From a stomach virus to flu and COVID-19, a fever is a common sign and a reaction of the immune system to fight pathogens. Fever is also one of the most common presenting symptoms in any child and the cause of up to 20% of all consultations in children but the fact is, fevers are usually harmless and often helpful.
Does my child have a fever?
A person’s normal body core temperature, when measured orally, is between 36.5˚C and 37.2˚C. Your child is suffering from a fever if their body temperature remains higher than 37.8˚C for some time. For very young children and infants, even slightly elevated temperatures may indicate a serious infection. In newborns, a subnormal temperature – rather than a fever – may also be a sign of serious illness.
Through the years, we have tried to “break” a child’s fever at all costs. Every household has their “remedies” to break a fever, but too little emphasis is placed on what the purpose of a fever is – a defence against infection. A fever (pyrexia) is a sign that the body is defending itself and one of the body’s reactions to infection. Since viruses and bacteria struggle to survive in a body with an elevated temperature, fever is an ally in fighting infection. An elevated temperature also increases the production of infection-fighting white blood cells, their speed of response and killing capacity.
For doctors, the severity, onset, and pattern of a fever as well as additional signs and symptoms, is often a guideline as to what the possible cause is. Rather than only treating the fever, the aim is to find the cause of the fever and treat the cause. In this manner, the fever will respond and be controlled. Fevers only need to be treated if they cause discomfort (makes your child feel bad). Most fevers do not cause discomfort until they go above 39° or 39.5° C.
Febrile seizures (convulsions caused by fever) are a concern, but this only occurs in 2 to 4% of the population. The young child’s brain is very sensitive to very high temperatures and it can therefor lead to febrile seizures. This most commonly occurs in ages 6 months to 6 years old. Although mostly innocent and uncomplicated, it can be very traumatic for the family and the aim is to avoid it by reducing a child’s temperature. If your child had a febrile seizure before, keeping the temperature normal can prevent it from re-occurring.
How is a fever treated?
Paracetamol is an antipyretic – a drug that helps to lower fever. It is also an analgesic (pain reliever) and can ease the discomfort and body aches that often accompany fever. Ibuprofen is another fever-reducing medication that relieves mild to moderate aches and pains.
Home treatment to bring down a person’s temperature:
- Remove excess clothing.
- Give medication or prescribed suppositories to reduce a fever of 39˚C or higher.
- Keep the patient hydrated by giving plenty of water or fruit juices. It is best to give small, frequent drinks.
- Sponge the skin with tepid water. Evaporation will have a cooling effect.
- Do not give aspirin to a child with a fever. Many fevers are caused by viral infections, and the combination of aspirin and viral illness has been linked to the development of Reye’s syndrome, a progressive and very dangerous liver disease.
When to call a doctor about a fever
- If a fever measures above 40°C, you need to seek immediate medical attention from your doctor, clinic or hospital.
- When a newborn or baby younger than six months has an elevated (or low) temperature.
- When the fever is accompanied by a stiff neck, confusion, lack of energy, difficulty in waking or inconsolability and headaches.
- If persistent vomiting, unusual skin rash or mental confusion accompany a fever.
- When the sufferer shows signs of seizures.
First-aid suggestions for seizures
- Secure the airway by putting the child on his side. Check that he is breathing.
- Lay him down, place a cushion under his head and loosen tight clothing.
- Remove any object that he could knock himself against.
- Don’t force anything into his mouth. Do not give him anything to drink.
- Don’t restrain your child.
- Once the fit has stopped, place your child on his side with his face turned to the floor.
- Any child who has had a seizure should be seen by a doctor to determine the cause.
- It is common for a child to be drowsy or sleepy after a seizure.
The bottom line: Keep in mind that fever is fighting off your child’s infection. Fever is one of the good guys. Normal fevers between 37.8° to 40°C are good for sick children.
