Fever is one of the most commonly encountered problem in a child . It is really a testing time for the whole family to manage a child with fever. Fever is considered bad and most of the worry arises from misconception rather than real danger . The following research based facts will allay the anxiety associated with fever .
What is fever ?
Fever is not a disease but it is a symptom of an underlying disease in the body .Most commonly it is due to underlying infection( virus or bacteria ) like viral fever / flu, sorethroat , sinusitis, diarrhea, urine infection etc. Sometimes it can be caused by vaccines , medicines (like antibiotics) , injuries or other rare causes.
What are the benefits of fever?
Fever is a protective response of the body to fight infection in the body. When the temperature is raised, the infection is cleared faster .As soon as the body is free of the invading organisms, the temperature automatically comes down.
How to measure fever?
Digital thermometer (widely available and have largely replaced mercury thermometer) can be used safely. Make sure that the mouth is closed when taking orally and to keep it tightly underarm. It has to be removed as soon as the alarm beeps.Oral temperature is about 1F more than axillary temperature.
When to consider it fever?
Normal body temperature fluctuates varies from 97.9 to 100 F and it is not constant at 98.6 F.Fever is defined as Oral( mouth) temperature > or = 100 F Axillary(armpit ) temperature > or = 99 F( NO need to give paracetamol if it shows 98.7 !)
How to treat fever?
In most of the commonly seen fevers like viral fever , just giving medicines(like Paracetamol, Mefenemic acid, Ibuprofen called anti-pyretics ) to bring down temperature alone is not useful .They just suppress fever and do nothing to clear the infection as they do not have either anti-bacterial or anti-viral action . The infection has to be cleared by body's own immune system .
Also repeated dosing of the child with Paracetamol has side effects like liver damage. Mefenamic acid and Ibuprofen can induce vomiting and stomach pain .Sometimes the fever can be due to infections like Dengue where Mefenamic acid or Ibuprofen can cause bleeding.
Paracetamol is the safest and must be used as and when needed only. Treat with Paracetamol ONLY if the child is distressed due to fever . If the child is comfortable then no need to give Paracetamol .
If the fever is high one can do sponging of the child with lukewarm water (NOT cold water/ice pack /alcohol). Remove excessive clothing. Use fan but not AC.
One has to investigate and treat the cause of fever Eg Antibiotics in case of Urine infection. So seek professional advice as soon as possible.
What else should be done in children with fever ?
Make sure child is well hydrated. Keep giving him water, Electral or Home made ORS ( 1 tsp sugar, 1 pinch of salt in 200 ml drinking water ) . Bland foods like rice or oats porridge, bread with milk, homemade soups etc in small amounts as desired by the child .Normally appetite comes down during fever.Never forcefully feed as it may cause vomiting . Rest at home is essential.
What about fever causing fits (Febrile seizures)?
Febrile seizures commonly occur in some children (not all) between 1 to 6 yrs of age. Usually they occur in the first day of fever and last less than 5 minutes.There is no scientific evidence to prove that giving paracetamol /other antipyretics prevents febrile seizures. Simple febrile seizures though frightening have no long-term consequences. They do not cause brain damage and are not life threatening.Seek immediate medical attention if child has febrile seizures.