Fever is one of the most common illness encountered by children right from infancy till they are about 5-6 years old. We spoke to Dr Zahilah Filzah Zulfikli, the founder of doktorbudak, and is a paediatrician of repute. Read on to find out more about fever, how you can deal with toddlers down with a fever.
GetDoc: What body temperature is defined as a fever?
Dr Zahilah: A temperature of over 37.5 C (99.5F) is considered a fever. One needs to remember that increase in temperature caused by other factors e.g heat stroke, hot baths is not the same as increased in temperature because of fever. There is a structure in our brain called hypothalamus that serves as a temperature regulator. It maintains our body temperature in the range of 36.5C -37.5C. When there is an infection , the hypothalamus increase the temperature setpoint as a defense mechanism. That being said, fever is actually a good thing.
GetDoc: When must I take action – take the child to a doctor?
Dr Zahilah: It is important to look at your child’s condition and not just the fever. Fever is a symptom and not a disease. Most often, fever is a presentation of an underlying infection. Of course there are other causes of fever apart from infection but I like to focus on infection as this is the cases in majority of children. As such, you need to pay attention to other symptoms that may pinpoint the underlying illness e.g if he/she has shortness of breath, worsening vomiting or diarrhoea, refusal to feed, rash, not active, seizure and drowsiness. Any signs of dehydration e.g. dry mouth, diapers are less wet than usual, sunken soft spot needs to be taken seriously and the child must be brought to the hospital immediately.
You also need to bring your child to see a doctor if :
- the baby is less than 3 months old and having fever of any temperature
- is in between 3 and 6 months old, the temperature is 39C and over
It is also important to note that babies can be unwell and yet may not have fever especially younger babies and therefore if they have other worrying symptoms, they need to be seen as well.
GetDoc: What immediate action must I take when I find my child is having high fever?
Dr Zahilah: My message to parents out there : You do not necessarily need to treat fever if your child is comfortable and active. That said, one should not wake a sleeping child for medicine. However , if the fever causes distress and discomfort to your child , you should check his temperature using a thermometer, keep your child lightly clothed, ensure that the environmental temparature is cool and give fever medication. Should children be bathed or sponged in cold water? The answer is NO. This will only cause further discomfort to the child.
GetDoc: How long can I wait before I take her to paediatrician or GP?
Dr Zahilah: There isn't a specific rule to this. And It all depends on the child’s condition. A child who has fever but is active and is able to tolerate feeds can be managed at home. On the contrary, a child who has worsening fever and worrying symptoms must be brought to see a doctor regardless.
GetDoc: Does frequent administration of paracetamol to keep fever down advisable in the long run?
Dr Zahilah: Paracetamol is a safe over-the-counter medication, as long as it is used in the correct dosage and at the right time interval (every 6 hourly). But as I mentioned earlier, treat fever only when it causes distress to the child, otherwise you do not need to give him the medicine. If used frequently ,then the cause of the frequent/ persistent fever needs to be thoroughly investigated.
GetDoc: What home remedies can I use if I do not want to give an antipyretic to bring the fever down, in case of a low grade fever?
Dr Zahilah: A child with low grade fever may not require medication. Keep the child lightly clothed and encourage them to rest and takes lots of fluid.
GetDoc: What diet can I follow for my child who is suffering from viral fever?
A child who suffers from viral fever is often lethargic and has no appetite. It’s best to encourage the child to take lots of fluid and rest. Soft diet e.g. porridge may be preferred by some when they are unwell.
Hope this information has been useful to you and will help you handle children better when they are down with fever.
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by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.