Fever in children - what should parents do?

Fever remains a common concern, prompting parents to bring their child to the emergency room or seek the assistance of a general practitioner. The concerns associated with fever are widespread not only in Latvia but also elsewhere in the world as frequently it is the only and impartial indicator used by parents to evaluate their child’s health.

Acting Dean of Rīga Stradiņš University (RSU) Faculty of Medicine, associate professor at the Department of Paediatrics and the deputy head of the Children’s Clinical University Hospital Clinic for General Paediatrics Jana Pavare talks about the causes of fever and recommends the measures to be taken by parents.

What causes fever in children?

The most frequent cause of fever in children are infectious diseases and in 95% of all cases, they are viral and not bacterial infections. Viruses and bacteria trigger the production of fever-causing substances that affect the thermoregulatory centre in the brain and account for an increase in internal body temperature. Temperature increases in two stages - initially the blood vessels narrow causing a feeling of cold and shivers, followed by the second stage during which the blood vessels expand and the child feels hot. As a rule, a temperature of 38ºC is classified as a fever in children.

Is fever harmful for children?

Many parents have concerns about the harmful effects of fever and believe that an increased temperature is harmful to one’s health, may cause irreversible brain damage and is life threatening – this is a misconception and fires up unnecessary anxiety in parents. At the initial stage, the fever is by no means harmful, as it is fighting off certain bacteria and viruses. As the most frequent cause of fever is a viral infection and considering there is no specific medicine for that, the child will get better in a couple of days and the parents just have to help the child feel comfortable.

In addition to measuring their temperature, it is important to monitor how the child feels. There are a number of symptoms that suggest the child may be developing a serious infection. One of such warning signs is excessive sleepiness – the child sleeps more than usual and will not wake up. There may also be signs of dehydration – dry lips, coated tongue, sunken eyes, reduced or no urination. The child may also have a headache, changed behaviour and an increased sense of anxiety. Another warning sign which, when accompanied by a fever could be a sign of a heavy infection in toddlers is excessive crying and a bulging fontanelle. If you observe any of these warning signs, you should immediately seek medical assistance.

The international rules and the guidelines outlined by our local medical practitioners prescribe that for babies younger than 3 months of age with a temperature above 38ºC it is mandatory to consult a general practitioner or call emergency services immediately, as in most cases infants are not vaccinated and therefore – at risk of serious illness and at times it is hard to detect the symptoms of a severe bacterial infection.

In the case of a fever, the children not vaccinated according to the immunization schedule are also in a risk group.

How to take a temperature?

There are different methods of taking a temperature. In Latvia, the most common way of taking a child’s temperature is by placing the thermometer in the armpit (axillary method). There are also other ways of taking the temperature, e.g. in the mouth, in the ear or in the rectum. It is important to remember that there are differences in the accuracy of such measurements and when informing the medical staff of your child’s temperature it is important to note the method by which it was taken. The temperature taken in the ear or in the rectum will usually be higher than the temperature taken in the armpit.

How to help?

First it is necessary to ensure that the child feels comfortable and not to dress him up too warmly or too lightly. Another important thing is sufficient fluid intake. We recommend that parents treat this issue as serious work – giving the child a sip of water practically every five minutes as fever is accompanied by extensive sweating and the child loses a lot of fluid. If the child’s urine output is sufficient, the intake of fluids is optimal. In the event that parents feel that this time the illness is taking a more severe form than previously, parents should listen to their intuition and seek medical assistance.

When to use fever-reducing medications?

As a rule, a temperature of 38ºC or above is classified as a fever in children, however if the child is active and lively you should not hurry with the intake of fever-reducing medication. It is important to administer medicines in the right dosages, depending on the child’s weight and in the prescribed intervals. Insufficient dosage is a common cause for the fever not subsiding and for parents seeking medical assistance at a hospital. I would like to stress that because of the side effects, children must never be administered aspirin.