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Fever in children

MY CHILD IS HAVING A FEVER!!

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Most common cause of anxiety in parents is fever in children

Fever is as such a body’s response to fight against the infection, usually. It is itself a symptom, not a disease, so don’t keep on giving paracetamol & wait for the fever to go away, need to know the reason.

Parents don’t want to see the fever in children and so they keep on giving fever medicine every 6 or 8 hours without measuring the temperature which later on causes overdosage and is totally wrong!

 

CAUSES OF FEVER

However, majority of fevers are caused by Viral fever and it can last for 3 days and may reoccur in every 6 hours.

Other common causes of fever are:

Throat infection (acute tonsillitis)
Typhoid fever
Urine infection (UTI)
Dengue fever
Chikungunya fever
Viral hepatitis (fever without jaundice)
Viral exanthematous fever (fever with rash)
Febrile seizure
Fever without focus
Undiagnosed fever

 

BASIC MANAGEMENT OF FEVER
    1. Paracetamol: Plain paracetamol should be used instead of combination medicines as the majority are irrational combinations. Whenever a combination medicine is used, either of the components goes in a high or low dose. Paracetamol is available as drops, syrup, and tablets to be given according to the age and weight of the child
    2. Encourage more liquids: Try to maintain hydration of your child. Dehydration causes more high-grade fever so give more liquids like lemon water, ORS, coconut water, or even simple liquids
    3. Cold sponging: It is effective to manage fever. Not necessary to be salt-water for sponging. Sponging is not to be done by putting a cold water sponge continuously on the forehead as it may cause chills. Cold sponging is to be done by doing a circular movement of cold water sponge at the neck, armpit, and groin (as all the major vessels pass from these sites), not to be put continuously.
    4. Other antipyretics that can be used are Meftal or Ibugesic as per the dose advised by the doctor.

 

What is fever?

When it is called fever?

A fever is defined as a temperature >100.4F or >38F.

There is natural variation in body temperature, and temperatures that creep up to 99F or so are not technically considered a fever. The reason that this matters is that when you talk to your doctor or healthcare provider, knowing how many days in a row your child spiked a true fever may be helpful for decision-making.

How to measure a temperature?

Temperature should be measured by mercury or digital thermometer by keeping it in the armpit.

If that temperature comes above 100F, then only action has to be taken otherwise it's not true fever. Core temperature can be high, ie if a rectal thermometer or regular thermometer is put in the mouth that will show a 1.5 to 2 F high temperature as compared to armpit so then 101.5 or 102 F is called true fever. But to keep the standard's same measure it in the armpit.

Fever or no fever?

If your child has a temperature below 100F, then it's called low-grade temperature but not fever. Tru Fever is a temperature above 100.4 F or 38 C. So if you are giving Paracetamol to your child for temperatures below 100 F then stop doing it now.

Viral fever

Majority of fevers are viral in origin.

In Viral fever, the fever will come and go.

For most viral illnesses, fevers can pop up for several days. If the fever comes back, it is not an indication of things getting worse.

Fever for more than 3 days?

Majority of time it is viral fever only but now a parent should act.

Viral fever can last more than 3 days and may last for a week too but now is the time to act. Better to consult a doctor and get your doubts cleared. Doctor may suggest investigation to rule out other infections like typhoid fever, urine infection, dengue fever, etc

My child has a fever of 102F, what should I do?

A higher number on the thermometer does not indicate a more severe illness.

There is no difference in severity between a fever of 100.4F and a fever of 104F! A higher temperature does not make it more likely to be a bacterial infection - in fact, MANY viruses can cause very high fevers. We care more about how your child looks and acts than the actual number.

I have a head scanner (infrared thermometer), can I use it?

Forehead scanners are notorious for over-estimating temperature.

They just aren't very accurate. Often a child will have an oral temperature of 101F but the forehead scanner will say 104F. Don't panic! The best way to take a temperature is under the tongue or under the armpit. For babies, a rectal temperature will be most accurate.

Dose of Calpol or crocin for my child?

Paracetamol dose for fever is 10-15mg/kg

However, it is better to ask a doctor before giving the dose. Paracetamol is available in various forms like syrup, drops, tablets, or suppositories. So be careful while using them and always better to ask as the child grows their weight also changes. Better be safe than sorry!!

RED FLAG SIGNS in fever

Fever for more than 3 days, Lethargy, Irritable child, Infant below 6 months having fever, Child not taking liquids, severe abdominal pain, repeated vomiting, severe headache, joint pain or rashes

or any unusual finding observed by the parent then consult your doctor immediately

Altogether, fevers can trigger anxiety for parents and can make children feel uncomfortable. Most fevers can be safely treated at home and many issues in kids get better on their own! Watch for signs of an emergency issue, and always call your doctor if you have additional questions.

It is very important to find the cause of fever and treat it accordingly. Paracetamol offers temporary relief to fever but you should identify the cause of fever and treat it accordingly.  Fever Management should be under a qualified Pediatrician.