Every parent already had to deal with a feverish child and none of them have reacted the same way… Some don’t give it enough importance and react too late, others panic as soon as there is a slight sign of fever and believe that their child will be brain damaged!
Fever is important, but not as much as the disease it is hiding! It may be the H1N1 flu, an ear infection, the measles or many other childhood diseases but it could also hide a urinary infection or even meningitis…
Bacterial or viral?
When a child has fever, one of the challenges is to determine what is causing the fever, or at least, to make sure the fever isn’t bacterial. The difference is crucial since viral infections are not treated with antibiotics, contrarily to bacterial infections. In general, the younger the child, the more he seems sick and the more persistent his fever is, the more chances the infection is bacterial. Furthermore, the general state of the child is as important as the intensity of the fever. For example, a child who looks very ill, but only has a slight fever may be sicker than an active and energetic child with a higher fever.
As a matter of fact, fever is one of the body’s normal defence mechanisms and should not always be lowered. Fever highly stimulates the immune system. Reducing the fever too rapidly decreases the amount of stimulation the immune system receives. It is good, to a certain degree, to have fever.
When giving a child acetaminophen or ibuprofen, it is mainly to ease the uncomfortable symptoms of fever rather than to lower the fever itself. However, there comes a time when you need to react (+ 38.5°C) and give the appropriate medication. The help of a pharmacist is essential at this point because he will be able to recommend the right medication, but most importantly, he will help you find the right dosage.
Thermometer and temperature
The rectal passage and the ear thermometer are the best ways to get temperature of a child under 5 years of age. The temperature under the armpit is not precise and is not recommended. After the age of 5, you can use an oral thermometer since the child is able to hold it still in his mouth.
The temperature varies from one thermometer to another. When using an oral or ear thermometer, there is fever when the mercury exceeds 37.5°C (99.5° F). With a rectal thermometer, fever begins at 38°C (100.4°F).
What are the normal gaps in body temperature?
The normal variation in temperatures is as follows:
- Rectal temperatures: from 36.6 to 38° C (from 97.9 to 100.4°F)
- Oral temperature: from 35.5 to 37.5°C (from 95.9 to 99.5°F)
- Axillary temperature: from 34.7 to 37.3°C (from 94.5 to 99.1°F)
There are few ways to lower your child’s temperature and make him more comfortable. Dress your child with light clothing, but do not have him naked; this will make your child shiver and it will increase the body temperature! If your child is shivering, warm him up with a blanket and remove the blanket as soon as the shivering has stopped. Warm baths may also help but most children react badly to warm baths! Do not apply cold bandages, give cold baths or give the child a sponge bath with alcohol.
The most important thing to remember is to have the child drink plenty of liquids to prevent dehydration. If the fever exceeds 39°C and does not lower after taking medication (it usually takes 60 to 90 minutes for the fever to drop), it is important to contact a doctor because there is always a risk of complications…
For babies under three months old, high fevers are usually due to infectious diseases, and these infections may be severe. Any fever for a child that age requires immediate attention. The fever in itself is not problematic, but the disease it is hiding is. High fever is often the only sign that a baby is sick.
See a doctor immediately if your child, no matter his age, has a temperature higher than 40.5°C (105 °F), is crying constantly, has difficulty staying awake or has trouble breathing.
See a doctor if a child, aged from 3 months to 2 years old, has a temperature higher than 38.5°C (rectal) for more than 24 hours.
Any child who has had a fever for more than three days, no matter their age, should see a doctor.
Do not hesitate to consult your pharmacist or your doctor to find the exact dosage to administer your child. The age of a child does not matter; it is their weight that counts.
Acetaminophen (Tempra, Tylenol): 15mg per kilo of the child’s weight, every 4 hours, if needed. If the child vomits or spits out the medication immediately or within the first 15 minutes, you may give him another full dose. If the child has a hard time with liquid medication, it is possible to use suppositories.
Ibuprofen (Motrin, Advil): 5 to 10mg per kilo of the child’s weight, every 6 to 8 hours if needed. This medication has a better lasting effect than acetaminophen. It lasts up to 8 hours, compared to 4 hours with Tylenol and Tempra.
Acetylsalicylic acid or ASA (Aspirin): Doctors recommend against giving Aspirin to children because of its negative side effects. ASA is associated with Reye’s syndrome, a rare and serious illness which provokes swelling of the brain and may even result in death.
Sources: CaringforKids.cps.ca and ROSS (Abbotts Laboratories)