Fever in children? Always try to bring it down!


10. 12. 2020

Your child has a fever and you’re sat there wondering whether you should treat them at home or take them to the doctor first, so that they can judge the severity of the fever themselves. If this is your case, then you should know that there is no sensible reason why you shouldn’t go ahead with the first option. This is because young children under the age of five or six are at risk of developing seizures from fevers (febrile seizures).

“What we often see in paediatric surgeries, are parents who for some incomprehensible reason decide not to treat their child’s fever prior to coming in to see a doctor. They often argue that they wanted the doctor to see the symptoms and measure their child’s fever themselves. This is completely unnecessary and can actually cause more harm than good,” warns Dr. Silvia Knoppova, Canadian Medical’s paediatrician.

Medication first, doctor second

A child with a fever should be given antifever medication at home and only after should they be taken to see a doctor. The only time it isn’t necessary to treat the fever is in the case of only a mild temperature (up to 38.5˚C). “The journey to your paediatric surgery can be lengthy and complicated, the waiting room can be full of other ill children, so letting your child sit with a high fever for a long time is only going to make them more ill,” Says Dr. Knoppova, adding that it will actually aid the doctor in finding the cause of the raised temperature by letting them know how your child reacted to the antifever medication, whether the fever responded to the medicine and if their symptoms got better or worse.

When should you seek medical attention without delay? “The most important thing is always the child’s overall condition. This includes how their fever symptoms and how they’ve responded to the antifever medication. It’s vital that a child with a temperature around 38˚C who presents with apathy, sleepiness, difficulty ingesting fluids, repeated vomiting, difficulty breathing and signs of dehydration or even loss of consciousness should be seen by a doctor immediately, no matter how long they have been presenting with a fever. Conversely, if you have a child with a fever of over 39˚C who responds well to antifever medication (when the fever is brought down for at least three to six hours), they “come to life”, drink well and are interested in their surroundings, it is not necessary to seek medical attention immediately. However, medical attention should always be sought out in case of a fever higher than 38˚C in newborns,” explains Dr. Silvie Knoppova.

When deciding when to go to the doctor with your child, do not be afraid to rely on your parental instinct, because you know your child the best. "Sometimes it is the parent who points out atypical behaviour, which may be unusual just for that particular child, perhaps something that could be signifying a start of a more serious condition that the doctor would never consider a symptom," says Dr. Knoppova.

How to treat a fever

A fever can be treated with antifever medication or by “cooling treatments” e.g. cold wraps, lukewarm showers or baths. “Paracetamol can be given to children of all ages, ibuprofen for children over the age of three months. These fever-reducing drugs (antipyretics) are available over the counter in the form of suppositories, syrups or orodispersible tablets, but also in the normal tablet and capsule form for adults. Acetylsalicylic acid (aspirin) should not be given to children under the ages of 15 years old as there is a risk of complications associated with the liver and brain in some infectious diseases, although most of today’s parents will remember being given aspirin as when they were children, however times have changed,” warns Dr. Knoppova.

Try to buy medication that can be adjusted according to the child’s weight. “Some manufacturers state the recommended dosage according to age on the box or the information leaflets, however the child’s weight can significantly vary within an age category, which can mean that your child might not get the appropriate dose for their needs and the treatment will be ineffective,” notes Silvie Knoppova, adding that it is essential that the child has enough hydration as not only are they at increased risk of dehydration, but also lack of fluids may reduce the effectiveness of antipyretics.


Raised temperature vs. fever

Normal human body temperature is between 36 and 37˚C, however in infants it can be a bit higher- slightly over 37˚C. A fever would therefore be any temperature above 38˚C. “If the fever is caused by a supposed one-day virus, it will be gone within 24 hours. For other infections, it may take significantly longer to recover. If the fever is the only symptom the child has, and is otherwise in a good condition, you should only seek medical attention if the fever lasts longer than three days,” explains paediatrician Dr. Knoppova.

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