Doctor in the House: How to Manage Fever in Infants – The Indian Express | Wonder Mind Kids

Most kids have had at least one episode of Fever before they become one Fever alone usually does not cause problems. In fact, it’s a good thing as it’s a sign that the body is fighting an infection. But in situations where your baby wakes up in the middle of the night burned, it can be difficult for you to know what to do next.

Fever is essentially the body’s “thermostat” that raises body temperature above normal levels while fighting infection. The hypothalamus in the brain is responsible for this. The hypothalamus manages to keep the temperature around 98.4 F, but when there’s an infection, it resets the thermostat. Our body temperature is not constant, it fluctuates throughout the day from 96.5 to even 99.5, the lowest is slightly higher mainly in the morning and evening, and may vary in children romping and playing.

The hypothalamus can reset the body temperature to a higher value in response to a infection, illness or any other cause. Doctors believe it helps the body fight the infection better, allowing our white blood cells to work more efficiently. Generally, fever means a temperature above 100.4 F.

Digital thermometers are inexpensive and the most accurate way to take temperature in children. Do not use glass thermometers that contain mercury, as contact with them can pose a potential risk of mercury poisoning.

Children from the age of 5 can have their temperature taken by placing the thermometer under their tongue. Younger children can have it checked from the armpit. Rectal temperatures are usually done on children under the age of three months, especially in hospitals.

You may get slightly different numbers depending on where you took the temperature — oral, axillary, rectal, ear, or forehead. Oral or rectal measurements are more accurate than the other measurements.

causes of fever

Parents need to remember that a fever is only a sign of an illness and not the illness itself. It’s just a symptom.

Infection: Most fevers are caused by a bacterial or viral illness. These include the common cold, gastroenteritis or stomach infections, ear infections, croup, bronchiolitis and urinary tract infections to name a few. Currently a spate of viral infections such as dengue and influenza can also lead to a high fever.

Overlay: This is the most common reason for newborns or young children, as they cannot regulate their body temperature well if they are over-clothed or the room is too hot. Because infections in babies can be serious, it’s important to have the baby checked out by a doctor if your baby has a fever under the age of three months.

booster vaccination: Many babies get a fever after vaccinations, but it’s usually mild and doesn’t last more than 24 hours.

teething can make the baby feel warm, but if the fever is more than 100F, it’s unlikely to be the cause.

In otherwise healthy children, not every fever needs medication. High fever (above 102F) can make the child uncomfortable and. therefore treatment may be required.

Doctors decide to treat a fever after looking at the baby’s overall condition. The level of a child’s fever is not always the best indicator of whether the child needs treatment and/or evaluation.

alarm bells

Children with a fever and any of the following symptoms need to be seen as soon as possible.”

— not responding to you or having trouble waking up.

— has blue lips, tongue, or nails

— The soft spot in the infant’s head is bulging

– has a stiff neck

– has heavy stomach pain

– has a rash or purple spots that look like bruises

– refuses to drink

– is very irritable and grumpy

Also talk to your doctor if your child suffers from several loose stools, burning urination, ear or throat pain for more than three days.

You must consult your doctor

– When infants under three months have a fever over 100.4 F

– Children three months to one year old who have a temperature greater than 100.4 F for more than three days

– Children aged three months to three years who have a temperature greater than 102F

– Children of any age who have a temperature greater than 104F.

– Children who have a febrile seizure

febrile seizure

feverish seizures are convulsions that occur in a child between six months and five years of age with a temperature greater than 100.4 F. The majority occurs between the ages of 12 months and 18 months.

It can be scary to watch. However, they cause no harm, and intelligence and other aspects of brain development are not affected by the seizure. They can occur with infections and also vaccinations that cause fever.

They usually appear on the first day of illness and in many cases the seizure is the first indication of the disease. Most seizures occur when the fever is above 102F.

They usually last less than a minute and typically involve the arms, legs, and face.

Once they stop, they need to be examined to see that they are not due to a serious brain infection meningitis. These children may relapse, and this usually occurs within the first year of the illness.

treatment of fever

In most cases, treating a child’s fever is not necessary. A child older than three months with a temperature of 102°F or less and who is otherwise healthy and behaving normally does not need treatment.


Paracetamol or ibuprofen are the most effective ways to treat fever. They reduce the fever and the symptoms associated with the fever.

Aspirin is not recommended in children because it can cause a rare and serious condition called Reye’s syndrome.

paracetamol can be administered for 4 to 6 hours, but no more than five doses in 24 hours.

Under the age of three months, you should consult a doctor before administering paracetamol. Ibuprofen should not be given under the age of six months. Combining paracetamol and ibuprofen, or even alternating them, is not usually recommended as it increases the likelihood of incorrect dosing. Antipyretics should only be given when needed.

Fever can increase the child’s risk of dehydration. Children who have fevers may be reluctant to eat, so it’s important that you encourage them to drink fluids. If the child does not want to drink, it is important to talk to the doctor. Quiet is important, but children don’t need to be forced to be quiet. When they feel tired and achy, parents can encourage them to rest. Once the temperature is normal for more than 24 hours, they can resume normal activities.

I’m not a fan of sponges, especially cold baths and ice packs, it can actually raise the temperature by shivering and have the opposite effect. All in all, fever alone is not a cause for concern. Just pay close attention to the temperature and how long your child has had one.

dr Saroja Balan is a consultant neonatologist and pediatrician at Indraprastha Apollo Hospital. Her column appears every two weeks

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