What you should know about fever in babies

Learn how to check temperature; always keep a thermometer at home. Remember the normal variations; do not imagine that your child has fever when there is none.

Fever in babies is usually due to a minor illness; do not be overanxious.

Fever in young babies below six months should be taken more seriously.

Do not expect instant cure; have patience. Giving too many drugs, changing drugs frequently and changing doctors unnecessarily should be avoided.

Follow the general instructions given below whenever there is fever.

Fever in babies is undoubtedly one of the most common complaints for visiting a doctor. Parents should be aware of some facts so that they can help the doctor to treat the child properly.

Many parents do not know the normal body temperature, imagine that their child has fever and get scared. Hence a few general guidelines will be given.

First of all it is important to remember that the normal temperature varies during the 24 hours of a day. It is lowest in the early morning and slightly goes up in the evening. Vigorous physical activity (so common in children), hot weather and excessive clothing can lead to mild elevation of temperature. Ignorance of these facts often results in undue anxiety.

Every mother should learn how to check temperature and keep a thermometer at home. Nowadays digital thermometers are available and are very convenient.

For younger children the temperature should be checked in the axilla (arm pit) or groin. After five years it can be checked in the mouth. The normal temperature also varies depending on where it is checked. Hence the doctor should be informed about the site as well.

Axillary temperature: Before keeping the thermometer, the axilla should be dried using a dry cloth. Sweat in the axilla can result in wrong reading. The arm should be slightly lifted and the tapering end of the thermometer inserted high in the axilla, after switching it on.

The arm should then be kept slightly pressed against the side of the body. The electronic thermometer will start emitting a series of short beeps when the body temperature is reached. Then the reading should be noted and the thermometer switched off. Up to 37.2 degree centigrade is normal.

Oral temperature: The child should not have taken any hot or cold drink for at least 20 minutes before recording the temperature. The sensor should be placed below the tongue and the child asked to close the mouth without biting the thermometer. When the thermometer starts emitting a series of beeps the temperature should be noted. Up to 37.5 degree centigrade is normal.

Rectal temperature: This is supposed to be the most accurate and most experts define fever in babies as rectal temperature of 38 degree centigrade and above which means temperature of up to 37.9 degree centigrade is normal. You need to use a different type of thermometer for checking rectal temperature preferably with a guard. Some people are uncomfortable with using a rectal thermometer.

Tympanic membrane: Recording the temperature of tympanic membrane by inserting a special equipment is becoming popular as it is quick and easy. However it is not accurate in infants under the age of 3 months and if the ear canal is occluded by wax.

Forehead: Temperature over the forehead may be recorded using liquid crystal strips. Though convenient this has not been shown to be very accurate.

Many mothers complain that the head of the child feels warmer compared to the rest of the body. This is not a disease and there is no need to worry. It may be due to the fact that the head and neck area receives relatively more blood compared to other parts.

What they feel is the relative difference between their skin temperature and that of the baby. If they wash their hands in cold water and touch the child without fully drying their hands they will feel that the child is having high temperature. When in doubt they should always check the temperature.

Once you confirm that your child is indeed having fever consult your doctor and tell him what you recorded. Remember the following facts.

1) Some newborn babies develop fever on the 2nd or 3rd day of life. This is usually not due to any disease and subsides without any treatment. It may be necessary to give a few sips of sterile water. But the doctor should always be informed.

2) Fever in young infants (up to six months) should be taken a little more seriously than in older infants and children. Younger the age greater is the risk.

3) There are many causes of fever but usually it is due to a minor and self limited illness.

4) There is no need to get too anxious about fever. It indicates that there is some problem which needs your attention.

5) There is no need to give injections for every fever. Let your doctor decide. Do not force him to give an injection.

6) Do not expect instant cure for fever. The usual fever in babies may take two or three days to subside. Nothing can be achieved by frequently changing drugs or doctors.

7) When there is fever the child loses more water from the body. Hence give more fluids like boiled and cooled water. Otherwise a young child may go on crying due to thirst.

8) If the fever is high (more than 38.5) dip a cloth in water (tap water will do) and wipe the whole body. If required do this repeatedly till the temperature comes down to normal.

9) Many mothers unduly worry about a slight rise in temperature (0.2 or 0.3 degree centigrade). They should look for the causes mentioned above and check the temperature again after half an hour.

10) While there is no harm in giving one or two doses of a drug which reduces fever, avoid giving too many drugs on your own. Administering a wrong antibiotic can be harmful. Do not assume that a drug prescribed for a particular fever can be given for all fevers. Consult your doctor.

Medicines used for controlling fever

Paracetamol is safe unless the child is having any liver disease and can be given in a dose of 15mg per kg body weight of the child per dose and can be repeated every six hours. Ibuprofen is another drug which can be used in children over the age of six months. The drug is given in a dose of 5 to 10mg per kg per dose and can be given every 8 hours. Avoid this drug if the child is vomiting.

Mefenamic acid is another medicine which can be used for fever in children over six months. It can be given in a dose of 7mg per kg every 8 hours. This drug also should be avoided if there is vomiting. Aspirin should not be given for fever as it is known to cause a disease called Reye's syndrome if the child is suffering from some viral infections.

Some children develop fits when they have fever. This is called febrile seizures and usually happens between the ages of six months to six years.

Learn more about febrile seizures

Common causes of fever in infants and children

Infections: The most common cause of fever in a child is an infection-viral or bacterial. Respiratory infections (associated with cough, cold, sore throat, ear ache and rapid breathing if the infection is more serious) top the list followed by gastrointestinal (loose motions, vomiting with or without abdominal pain), skin and urinary tract infections. Infections of the nervous system (eg. meningitis) are fortunately less common. Infections of bones and joints (associated with pain and swelling) are occasionally seen.

Rheumatic diseases: Juvenile Rheumatoid Arthritis (JRA) is the most common in this category. Other diseases are Systemic Lupus Erythematosus (SLE), Dermatomyositis and Polyarteritis Nodosa.

Malignancies (cancers): Common malignancies seen in children are leukemia, lymphoma, wilm's tumor, neuroblastoma and bone tumors.

Return from fever in babies to common childhood problems