Fever In Children

The human body has a thermostat which helps us to regulate our body temperature. The normal body temperature is between 36.5°C and 37.5°C. With infection or other illnesses, various chemicals are released in our body. This re-adjusts the thermostat, resulting in fever. A body temperature of 38.5°C and above is considered high fever.

A few points to note about fever:

• Fever is the body's way to fight infection. However, it is not just caused by infections alone. 
• How high a fever is does not indicate the severity of the illness that is causing the fever. 
• Over-wrapping and a generally hot environment can cause the body temperature of a child to be slightly above normal. 
• Fever caused by viral infections may persist for up to 5 to 7 days and will only completely settle when the viral fever has resolved. 
• High fever per se does not cause brain damage, though a small percentage between 6 months to 6 years may have seizures with high fever. However, febrile seizures usually do not lead to brain damage.

Medications 

Paracetamol
First line of medication to be used 

• Can be given 4 - 6 hourly
• 4 hourly if temperature above 39°C
• 6 hourly if temperature less 39°C
• Do not use in infants less than 3 months

Ibuprofen

• Use only when fever is persistently above 39°C, 1 - 2 hours after paracetamol
• Given 6 hourly
• Do not use in infants less than 1 year old unless adviced by your doctor

Diclofenac Na (Voltaren suppositories)

• Use only when fever is persistently above 39°C, 1 - 2 hours after paracetamol
• Given 12 hourly
• Do not use in infants less than 1 yaer old unless adviced by your doctor 

Do not give your child:

• both ibuprofen and diclofenac at the same time as they belong to the same class of medications
• either ibuprofen or diclofenac, if there is any severe vomiting or bleeding disorders, in view of possible bleeding from the stomach and intestines

Anti-pyretic usually brings down the temperature by 1 - 2°C. So do not be alarmed if your child is still having a fever after the medication. Antibiotics are of no use in viral fevers.

Do not use Aspirin in children.

Other Measures 

1. TEPID SPONGING may help if the temperature is more than 39.5°C. 
   • Use tap or lukewarm water to sponge.
   • Remove clothings, cover the child with towel, sponge and dry his face. 
   • Apply the cool compress to forehead, nape of neck, armpits and groin. 
   • Proceed to sponge body starting with the front then to the back. 
   • Generally you should not sponge a child for more than 30 minutes at a stretch. Stop sponging when shivering occurs, or when the child turns blue. When your child shivers, cover him up and wait a while before resuming sponging. 
2. Encourage your child to take plenty of fluids 
3. Dress your child in light clothings to allow heat exchange. 
4. Keep the room environment cool and well-ventilated to allow the ambient temperature to help bring the fever down. 

Consult your doctor when your child:

• is feeding poorly, vomiting or lethargic. 
• is very young, especially less than 3 months old. 
• has difficulty breathing . 
• is drowsy. 
• looks sicker than previously. 
• has abdominal pain and discomfort. 
• has rash. 
• has decreased urine output. 

The information above is also available for download in pdf format here.