Your child wakes up in the middle of the night feeling flushed, hot,
and sweaty. You are struck by uncertainty and a tinge of panic. What
do you do next? Should you get the thermometer? Call the doctor?
Rush him or her to the hospital? We are usually scared of the
unknown. And once you have knowledge of it, you can be in a better
position to cope with it.
Here is everything you need to know about a fever, including when a
doctor is necessary.
What is fever?
Fever happens when the body's internal 'thermostat' raises the body
temperature above its normal level. This thermostat is found in a
part of the brain called the hypothalamus. The hypothalamus knows
what temperature your body should be (usually around 37°C /
98.6°F) and will send messages to your body to keep it that way.
Most of our body temperatures change a little bit during the course
of the day. It is usually a little lower in the morning and a little
higher in the evening and can vary especially if children run
around, play, and exercise.
So, what happens when there is an infection, illness, or some other
cause? In response, the hypothalamus will reset the body to a higher
temperature. Turning up the heat is a way for the body to fight the
germs that cause infections, making it a less comfortable place for
them and also to activate your immune system to fight the infection.
What can cause a fever?
It is important to remember that fever by itself is not an illness
— it is usually a symptom of another problem. Fevers can be
caused by a few things, including:
- Infections such as common cold, influenza, gastroenteritis,
pneumonia, tonsilitis. A fever helps the body fight infections by stimulating
natural defence mechanisms
- Overdressing. Infants, especially newborns, may
get a fever if they are over-bundled or in a hot environment
because they could not regulate their body temperature as well
as older children. However, a fever in newborns can also
indicate a serious infection. So, even infants who are
overdressed must be checked by a doctor if they have a fever
- Immunisations. Babies and children sometimes
get a low-grade fever after getting vaccinated.
- Teething. Although teething may cause a slight
rise in body temperature, it’s probably not the cause if a
child’s temperature is higher than 37.8°C / 100°F.
- Certain cancers like Leukaemia or Lymphoma
- Some autoimmune diseases
When is it a fever?
Use a reliable digital thermometer to confirm a
fever. It is a fever when a child's temperature is at or above one
of these levels:
- Measured orally (in the mouth): 37.8°C /
100°F
- Measured rectally (in the bottom): 38°C /
100.4°F
- Measured in an axillary position (under the
arm): 37.2°C / 99°F
But how high a fever is does not indicate how sick your child is. A
simple cold or other viral infection can sometimes cause a rather
high fever (in the 38.9° - 40°C / 102° - 104°F
range), but this does not usually mean there is a serious problem.
In fact, sometimes, a serious infection, especially in infants,
might cause no fever or even a low body temperature (below
36.1°C / 97°F).
Because fevers can rise and fall, a child might have chills as the
body's temperature begins to rise. The child may sweat to release
extra heat as the temperature starts to drop. Sometimes children
with a fever breathe faster than usual and may have a faster heart
rate.
Call the doctor if your child has trouble breathing or is breathing
faster than normal or is still breathing fast after the fever has
come down.
What if the fever is a sign of something serious?
In healthy children, not all fevers need to be treated. High fever
though, can make a child uncomfortable and worsen problems like
dehydration.
Doctors decide on whether to treat a fever by considering both the
temperature and a child's overall condition.
Children whose temperatures are lower than 38.9°C / 102°F
often do not need medicine unless they are uncomfortable. There is
one important exception: If an infant 3 months or younger has a
rectal temperature of 38°C/100.4°F or higher, it is time to
call your doctor or go to the emergency department immediately. Even
a slight fever can be a sign of a potentially serious infection in
very young babies.
If your child is between 3 months and 3 years old and has a fever of
39°C / 102.2°F or higher, call to see if your doctor needs
to see your child. For older children, please take behaviour and
activity level into account. How your child behaves will give you a
pretty good idea of whether a minor illness is the cause or if your
child should be seen by a doctor.
You do not have to worry too much if your child has a fever and does
not want to eat. This is very common with infections that cause
fever. If your child still drinks water and urinates normally, it is
all right if he / she is not eating as much as usual.
A prolonged fever is one that extends its usual duration of 5 to 7 days. Learn about the possible causes, associated symptoms and treatment options.
When should I call the doctor and emergency?
The exact temperature that should trigger a call to the doctor
depends on a child's age, the illness, and whether there are other
symptoms with the fever.
Call your doctor if you have an:
- Infant younger than 3 months old with a rectal temperature of
38°C / 100.4°F or higher
- Older child with a temperature of higher than 38.9°C /
102.2°F
Please also call a doctor if an older child has a fever of lower
than 39°C / 102.2°F and has the following conditions:
- Refuses fluids or seems too ill to drink adequately
- Has lasting diarrhoea or repeated vomiting
- Has any signs of dehydration (peeing less than usual, not having
tears when crying, less alert and less active than usual)
- Has a specific complaint such as a sore throat or an earache
- Still has a fever after 24 hours (in children younger than 2
years old) or 72 hours (in children 2 years or older)
- Total recurrent fever more than 7 days Is getting fevers a lot,
even if they only last a few hours each night.
- Has a chronic medical problem, such as heart disease, cancer,
lupus, or sickle cell disease
- Has a rash with fever
- Has pain while peeing
Get Emergency Care if your child shows any of these signs:
- Non-stop crying
- Extreme irritability or fussiness
- Sluggishness and trouble waking up
- A rash or purple spots that look like bruises on the skin (that
were not there before your child got sick)
- Blue lips, tongue, or nails
- Infant's soft spot on the head seems to be bulging out or sunken
in
- Stiff neck
- Severe headache
- Limpness or refusal to move
- Trouble breathing that does not get better when the nose is
cleared
- Leaning forward and drooling
- Fits or seizure
- Abdominal (belly) pain
Also, ask if your doctor has specific guidelines on when to call
about a fever.
What else should I know about fever in children?
All children get fevers. In most cases, they are completely back to
normal within a few days. For older babies and children, the way
they act can be more important than the reading on the thermometer.
Children get irritable when they have fever. This is normal and
should be expected.
However, if you are in doubt about what to do or what a fever might
mean, or if your child is acting ill in a way that concerns you even
if there is no fever, always call your doctor for advice.
How do you bring a child’s fever down
It is important to understand that not all fevers need to be
treated. In most cases, a fever should be treated only if it's
causing a child discomfort.
- Medicines
Infants younger than 2 months old should not be given any
medicine for fever without being checked by a doctor. If your
child has any medical problems, check with the doctor to see
which medicine is best to use.
Remember that fever medicine can temporarily bring a temperature
down. However, it usually does not treat the underlying reason
for the fever.
- Meals
Offer plenty of fluids to avoid dehydration because fevers make
children lose fluids more rapidly than usual. Water, soup, ice
pops, and flavoured gelatine are all good choices. Avoid drinks
with caffeine like coffee including colas and tea, because they
can make dehydration worse by increasing urination (peeing).
If your child is also vomiting and/or has diarrhoea, ask the
doctor if you should give an electrolyte (rehydration) solution
made for children. You can find these at pharmacies and
supermarkets. Don't offer sports drinks though —they're
not made for younger children and the added sugars can make
diarrhoea worse.
In general, let children eat what they want in moderation. Do
not force children to eat if they do not feel like it.
- Taking it easy
Make sure your child gets plenty of rest. Staying in bed all day
isn't necessary, but a sick child should take it easy. It's best
to keep a child with a fever at home and out of school or
childcare. Most doctors feel that it's safe to return when the
temperature has been normal for 24 hours.
- Dress lightly
Overdressing will trap body heat and thus, cause your
child’s temperature to rise. Ensure that your child is not
shivering, but do not put on excess clothing.
- Take a bath / Sponging
You can use a piece of damp cloth to help cool your
child’s body if the temperature seems to be very high. If
you give your child a bath, ensure that the water is lukewarm as
shivering from cold water can cause the body temperature to
rise. Remember not to leave your child alone in the bathroom or
bathtub.
Child fever FAQ
- How to take your child’s temperature?
While a rectal thermometer will give you the most accurate
reading, this will probably be hard to do at home as it can be
quite uncomfortable for your child. Fortunately, it is possible
to get a good reading with a thermometer under the arm or in the
mouth as well.
As for how often to check, it is best to ask your paediatrician
as this would depend on the situation. However, you do not
typically have to check obsessively. Neither do you have to wake
them up for a temperature check if they are sound asleep.
Nonetheless, be aware of their condition and take their
temperature if they seem listless or low energy. If your child
has had a seizure with fever before, then consult your doctor on
how regularly you should take his or her temperature.
- Can fever cause hallucinations?
Yes, fever can cause hallucinations although this is more common
in adults than children. Hallucinations when your child has a
temperature usually only occur when there is a high fever.
Fortunately, they are harmless, although they might be
frightening.
- What is a febrile seizure?
A febrile seizure occurs when there is a quick increase in
temperature that causes a disruption in your child’s
normal brain electrical activity. Symptoms of a febrile seizure
include twitching, rolling of the eyes and vomiting.
Nonetheless, while it is worrying, these seizures rarely cause
any harm.
If your child has a febrile seizure, ensure that he or she is on
the floor. Turn the head sideways so that his breathing is not
obstructed. To be safe, remove any nearby sharp objects. Call
for emergency help if the seizure lasts more than five minutes.
Make an appointment at Pantai Hospital
If you want to be sure of your child’s condition, do make an
appointment with a Paediatrician at
Pantai Hospital or go to the
Accident & Emergency Department.