Fever in children

Fever itself is not life-threatening unless it is extremely and persistently high. Fever may indicate the presence of a serious illness, but usually a fever is caused by common infections which are not necessarily serious.

The part of the brain called the hypothalamus controls body temperature. The hypothalamus increases the body’s temperature as a way to fight the infection. However, many conditions other than infections may cause a fever.

When to Seek Medical Care

You should seek medical care from your child’s doctor if any of the following are present with fever:

  • Your child is younger than 6 months of age (regardless of prematurity).
  • You are unable to control the fever.
  • Your child is vomiting, has diarrhoea or is not drinking, and may become dehydrated (sunken eyes, dry nappies, tented skin, unarousable, etc.).
  • Your child is now getting worse or new symptoms have developed.

You should take your child to casualty when any of the following happen:

  • You have serious concerns and are unable to contact your child’s doctor.
  • You suspect your child is dehydrated.
  • A seizure occurs.
  • Your child has a purple or red rash.
  • A change in consciousness occurs.
  • Your child’s breathing is shallow, rapid, or difficult.
  • Your child is younger than 2 months of age.
  • Your child has a headache that will not go away.
  • Your child continues to vomit.
  • Your child has complex medical problems or takes prescription medications on a chronic basis (medications prescribed for more than two weeks’ duration).

 

Self-Care at Home

The three goals of home care for a child with a fever are:

  1. Control the temperature
  2. Prevent dehydration
  3. Monitor for serious or life-threatening illness

The first goal is to make the child comfortable by monitoring and reducing the fever. This is achieved by using a thermometer and medications and dressing the child appropriately.

  • To check your child’s temperature, you will need a thermometer. Different types of thermometers are available, including glass, mercury, digital, and tympanic (used in the ear).
  • Various medications can be used to reduce a fever. Follow the dosage and frequency instructions printed on the package insert. With over-the-counter medicines, it is also important that the ingredients are studied to ensure that children do not receive two doses of the same drug from different preparations.
  • Children should not be overdressed indoors, even in the winter. Overdressing keeps the body from cooling by evaporation, radiation, conduction, or convection. The most practical solution is to dress the child in a single layer of clothing, then cover the child with a sheet or light blanket.
  • A sponge bath in warm water will help reduce a fever. Such a bath is usually not needed but may more quickly reduce the fever. Put the child in a few inches of warm water, and use a sponge or washcloth to wet the skin of the body and arms and legs. The water itself does not cool the child. The evaporation of the water off the skin does, so do not cover the child with wet towels (which would prevent evaporation).

The second goal is to keep the child from becoming dehydrated. Humans lose extra water from the skin and lungs during a fever.

  • Encourage the child to drink clear fluids.
  • Your child should urinate light-colored urine at least every four hours if well hydrated.

 

The third goal is to monitor the child for signs of serious or life-threatening illness.