A fever in a child tends to worry most parents and naturally so. It is a sign of some disturbance within the body where the core temperature has been raised to levels above the norm. Often a fever is a sign of an infection and usually there are other symptoms that may indicate where the problem is located, like a sore throat with a fever may be due to tonsillitis. But not always. Sometimes a fever occurs for no apparent reason. The raised body temperature may be all that is present with no other clearly identifiable symptoms. This does not mean it is any less serious.
In these cases it can be confusing and requires diagnostic investigations to identify the source of the problem. But there are still instances where no source can be found – fevers in these cases are referred to as a fever of unknown origin (FUO). Irrespective of the suspected cause, parents should consult with a doctor as soon as possible if their child has a fever. In infants in particular, the slightest fever requires immediate medical attention. For children older than 2 years, acetaminophen and ibuprofen can be administered for a fever alone but medical care is necessary if the fever persists. Remember that aspirin must not be used for any child under 18 years of age.
Here is a list of ways to help reduce and control a fever in children. This does not mean that medical attention is not necessary. The advice of a doctor is crucial, especially if a fever is accompanied by other symptoms like a headache and/or neck, convulsions, sensitivity to light, sore throat, persistent vomiting, abdominal pain especially when passing urine, difficulty breathing or skin rashes.
Wear Light Clothing
Even though a child will complain of feeling cold and insist on being covered, a fever means that the core body temperature is too high and you have to limit warming in any way. Clothes act as an insulator and prevents heat from the skin surface dissipating into the environment. Children with a fever should not be covered up with blankets or given a hot water bottle, heat paid or electric heater to stay warm. Although as much clothing should be removed, if it is not appropriate to do so then make sure that the child is wearing thin clothing made of textiles that allow for ventilation. Heavy clothing like thick shirts, sweaters and jackets as well as hats must not be worn.
Use A Fan or Air Conditioner
An electric fan or air conditioner may be an effective way to keep a child cool during a fever. Try not to place the child near the fan or air conditioning. Excessive cooling with a drop in the body temperature below normal levels can also be dangerous. Use an electric fan or air conditioner to circulate cool air through the room rather letting the air flow strike the child directly. Even a simple hand-held fan or newspaper to move air can be helpful in cooling. However, it is important for parents to user their judgement in these instances. If the room temperature is low and if it is a cold day, then there is no need to use a fan or air conditioner to further lower the environmental temperature.
Bed Rest And Sleep
When your doctor says bed rest, he/she means it for a number of reasons. Firstly bed rest will reduce heat generation by the body. Sleeping is more effective as the body’s core temperature naturally lowers a bit more when asleep than when awake. But even if a child is not sleepy, bed rest is important when ill. The body needs the rest and sleep as well to recover. However, it is also important to note when sleep may not be a good sign. Naturally any person will want to sleep more when they are unwell. But if a child with a fever is sleeping excessively, not responding when being awoken and not taking any food or drink, then they need to see a doctor as soon as possible.
No Vigorous Activity
Physical activity means that the body needs more energy. And energy production means more heat is generated. While a child may not always want to stay in bed all day, it is important to ensure that there is no vigorous activity. Naturally children will want to play and this usually involves more physical activity than for adults. But this will only increase the core body temperature further, even if the child is wearing light clothing and there is sufficient ventilation in the area. With infections, physical activity may also further promote the spread of the causative microorganisms. Rather have the child sit quietly and do less physically-intense activities like playing a board game.
Spray or Rub Down With Water
Water that evaporates from the skin surface is able to dissipate heat effectively. It works similar to sweat. In addition, water has the ability to absorb heat without its temperature increasing accordingly since it has a high heat capacity. For this reason, water can be useful in cooling down the body. Parents should gently spray the skin or use a damp cloth to rub down the skin with water to help cool down the child. It is important not to use too much of water. Just dampening the skin repeatedly will suffice. Do not use ice water as this can be uncomfortable. Ice cubes should never be applied directly to the skin as it can damage the skin.
Bathing To Cool Off
Bathing can help to cool the body due to the properties of water discussed above. Sitting in a bath tub can be helpful as the heat from the body is absorbed by the surrounding water. But do not put a child in a cold water bath or a bath filled with ice. Rather fill the bath with lukewarm water. Allow the child to sit in the bath and apply water on the head and face gently. If the child starts to shiver, remove them from the bath immediately. Even though you want to lower the temperature, put at least light clothing on a child afterwards as the body temperature can drop rapidly after a bath. Never fill a bath tub too high or leave a child unattended in a bath tub filled with water.
Drink Plenty Fluids
It is vital that a higher than normal fluid intake is maintained throughout the time that a child is unwell, especially during a fever. Naturally the child may not want to eat and while meals can be skipped for short periods, fluid intake should be increased. Fluid from the body is lost primarily in the form of sweat during and after a fever. If the child is vomiting or has diarrhea, then fluid loss is exacerbated significantly and can lead to dehydration. In fact a fever can be a symptom of severe dehydration. Ideally you should give a child an oral rehydration solution (ORS) which has the optimal mix of water and electrolytes to prevent dehydration and not worsen diarrhea. Breastfeeding must not be stopped.
Use Fever-Breaking Medication
Parents can use medication to treat a fever. Acetaminophen and ibuprofen is safe to use for a fever in children. It is important to use these drugs exactly as prescribed on the packaging. Remember that these drugs should not be used on infants younger than 6 months of age without medical supervision. You should see a pediatrician as soon as possible. If you are using these fever-breaking medication (antipyretics) then it is important that you stick to the instructions on the packaging. Never try to increase the dose above that which is recommended for your child’s age. If these drugs do not help to break the fever, or if the fever recurs then you should see a doctor as soon as possible.
Monitor Body Temperature
An important part of managing a fever is regularly taking your child’s body temperature and writing it down. This can help a doctor assess the changes that have occurred for the duration of the fever. Remember that a fever can be treated without any drugs. In fact bed rest and plenty of fluids is sufficient to manage a fever of 102F or less in a child, although infants under 6 months need to be seen by a doctor even if the fever is very slight. Medication is only necessary for fevers higher than 102F. Do not rely on your hand as a means of assessing the child’s temperature. You have to use a thermometer and take the temperature in the mouth (orally), armpits (axillary) or rectally in infants.
Article reviewed by Dr. Greg. Last updated on July 31, 2013