Most of the commonly occurring fevers are not harmful and are commonly caused by seasonal virus. These fevers are self-limiting . Parents and other family members are really worried and the only thing they want is to decrease the temperature somehow .
Latest guidelines from American Academy of Pediatrics(AAP) and also National Institute for Health and Care Excellence (NICE guidelines from UK) de-emphasize the excessive and routine use of fever reducing medicines like Paracetamol, Ibuprufen & Mefenemic acid. All these medicines have side effects and Paracetamol is one of the most common cause of poisoning in children in many countries .
AAP states that " Fever is a physiological mechanism that has beneficial effects in fighting infection.Parents should focus on the general well-being of the child, his/her activity, observing the child for signs of serious illness and maintaining appropriate fluid intake." Therefore always stay calm and take appropriate action .
The danger signs(requiring urgent medical attention ) in a child with fever( either low grade or high grade fever ) are
- Altered consciousness - speaking abnormally or not responding to call at all or difficult to arouse from sleep or head rolling from side to side or a child having fits or inconsolable crying or child is not interacting ( may indicate Brain infection- Meningitis/Encephalitis )
- Fast breathing with or without chest in drawing or skin bluish in color ( may indicate Lung infection - Pneumonia)
- Poor feeding, not able to suck at breast, and poor activity in infants( may indicate Blood infection - Septicemia) . Most of the children with fever have a decreased appetite. This is not a danger sign .
- Fever in babies less than 3 months of age even without any other symptoms( may indicate Blood infection - Septicemia)
- Passing urine very frequently or crying much when passing urine (Urinary Tract Infection)
- Any rash during fever ( may indicate Dengue )
- Persistent vomiting and child not retaining any fluid or food ( child may become dehydrated )
- Eye balls sunken , no tears during crying , decreased frequency of urine in a child with Diarrhea or otherwise also ( indicates dehydration )
High grade fever in an otherwise healthy child and fever not coming down even after using paracetamol are not danger signs per se .
Do see a doctor anytime you just feel that the child is not doing well even though you may not definitely identify any of the above symptoms.