Health - Conditions
By: - at June 20, 2013

Dealing With a Child Who Has a Fever

Child with feverThe first and the foremost thing I would like to tell parents is that fever is not a disease, but a symptom of a disease. Whenever an infective agent enters the body, it could be bacterial, viral or fungal; the bodys immune system fights it. Fever is a manifestation of this battle.

High body temperature inhibits the growth of invading germs thus, too vigorous an attempt to control the fever may actually prolong the duration of the disease. On the flip side, if a child is prone to convulsions with the sudden rise of fever, not starting or delaying temperature control measures may result in the child getting convulsions. This would be unfortunate because each episode of convulsions damages a few neurons (nerve cells) of the brain.

What Is The Normal Body Temperature?
The standard normal body temperature is 98.6F or 37C. A normal child can have 98F in the morning and 99F in the evening. A variation of two degrees or more (98 to 100 or even 97 to 99) is abnormal and should be investigated.

How to Record Temperature Correctly
Taking a child's temperatureThe mercury thermometer is still the most reliable means of recording temperature. Digital thermometers also work satisfactorily. Strip thermometers, which are to be placed on the forehead often give false readings and cannot be relied upon.

Temperature can be recorded in the armpit (small children), in the mouth (older children) and in the rectum (by a rectal thermometer). Temperature recorded in the mouth is higher than the temperature recorded in the armpit, but lower than the temperature recorded in rectum. For example, the child's armpit temperature may be 100 degrees, oral temperature may be 101 degrees and rectal temperature may be 102 degrees. Always tell your doctor where you have recorded the temperature, whether in the armpit, mouth or rectum. Let your doctor do the adding or subtracting if you have not recorded the temperature in the mouth. Do not do it yourself.

A quick assessment of fever can be done by using the back of your hand. If the child's skin feels:

  • Cold - No fever
  • Warm - Equivocal
  • Hot Fever

When Should You Take The Child To A Doctor?

  1. Doctor checking a child's feverAny child less than two months old having fever should be taken to a doctor as soon as possible.
    Especially if he/she is not feeding well.
  2. If the child appears to be dull, listless and generally sick
  3. Difficulty in awakening the child
  4. Irritability, confusion or delirium
  5. Excessive crying
  6. Rapid breathing
  7. Repeated vomiting
  8. If the child has a stiff neck
  9. If there is a seizure (convulsion)
  10. Looking in one direction with fixed gaze
  11. The child has rashes
  12. Fever more than 102F

Managing a Fever

  • Using ice packs to treat feversThe child should wear minimum clothes, preferably cotton. The room should be comfortably cool. It is advisable to put on the fan/AC depending on the weather.
  • The fastest way to bring down the fever is cold sponging. Ice water should not be used as it may cause shivering and rise in temperature. There is no use of just keeping a wet cloth on the forehead. You must sponge the entire body. Remember, the larger the area you cool, the faster the temperature comes down. In case of a heat-stroke with hyperpyrexia (temperature above 105F), it may be necessary to bring down the fever rapidly. In such cases, ice cold water is used or patients are packed in ice bags at the hospital.
  • Give Paracetamol (15mg/kg per dose) simultaneously, while starting the cold sponge. Paracetamol takes an hour and a half to bring down the fever. Thus, initially the fever is controlled by sponging and later the drug takes over. You can repeat the dose of Paracetamol every four to six hours if the fever recurs.
  • After examining the child, your doctor may straightaway prescribe antibiotics/antimalarials, etc. or he might decide to investigate the child while controlling the fever with an antipyretic (fever reducer) like Paracetamol, Ibuprofen, Mefencmic acid or Nimesulide.
  • With fever most children tend not to eat, some don't even drink water. If the child refuses solids, try to give semi-solids along with plenty of fluids like fresh fruit juice, thin soups, freshly prepared lemonade, plain water, and yes even colas. If the child doesn't accept regular food, give chocolate bars, biscuits and cakes. The aim is to provide enough fluids and calories.





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