How To Manage Fever In Children

Mrs. Kumar gets tense every time her three year old son, Rohan, gets fever. She knows that she is in for a tough time, as Rohan becomes almost unmanageable when this happens. He stops eating, tends to throw up and keeps whining the whole day.

A child with high fever or convulsions may need hospitalization

He won’t leave his mother, sticking to her like a leech. He doesn’t sleep, and also has a tendency towards fever-induced convulsions. The combination of all these factors is enough to drive Mrs. Kumar up the wall at the thought of her son getting fever.

Hers is not an isolated case; almost all mothers dread fever in their child, for they know that ensuing week is likely to be completely crazy.

Fever is the commonest symptom that indicates that the child is unwell. All of us know what fever is, and are acquainted with it. But while managing an adult with fever is one thing, a child with fever can challenge even the best of parents who know they have a tough few days ahead of them. Let’s take a look at fever in children.

What Is Fever?

Fever is the sensation that we feel when our body temperatures are raised, above the normal limits. Whenever our body temperature, as measured by a thermometer, is above 98.4 degrees Fahrenheit or 36.9 degrees Centigrade , it indicates that we have fever. The definition of fever is the same whether you are an adult or a child.

What Is The Normal Range Of Body Temperature?

The normal range of temperature can be anywhere from 95 or 96 degrees to 98 degrees F. Normally, the body temperature is lowest in the early morning and keeps rising slowly. It peaks at 2 am in the night, and then starts to fall. Hence, if you were to measure your child’s temperature in the morning, it might show 96 or 96.5 degrees. In the evening, it might show 98. This is the normal pattern.

How Is Fever Caused?

Our body temperature is controlled within the normal range, by an area of the brain, called the Hypothalamus. This structure is responsible for maintaining our body temperature in the normal range.

When there is an infection, the germs that cause the infection act on this structure and temporarily change it, so that it raises the body temperature. This leads to fever, with the child’s entire body feeling hot. If the germs are weak, the fever is mild; if the germs are powerful (like Malaria or Typhoid germs), then the fever is also very high.

When we administer a drug, like Paracetamol, to the child, in order to reduce fever, the medicine acts on the same structure in the brain, and brings about the opposite action that the germs do, and makes the fever come down.

When the effect of the medicine wears off, the fever rises again. This process goes on till the germs are eliminated from the child’s body, either by the body’s own immune system, or by antibiotic medicines that doctors administer to the child, along with fever reducing medicines.

It is a normal observation that when fever is rising, the child starts to feel cold, and may shiver. When medicines are administered and the fever reduces, the child starts sweating. Sweating often tells us that the fever is reducing.

Is Fever Bad, Or Does It Have Any Benefit?

Fever, apart from making the child lose his appetite and sleep, and making him irritable, can also cause convulsions in small children. As Mrs. Kumar discovered.

Once, when her son got high fever, he had a convulsion, and become unconscious. He had to be rushed to the hospital, and was admitted for a couple of days. Only when his fever came down, and all the tests were normal, was he discharge from the hospital.

Though fever is a sign of infection and signals that the child is sick, it has some advantages. Fever makes the child compulsorily take rest, which is required in any illness.

A child, who is otherwise playful and active will become quiet, and will cling to the mother, or remain in bed, when she gets fever. Also, when the body temperature rises, a lot of anti-inflammatory and anti-infective substances like antibodies are thrown out by the body into the blood stream, to fight the infection.

The Dangers Of Fever In Small Children:

The first worry about fever is that it could signal a serious infection, and if the fever is very high and is not improving in two or three days, then a doctor should be consulted, to ascertain the cause of the fever.

Some of the infections that come with high fever, and can be harmful include typhoid, malaria, dengue, pneumonia, urinary infections and brain fevers. So, fever worries us because it may be part of some serious disease.

The second consideration is that some children are prone to fever induced convulsions, as mentioned before. Such children need to be closely observed every time they get fever, and will need to be given anti-fever medicines every four to six hours, till the fever subsides, along with sponging the body with water. Children who have convulsions many times may need  anti-convulsive medication, usually for a period of two years or so.

What Causes Fever In Children?

Common causes:

1)    Viral fevers
2)    Ear, nose and throat infections
3)    Urinary infections
4)    Stomach infections
5)    Pneumonias
6)    Typhoid fever
7)    Malaria and Dengue fevers
8)    Tuberculosis
9)    Fever following vaccinations

Uncommon causes:

1)    Brain fever and meningitis
2)    Bone and joint infections
3)    Infections of kidney and liver
4)    Cancers, including blood cancer
5)    Autoimmune diseases
6)    Pus collections anywhere in the body

How To Treat A Fever:

Though a mild fever can be left alone without treatment, high fevers will need to be treated with anti-fever medicines like paracetamol. Also, sponging the entire body of the child with tepid water and keeping strips of cloth soaked in water over the forehead help to lower the temperature.

A child with fever should be made to wear as less clothes as possible and these too should be light loose fitting cotton clothes. Covering a child with heavy blankets or sweaters is not the right thing to do, though most mothers are taught to do this, during fever.

The insulation that results because of woolen garments prevents the heat of the fever from being conducted to the atmosphere. Woolen clothing can actually increase the fever by a degree or two, and a mild or moderate fever can become severe, due to tight, warm clothing.

This needs to be avoided. Using a fan or an air conditioner is permitted for a child with fever, as it helps in cooling the body faster.

Fever, by itself is rarely harmful. However, it often becomes necessary to find out what is the cause of fever, and to treat it accordingly with the right medicines.

Only when the infection is eliminated, either by the body’s own immune processes or by medicines does the fever go away, permanently. Though parents need not panic every time the child gets fever, they should consult their doctor if the fever is very high, or if it not gone after three to five days.

Copyright © Dr. P. V. Vaidyanathan

Dr. P. V. Vaidyanathan is a Mumbai-based pediatrician and published author. His recent book on child stress management has won critical acclaim.

Photo credit weatherbox


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