Fever

Introduction

Fever is a circumstance in which the body temperature increases, triggered by an immune response to an external infection.

What some parents don’t realise is that fever is not a disease to be treated. Some well-meaning parents tend to give fever medication when it is not required, waking up children to administer their medicines or even worse, sponging their children with rubbing alcohol. This is so common that some healthcare professionals have dubbed this fear as “fever phobia”. Instead of working to bring the child’s temperature back to normal, make your child’s overall wellbeing and comfort your priority.

Please take note that this article does not apply to an elevated body temperature as a response to environmental heat e.g. excessive sun exposure. If this happens, remove your child from the heat, ensure sufficient rehydration and bring him/her to a doctor for evaluation if necessary.

Signs & Symptoms

A fever occurs when the temperature of the child increases above about 37.8oC when measured with an oral thermometer. Other symptoms might include shivering, chills and discomfort.

When to seek medical attention

Fevers on their own rarely cause serious problems. However, complications can arise due to underlying causes. See a doctor if your child:

  • Is under 3 months of age and has a temperature of 38oC
  • Has other worrying symptoms such as seizures, confusion, difficulty breathing and extreme discomfort.
  • Looks very ill or is crying inconsolably
  • Was previously diagnosed with other medical problems as immune system and blood problems.
  • Exhibits signs of dehydration such as dry eyes and skin, crying with no tears, small amounts of dark yellow urine or fatigue

Causes

Fever occurs when the body’s internal thermostat is reset in order to aid the fight against external infections.

Some common causes of fever in children are:

  • Viral or bacterial infections
  • Reactions to Vaccinations

Lifestyle Modifications

Administer more fluids, especially to children to prevent dehydration. Oral rehydration salts might be of use.

Let your child rest. Try not to wake him/her up to administer medication or to take a temperature recording unless absolutely necessary.

You can try giving your child a lukewarm water sponge bath if it does not cause the child excessive discomfort. Do not use cold water, or blow a fan onto a wet child as this can be very distressing. More importantly though, do not sponge the child with rubbing alcohol as it can be absorbed into the body, leading to serious side effects.

Avoid piling blankets onto the child as this can affect the body’s cooling mechanism.

Always ensure that you use the appropriate dose for your child’s medication. Look out for the strength of the medication, especially when you are changing to another brand. For instance, check if the paracetamol content should be 120mg/5ml or 250mg/5ml. Also, ensure your dosages are up to date as your child’s weight might have changed since the last time you have used this drug. If you are unsure at any point of time, seek advice from your pharmacist or doctor.

Ensure other family members in the household practise good hand washing and other good hygiene habits to prevent spread of any bacteria or viral illnesses. Do not share food or utensils.

Treatment options

Medication might not be necessary, especially if child is reasonably active and are doing well. You only need to administer medications to children if they are feeling uncomfortable, or if advised by a healthcare professional.

Paracetamol is a common fever medication given to children 3 months and older. Although it is perceived as rather safe, it can cause serious liver toxicity. Please do not adjust your dosage and ensure that you do not use two paracetamol-containing products at the same time, especially when using cold medications containing more than one ingredient.

The nonsteroidal anti-inflammatory drug (NSAID) commonly used in children for fever is ibuprofen syrup. Although aspirin is also an NSAID, do not use in children under 16 years of age as it has been associated with a life-threatening disease known as Reye’s Syndrome. In some cases, doctors might prescribe your child diclofenac suppositories (anal tablets). Do not combine this with ibuprofen as they are both from the same class of medicine.

Try not to use paracetamol and ibuprofen for the same instance of fever unless advised by a healthcare professional. Always follow instructions as to how to alternate the doses.

If the fever is found to have bacterial origins, your doctor might prescribe a course of antibiotics. Finish the entire course of medicine unless serious side effects occur, in which case you should bring the child back to the doctor to replenish the medicine.

 

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