Managing baby’s fever at home

Parents tend to panic when a baby or child has a fever, as this is a sign that something is wrong. But when is it a minor issue that can be controlled at home, and when should you see a doctor? And what’s effective at-home treatment?

Dr Debra Hall-Parkinson, paediatrician at Delgado Health Services and J-Care Medical, says fever in children can be worrying to parents, and is one of the most common reasons parents seek medical care.

She explained that with a thermometer, a fever is defined as an armpit temperature of more than 99 degrees Fahrenheit or 37.20 degrees Celsius, or a rectal temperature of 100.40 degrees Fahrenheit, 38 degrees Celsius or higher.

“Fever is not an illness. Rather, it is a sign or symptom of sickness and is usually a positive sign that the body is fighting infection,” Dr Hall-Parkinson said.

She said an infection is the most common cause of fever in children, and common viral and bacterial illnesses like colds/flu, gastroenteritis, ear and throat infections, and urinary tract infections are some of the more common illnesses that cause fever in children.

She added that nearly every child develops a fever at some point in their lives, but the challenge for parents is to know when to be concerned.

Medical attention should be sought as soon as possible if your child:

1. Looks very ill, is unusually drowsy, or very irritable.

2. Has symptoms such as a stiff neck, severe headache or belly pain, severe sore throat or ear pain, an unexplained rash, or repeated vomiting and/or diarrhoea.

3. Has difficulty breathing or is drooling.

4. Is not eating/drinking or looks dehydrated.

5. Still “acts sick” once his fever is brought down.

6. Has immune system problems such as sickle cell disease or cancer.

7. Has had a seizure.

8. Has swelling of the joints.

9. Has worsening symptoms.

1. Is younger than three months and has a temperature of 100.4 degrees Fahrenheit, 38.0 degrees Celsius or higher.

2. Is younger than two years and has had a fever for more than 24 hours.

3. Is two years or older and is having a fever for more than three days.

4. Repeatedly has a fever above 104 degrees Fahrenheit, 40 degrees Celsius.

The paediatrician said parents should seek medical care at any point of discomfort during the course of their child’s fever.

“The main reason for treating a child’s fever is to make him or her more comfortable. Controlling the temperature will not alter the course of the illness. The most effective way of treating a fever is to use acetaminophen (Panadol, Cetamol) at an appropriate dose and schedule,” she said.

Importantly, Dr Hall-Parkinson said non-steroidal anti-inflammatory drugs (NSAIDs) such as Cataflam are also effective in treating fever, but medical attention should be sought before administering them.

“There have been several recent cases of dengue fever, and administering NSAIDs in a child who has dengue may have detrimental effects such as severe bleeding,” she said.

Added Dr Hall-Parkinson: “Aspirin should never be used in persons younger than 18 months old, as it may cause Reye’s syndrome, a disorder that may damage the liver and brain and may cause death.”

Otherwise, Dr Hall-Parkinson said tepid sponging can also help to reduce fever.

“This should be done with water that is just slightly warm, for at least 30 minutes,” she said.

As it relates to placing a baby on ice as some mothers have been advised to do, the paediatrician said cold or ice water should not be used as this may cause shivering, which can raise the body temperature and worsen the fever.

Additionally, she said children should not be sponged with alcohol as this may be absorbed through the skin into the bloodstream and cause serious side effects.

Dr Hall-Parkinson said rest and hydration are also important for a febrile child as fever can contribute to dehydration, and therefore they should be encouraged to drink plenty of fluids.

However, she warned that parents should not overdress their children while they are having a fever as this may increase the body temperature and worsen the fever.

“It is also important for parents to know that antibiotics are used to treat the infection causing the fever. However, antibiotics only work to treat bacterial infections and do not work for infections caused by viruses such as the common cold.”