Fever in Children: Your Questions Answered

What determines a fever?

Your child is running a fever if he or she:

• Has a rectal temperature of 38°C or higher.
• Has an oral temperature of 37.8°C or higher.
• Has an armpit temperature of 37.2°C or higher.

Forehead temperature readings may not always be a reliable gauge for fever. Whenever in doubt, use another method to confirm the results. Always make sure to use a reliable thermometer too.

Speak with any one of our paediatricians about your child's health concerns today.

What causes a high fever?

A high fever typically falls in the 38.9 – 40°C range.

Causes of a higher fever include the common cold or other viral infections, but this doesn't usually indicate a serious problem. Serious infections, on the contrary, may not cause a fever, and could present themselves as abnormally low body temperatures, especially in infants.

A fever may also cause chills as the body tries to generate additional heat, resulting in a higher body temperature. A child may also sweat as the body releases extra heat when the temperature starts to drop.

Why does my child have a fever?

A fever is our body's natural defensive reaction to an infection caused by germs that have entered the body. With a higher body temperature, germs will find it harder to multiply as our immune system kills them off. Infections in children may not necessarily be bad as it can help build up their immune system.

Types of germs that cause infections:

• Viruses
• Bacteria

Most of the time, your child's fever will be due to a self-resolving common virus that the immune system will fight.

Bacterial infections, on the other hand, may get worse if not treated with antibiotics.

An important point to note, is that the height of the fever does not correlate to the severity of the child's illness.

How long will my child's fever last?

In most cases, a fever on its own is harmless and should subside in 3 – 5 days. Keep your child comfortable and let the body do its part in fighting the fever naturally. However, keep watch to make sure the fever does not escalate.

How do I make my child comfortable with home remedies?

There are many ways you can manage the fever and keep your child comfortable:

• Place a cool compress on the forehead
• Keep the room at a moderate temperature – not too hot and not too cold
• Dress your child in a layer of light clothing
• Use a light blanket when sleeping
• Cool your child off with lukewarm sponge baths
• Make sure your child drinks a lot of fluids to prevent dehydration
• Let your child eat as much as he or she can. What's important isn't how much your child is eating, but if he or she is still drinking and urinating normally.
• Keep your child indoors
• Let your child rest as much as possible
• Give your child paracetamol or ibuprofen in accordance with the recommended dosage for children.

Over-the-counter-medication

Over-the-counter medications can be purchased without a prescription. Common options that are safe for children include paracetamol and ibuprofen.

Paracetamol (acetaminophen)

Paracetamol is a pain reliever that also helps to bring down a fever. For children, it may come in the form of a suppository or syrup. Children below 2 months of age are not advised to take paracetamol unless advised by a doctor. Dosage is recommended based on your child's age and you should not give your child more than 4 doses in 24 hours.

Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that helps to treat inflammation, fever and pain. Children under 6 months of age should not be given ibuprofen.

For children above 6 months of age, formulations for children may come in drops, liquids or chewable tablets. You should follow the recommended doses, which are based on your child's weight. You should not give your child more than 4 doses in 24 hours.

Medications to avoid

Never give aspirin to children. It can result in a higher risk of Reye's syndrome, a rare but very serious condition that causes swelling in the liver and brain.

Infants under 2 months of age should not be given any medication for fever without first being evaluated by a doctor.

Why is my child's fever higher at night?

Children are more prone to getting fevers as their immune systems aren't fully developed. But do not be alarmed if your child's fever is higher at night. Body temperatures rise naturally in the evening, so a slight fever in the day can easily spike during sleep.

My child has a fever and other symptoms. Should I be worried?

The general symptoms commonly associated with a fever can include:

• Shivering
• Cold hands and feet
• Tiredness and discomfort
• Aches and pains
• Headaches
• Sweating or feeling flushed
• Lack of appetite
• Weakness or lack of energy

These symptoms are usually not a cause for concern. Over-the-counter medication can help relieve them.

When should I call a doctor?

While the body is very adept at fighting infections, bring your child to see a medical professional if you note these warning signs:

• Your child is younger than 2 months and has a temperature of 38°C or more
• Your child is aged 3 – 6 months and has a temperature up to 38.9°C or more
• Your child has persistent fever that lasts for more than 72 hours.

The following symptoms are abnormal and could be a sign of a serious infection. Your child should receive immediate medical attention. Our A&E accident and emergency department provides immediate medical attention for urgent medical problems to patients 24 hours a day.

• Extremely sleepy or irritable
• Trouble breathing
• Rashes or purple spots that look like bruises on the skin
• Pain, redness, or swelling in a localised area
• In infants, the soft spot on the head bulges out or is sunken inwards
• Drinking very little water
• Severely decreased urination or pain with urination
• Heavy coughing
• Vomiting
• Seizures
• Has difficulty walking
• Has blue lips, tongue, or nails

Read this article for more information on fever in babies and how to manage your infant’s fever.