A fever is defined as an increase in body temperature above the normal level, i.e. above 38 degrees Celsius when measured in the anus. There is no need to treat this reaction as it is a normal reaction of the body. Modern medicine views heat as a sign of an inflammatory process, regardless of the cause, and not as a potentially harmful factor.
In spite of the fact that fever is a normal reaction of the body, it will not reach unreasonable levels without treatment. The heat rarely poses a threat to the child. If the child is generally healthy, relaxed, and does not appear to be suffering, it is not necessary to insist on lowering the fever.
Despite the high fever, it is important to remember that it is not dangerous and does not harm the body (for example, antipyretics have not been proven to reduce the risk of convulsions).
How to measure heat?
The temperature of the mouth, armpits, forehead, and buttocks can be measured.
Temperature should be measured with a digital device and not with a mercury thermometer, since poisoning is possible in the event of a broken thermometer. Generally, an accurate temperature measurement is not required, only a check to see if the temperature is higher than normal. The most child-friendly measuring device should be used for this purpose.
According to the parent's perception of the child's feelings, it may be necessary to lower the temperature. Generally speaking, fever is not a disease and does not pose a threat to a healthy child. In order to improve a child's feeling, it is recommended to treat him when his temperature exceeds 40 degrees, or when he exhibits signs of discomfort and feeling unwell. It is common for children suffering from high fevers to behave normally.
Consult your child's physician regarding fever treatment if your child is prone to febrile convulsions or epilepsy.
How is fever treated?
Make sure the child drinks enough water to prevent dehydration. As many parents tend to do, it is not recommended to wrap the child in clothes. A fever should be lowered only in children suffering from a chronic underlying disease, such as a severe heart defect, lung disease, or brain injury. As these children have a smaller body's ability to cope with an increase in temperature, the heat itself can aggravate the condition.
A bath in lukewarm water or the use of wet wipes may be somewhat effective, but may increase the child's sense of discomfort. In general, these measures should only be used in temperatures above 41 degrees. The use of alcohol and complete stripping are not recommended.
To reduce fever, the following medications are recommended:
For newborns up to one month of age, one dose every 6-8 hours is recommended for paracetamol (Paracetamol, Paracetamol, Novimol). Older children should receive a dose every 4-6 hours, with a maximum daily dose of five doses (75 mg/kg).
At the age of 3 months and older, a doctor's prescription is required for ibuprofen (Advil or Norofen). Over the age of 6 months, a doctor's prescription is not necessary. The recommended dose from the age of 3 months is 5-10 mg/kg. Doses are administered every 6-8 hours, with a maximum dose of 40 mg/kg per day.
In general, all drugs approved for use are effective and safe when they are used correctly (according to the directions on the bottle).
Antipyretic medicine should not be given in a higher dose or frequency than what is recommended on the label.
Babies under two months of age suffering from rectal-anal fever of 38 degrees and above should be immediately taken to the doctor for examination in order to rule out a potentially life-threatening infection. Emergency care should be sought by babies under one month of age.
In order to lower the fever, it is recommended that you do not use medicinal means at first, but rather reduce the amount of clothing and blankets, and maintain a comfortable room temperature (22-24 degrees). You may add paracetamol (Acemol, Novimol) orally or as a suppository if these measures do not help and/or the fever is particularly high.
Fever in children: frequently asked questions
There are many important questions regarding fever in children that I have not addressed in other sections of the site, which are more specific and focus on precisely how to reduce fever in children.
In this section, you will find answers to fundamental and interesting questions such as 'Does teething cause fever in children?' or 'Is a high fever more dangerous than a low fever?' .
Here are a few things to keep in mind:
As a result of the current illness, many parents come to be checked because the child is not responding properly to the antipyretics. There is no evidence in the medical literature that the response to antipyretics predicts the occurrence of significant bacterial infections.
Consequently, I recommend minimizing fever by using appropriate medications and dosages, however, remember that most fevers are just numbers, and if the child is vital, sue him.
As a general rule, one should not repeat a dose of a given drug except after the time allowed between doses (see the specific chapter) in order to avoid an overdose. Why is that? We cannot always be certain that the child has vomited all the medicine that was given, and if the vomiting/ejection was not immediate, it may be possible that some medicine has already been absorbed.
In contrast, if a medicine given immediately (in front of the eyes) is ejected, the same dose may be repeated once and for all with two restrictions:
If we give it to the baby and he/she vomits after a few minutes, what should we do? Considering this medicine as a given, you may either wait about half an hour to 45 minutes and hope that some of the medicine absorbed will reduce fever, or you may immediately administer a medicine from another family (see the specific chapter on acetaminophen versus ibuprofen).
Pediatricians face this issue.
What is the difference between a child with a temperature of 38.5 and a child with a temperature of 39.5?
There is probably a bit of complexity and confusion in the answer.
In one sense, no. In the absence of any good, high-quality scientific work, it cannot be proven that the higher the fever, the more 'dangerous' the situation or the greater the chance that the sick child will have a serious bacterial infection. As an example, almost every child under the age of one gets rubella. This is a disease in which the temperature is usually very high, around 40 degrees Fahrenheit. However, this is a relatively simple disease, which is caused by a virus and does not cause complications in most cases. On the other hand, every experienced pediatrician has seen cases of serious bacterial infections in which the fever was not very high.
But, it may be possible. For two reasons:
With a high fever in a child, it is recommended that you 'keep your finger on the pulse' and arrive at a pediatrician's office earlier than when the fever is lower.
The pediatrician should examine the child and make a recommendation.
In the literature, hypothermia (temperatures below 36 degrees Celsius) has also been associated with severe infections; however, in everyday life, the majority of cases are caused by inaccurate measurements or excessive use of antipyretics.
Sometimes, I see children who have recovered from a febrile illness with hypothermia, which can last for several weeks (especially at night). The majority of these children are able to manage without any specific treatment.
In spite of this, these children should be examined by a physician.
Parents and caregivers should be aware of certain symptoms, including sighs, chills, and changes in color. The following is my position regarding these symptoms:
Children's sighs - The sound made by a child when exhaling (exhalation). The majority of the time, sighs are a sign of a high fever in some children (with my eldest, we knew she had a fever because she would start sighing...) and are not of concern in and of themselves. A sigh, however, can also indicate shortness of breath (and in extreme cases, bacterial pneumonia), pain (mostly abdominal pain), or a cardiac problem (rare, rare, rare).
If a child sighs and his temperature drops, I am less concerned if he is vital and cute.
It is important to see a doctor as soon as possible if the child sighs and does not appear well, even after the fever has subsided.
Children's chills - When children are suffering from a fever, they may shiver. It is a real chill when it is also accompanied by teeth chattering (or before teething...). It is not like there exists a lot of research linking chills in children directly to diseases, but for me, a real chill is significant and it is appropriate to consult a pediatrician about it. When a child (usually a girl) has a history of urinary tract infections, the presence of chills should raise the suspicion of a urinary tract infection, and a urine sample should be obtained.
Children's color changes - My ability to be specific is a bit limited, but I will do my best.
Pallor - It is common for sick children to have pale skin tones. In most cases, it is not a sign that indicates a more serious illness (such as a bacterial infection).
Blueness - This is extremely alarming and requires immediate referral for testing, including a blood oxygen saturation test (saturation).
Jaundice - Except for newborns, fever is always worrisome and requires medical evaluation as soon as possible.
There is no book answer to this question, of course. There is no logic to diseases.
Despite the fact that most viral illnesses last just a few days (one to three or four days), there are viruses that can cause signs of illness and fever for up to a week.
Is there a bacterial infection? This usually warrants the use of antibiotics, and without such treatment, the fever may even be prolonged even further.
As a result, there is no textbook answer to this question. Even when a child appears well and vital after two or three days of fever, it is recommended that a pediatrician be consulted for an evaluation. There is a need to behave differently if the child is not vital or if one of the signs described in the chapter 'Signs for which you should go to a medical examination as soon as possible' appears.
There is a difference between a fever and a fever.
As the temperature rises, many children will grind their teeth and complain that they are being misled. During this stage, you may cover the child with a blanket while administering antipyretics.
It is recommended to remove a blanket or layers of clothing from the child after administering an antipyretic to allow for sweating and evaporation of the heat.
Similarly, there is no book answer to this question, but there is common sense.
It is possible, in my opinion, to let a child sleep and wait with the antipyretics when he wakes up if he sleeps deeply and is not restless or in pain.
It is important to remember that we do not only treat fevers, but also their symptoms, therefore it is not necessary to wake a sleeping child if the parents perceive a high fever to be present.
You may want to wake up the child and give some form of antipyretic if he or she wakes up frequently, moves in bed with considerable restlessness, or appears to be in pain.
It is not advisable to give medicine to a sleeping child.
One thing I do not intend to do is argue with mothers...
Studies have demonstrated that, contrary to what we all believed, the eruption of teeth (especially the first, especially the front incisors) causes a slight increase in the body temperature in children, but not to a level exceeding 38 degrees.
In children, teething is associated with restlessness, gum sensitivity, and drooling, but not with fever.
In such a case, fevers of 38 degrees or higher should not be attributed to teething, but rather to a real cause (usually an infection, usually a viral infection) of fever in children.
According to the previous question, teething does not actually raise the temperature to 'real' levels. Teething, however, causes a great deal of suffering and discomfort to the child. Therefore, it is certainly possible to administer the aforementioned drugs (paracetamol or ibuprofen) to children who are experiencing teething symptoms. In most cases, parents give their children a dose before bedtime or during difficult nights.
There is no doubt that it is legitimate.