At any age, fever should not be ignored. An evaluation may find only a minor or self-limited disease, but serious diseases often become visible first through fever.

What is Fever?

The normal body temperature is 35.5º to 37.5º (C), or 95.9º - 99.5º (F). A child is said to have fever when the temperature is greater than 37.8º (C ) or 100º (F). These temperatures are taken in the mouth. In very young children, the temperature should be taken by a rectal thermometer. The rectal temperature is usually slightly higher than that in the mouth. Temperature taken in the armpit (axillary temperature) is not considered reliable.

Fever is the body's response to infections, inflammation, cancers, and several other processes that are harmful. Fever is a response that helps the body in controlling the harmful process. For example, when there is an infection, a fever helps in two ways. The higher temperature slows down the growth of most germs, and some cells of our immune defense system work better.

Dealing with Fever

Though fever has many causes, the most worrisome causes are bacterial infections. Infections like pneumonia, urinary infections, bacteremia, and meningitis can present with just a fever initially. Especially in young children and babies, these infections can progress rapidly and become serious or life-threatening. The first step in managing a fever is always to look for signs of serious disease. These are some pointers that you should have the child seen by a pediatrician:

Treatment of Fever

Fever is a sign of disease, not a disease by itself. As such, it does not need specific treatment. However, it indicates the presence of a disease process, which needs to be identified and treated.

Very high fever can make a child uncomfortable, make him irritable, and reduce appetite. Some children also develop seizures (fits) with fever. Prolonged fever can also need to poor nutrition and dehydration. Giving some fever medicine can reduce the fever, and make the child comfortable. Most fever medicines will also help the accompanying headache, muscle pain, and fatigue.

Apart from medicines, food and drink are important. Children often become dehydrated with a fever, and offering them lots of liquids is important. The appetite is usually poor during a fever. Food should be offered when the fever is low after a dose of antipyretic medicine.

What about sponging? Well, fever results from the disturbance in the part of the brain that controls body temperature. Bringing down the temperature by physical means like cold water baths and sponging have a very temporary effect. The child starts feeling cold, shivering develops, and the temperature shoots up again.

Sponging has a role in bringing down very high fever. After a dose of fever medicine is given sponging can be used to bring down the temperature. The medicine will by then be absorbed and prevent the rise of temperature later.

Alcohol rubs and sponging should never be done in children and babies. The alcohol can be absorbed through the skin, and have side effects.

Dangerous Fever
Treatment of Fever

 

Last revision: September 16, 2011

Medicines For Fever

There are many drugs available to treat fever. These drugs, called anti-pyretics, have an action on the body temperature only. They reduce the temperature of the body, but usually have no effect on the cause of the fever.

Acetaminophen / Paracetamol: This is perhaps the most widely used drug to treat fever. It is available as syrups, tablets, and injections. It is considered a safe drug at the recommended doses, and is popular with pediatricians because of its safety. The drug is most commonly used as syrup or tablet, and the effect of a dose lasts 2-6 hours. Paracetamol is dangerous when too much is used, and not more than 5 doses should be given in 24 hours.

Ibuprofen: This is another popular drug. It is mainly used as an anti-inflammatory drug. However, it is effective in reducing temperature, and its effect lasts a little more than thet of paracetamol.

Aspirin: This drug, very popular once, is now avoided in children. Apart from the usual side-effects like gastritis, the drug has been to be associated with a rare, dangerous disease called Reye's Syndrome. Children who receive aspirin while they have varicella (chicken pox) or influenza are at high risk of getting Reye's syndrome.

Other Drugs: Many other anti inflammatory drugs like mefenamic acid and nimesulide are successful in reducing body temperature. However, they usually offer no advantage over paracetamol and ibuprofen, and sometimes have significantly more frequent or more serious side effects.

Contact Information

Dr. Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat. Tel: +91 98241 53923.
Email: