Fevers are something parents get used to, but it’s important to know the cause and what to do, says Dr Phil Kieran.
You're putting your child to bed on a Sunday night and as you tuck them in, you notice they feel hot. You go digging through cupboards and drawers to find at her mometer and when you check, their temperature is 39C and you need to figure out what to do next.
This is a scenario familiar to any parent all over the world and we have all felt that fear, wondering if this is something serious or something not to worry about.
Thankfully, the huge majority of these cases will be very mild and resolve by themselves with no intervention needed other than simple home-based care.
So, what is a fever? This is a question which has a lot more debate around it than you would think, but it is safe to set a mark of 38 degrees CelsiusC as the definition.If the child (or indeed adult’s)temperature is above 38C, it is abnormal.
Anything between 37.5C and 38C might be normal or might be abnormal and anything between 36C and 37.5C I would consider completely normal.
Fevers are particularly worrying in the first six to eight weeks after a child is born and if they develop a temperature above 38C in this period, they need urgent medical review.
This is because a number of the functions of their immune systems are not developed at this point and they can become sick very abruptly. It’s why I tell all new parents to go an buy at hermometer and learn how to use it properly. Relying on whether or not they feel hot isn’t accurate enough.
Fever is a normal part of the body’s tools in fighting infection and should only be interfered with if it is causing distress. One of the most frequent questions I get asked is “what temperature should make me come back to the doctor?”.
I always answer this question by explaining that what is more important than the temperature is how the child is. If the child has a temperature of 38.9C and is happy, alert, eating, and drinking well and interacting, I wouldn’t intervene.
However, if the child has a temperature of 38C and is miserable and seems very unwell, then they need to be reviewed.
If your child has a high temperature and isn’t themselves the first treatment I would recommend is get them to lie down and drink cool fluids. If this isn’t bringing the temperature down the next step is paracetamol.
Make sure you give the right dose and give it 30 to 40 minutes to have an effect. Most of the time, this is absolutely sufficient to bring their temperature down.
If not you can also give ibuprofen, but it is very important with ibuprofen to make sure that they are well hydrated, so if they are vomiting or have diarrhoea, best to avoid this.
The most important thing with a fever is to figure out the cause. If your child has a runny nose, a cough and a fever, they have an upper respiratory tract infection.
This is the most common cause of fever in children and usually lasts three to five days and then resolves. In this setting, it isperfectly reasonable to treat the child yourself and if they remain fairly well (eating, drinking, and interacting normally) then a doctor’s visit is unnecessary.
These are viral illness and antibiotics will not make them get better quicker or stop the child from getting sick with a virus if given early enough.
One scary complication of fever can be a seizure. These febrile seizures happen in 2% to 4% of children and for the majority, will happen once and never again. If your child has a seizure, take them for medical review.
I bring this up not to scare you, but to point out that just because it happened once, doesn’t mean you need to live in fear of it happening again.
Nor does it increase the risk of epilepsy in later life and it is not triggered by a specifically high temperature or likely to cause any damage to the child in question.
On the whole, fevers are something you will get used to. Early school or preschool children will get eight to 12 viral infections per year, which works out at one every three weeks during the winter months. This means hfevers will come and go regularly.
If your child is very sick with it and doesn’t improve when the temperature comes back down with home treatment, bring them to the doctor. If their temperature is staying above 38C for three to four days bring them to the doctor to make sure it’s not a bacterial infection.
I recommend bringing a urine sample with you in this case for the doctor to check, bottles and collection bags can be got in the pharmacy.
Lastly, trust your instincts. If you think your child is doing OK they probably are and, in the reverse, if you think they are very sick, they need to be checked out.