27 Sep Fever – how to treat it

Fever in itself is not detrimental, but rather a normal physiological response to infection or illness. Although it is often associated with a self-limiting viral infection in children, it may also be a presenting symptom of more serious conditions requiring urgent medical care. Therefore, it is essential to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who can be managed conservatively at home. Fever is defined as a body temperature ≥38oC. Any fever in a child younger than 3months is significant and should be thoroughly investigated and referred to specialist care if the source of the fever cannot be found.

Body temperature should be measured in the ear using an infrared tympanic thermometer, or under the arm. Oral and rectal routes should not be used to measure body temperature in a child. To measure temperature via an infra-red ear measurement gently pull backwards on the ear lobe to open the ear canal. Insert the probe of the thermometer into the ear canal and press the activation button until the beep is heard. Remove the thermometer from the ear and read the temperature on the LCD screen. You can take a temperature by placing a thermometer under the child’s arm and holding it firmly in place for 2 to 3 minutes. Make sure the mercury bulb is in contact with the baby’s skin and not just sitting in the space of his armpit.

The temperature itself does not need to be treated but often there is discomfort or associated pain eg muscle aches, sore throat, headache. Antipyretics such as Panado syrup may be considered to improve comfort (with accompanying improvements in feeding activity and irritability).

The first time your baby has a fever will often be after his first immunisations at 6weeks. You do not need to be anxious about this nor does it need treatment. Do not administer anti fever medication before immunisations as it lessens the effect of the immunisation. You can administer medication to ease the discomforts of complications of the immunisation.

When a child has a fever, the skin is hot and dry to the touch and the child looks flushed. He will most likely be off his food and his mood will have changed.

How to bring down your child’s temperature

• Give the recommended dose of Panado syrup, Calpol or Nurofen according to your child’s age – this should bring the temperature down
• Take off his clothes, leaving him in just a nappy – and don’t cover him up with heavy blankets or duvet – bundling your child up could actually raise his fever
• Encourage him to drink extra water or juice, preferably cold – to replace fluids lost by perspiring. If your child isn’t interested in drinking, try offering an ice lolly instead
• Make sure that the room is not too warm. Use of an electric fan can be helpful

The above procedure will probably need to be repeated in 3-4 hours when the temperature is rising again.