Dr Prabhakar Patil, Specialist Paediatrician at Medcare Women and Child Hospital answers your questions when it comes to temperatures in children - should we be worrying as much as we do?
What constitutes a ‘high’ temperature in children?
A temperature above 38C is considered a high temperature in children. A normal body temperature is between 36.5 to 37.5. A temperature above 39 can be considered very high.
What is a ‘fever’?
A fever is a rise in body temperature that goes above a certain level, due to internal thermostat adjustment. Normally the body temperature is around 37, but can be a slightly different number depending on the location of the temperature you take like oral, armpit or rectal. Armpit, ear, and forehead temperatures are easier to measure than rectal or oral temperatures, but they are not as accurate. Even so, the height of the temperature is less important than how sick your child seems to you.
We are always told that a temperature of 40 is ‘extremely dangerous’ – is that true?
It’s partly true. The degree of fever is one of the indicators of the severity of infection, but a high temperature does not necessarily mean severe infection. There is myth that high fever causes seizures, it’s not the degree of the temperature, but rather the rapidity by which it increases, causing the fever. Not all children will necessarily have seizures, only those children that have the risk factors are more likely to develop febrile seizures.
Is a fever a bad thing, or does it help fight the illness?
Fever is the body response to any infection, it’s not bad in itself. It's one indication that body is responding to infection as heat tends to kill the germs.
On average, how long should a temperature last?
In most cases the temprature should return to normal within 3 to 4 days. It depends on the cause of fever though as sometimes if a fever is caused by a viral infection it might last 5 to 7 days, while for a bacterial infection if it remains untreated it can last much longer. In some unusual cases of non infective disease it can last up to few weeks to months as initially the diagnosis is difficult in these cases
When a child has a fever is it better to reduce the clothing they wear to sleep or keep it as normal?
That's good question. It’s better to keep clothing comfortable and regular and to not over or under clothe the child
What are the best methods to help reduce a fever?
The most effective way to treat fever is to use a medication such as paracetamol or ibuprofen. These treatments can reduce the child's discomfort and lower the child's temperature by 2 to 3°F (1 to 1.5°C). Aspirin is not recommended for children under age 18 years due to risk of serious illness known as Reye syndrome.
Paracetamol can be given every four to six hours as needed but should not be given more than five times in a 24-hour period. It’s not to be used in children younger than three months of age without consultation.
Ibuprofen can be given every six hours. Ibuprofen should not be used in children younger than six months of age.
Giving combinations of paracetamol and ibuprofen or alternating acetaminophen and ibuprofen increases the chance of giving the wrong dose of one or the other of the medications and is not recommended routinely.
Fever-reducing medications should only be given as needed and should be discontinued once bothersome symptoms have resolved.
Always Increase fluids — Having a fever can increase a child's risk of becoming dehydrated. To reduce this risk, parents should encourage their child to drink an adequate amount of fluids. Children with fever may not feel hungry, and it is not necessary to force them to eat. However, fluids such as milk (cow's or breast), formula, and water should be offered frequently.
Rest - Most children may feel tired during a fever. Parents should encourage their child to rest as much as the child wants but it is not necessary to force the child to sleep or rest if they begin to feel better.
Sponging is not as effective as medications for fever and generally is not recommended.
If you have any concerns or need more information make sure that you consult your doctor.