Fever (High Temperature) In Kids (for Parents)

All kids get a fever from time to time. Usually, a fever isn’t dangerous or bad for kids. It can even be a good thing because it can help the immune system fight infection.

Still, parents might be unsure about how to handle a fever at home and when to call the doctor. Here are some tips.

What Is a Fever?

In general, a fever means the body’s temperature is 100.4°F (38°C) or higher. Different ways of measuring a temperature — rectal, armpit, ear, forehead, mouth — get a slightly different number, so the number that means a child has a fever is a little different too. 

What Causes Fevers?

Fevers in kids are usually caused by an infection. A fever helps the body by stimulating the immune system to fight the infection. Doctors also think the higher temperature makes it harder for the germs to grow.

A few other reasons kids can have a fever:

Overdressing: Infants, especially newborns, may get fevers if they’re overdressed, wrapped in a blanket, or in a hot environment because they don’t regulate their body temperature as well as older kids. But because fevers in newborns can be a sign of a serious infection, even infants who are overdressed must be checked by a doctor if they have a fever.

Immunizations: Babies and kids sometimes get a mild fever that lasts about a day after getting vaccinated.

A child who is teething might have a slight rise in body temperature, but it’s probably not the cause if the temperature is higher than 100°F (37.8°C).

When Is a Fever a Sign of Something Serious?

In most healthy kids who are acting well, a fever isn’t serious.

But a fever can be serious for:

• Infants younger than 3 months: If an infant younger than 3 months has a rectal temperature of 100.4°F (38°C) or higher, call your doctor or go to the emergency department right away. 
• Kids with some health conditions: If your child has an ongoing health issue, make sure you know if the doctor should be called for fever.

A fever is probably not serious if your child is 3 months or older and:

• is still interested in playing
• is drinking well
• is alert and smiling
• has a normal skin color
• looks well when their temperature comes down

Don’t worry too much about a child with a fever who doesn’t want to eat. This is common with infections that cause fever. For kids who still drink and urinate (pee) normally, not eating as much as usual is OK.

What Are the Signs of a Fever?

Kids with a fever might:

• feel warm
• act differently (they might be fussy or cranky, or quieter than usual)
• breathe a little faster or have a faster heart rate than normal
• have a headache
• have chills or sweating
• have red or flushed skin

For any of these signs, take your child’s temperature to know if they really have a fever.

If your child feels warm or is acting unwell, use a digital thermometer to confirm a fever. Different ways of taking the temperature are more accurate than others at measuring the true body temperature.

The best way to take a temperature:

• for kids 3 years old and younger: a rectal temperature
• for kids 4 or older who can cooperate: an oral temperature (by mouth)
• for any age: under the armpit (axillary) and temporal artery (forehead) are easiest but less accurate. Tympanic (in the ear) is OK for kids 6 months and older.

It’s a fever when a child’s temperature is at or above one of these levels:

• rectal (in the bottom), tympanic (in the ear), or temporal artery (across the forehead): 100.4°F (38°C)
• oral (in the mouth): 100°F (37.8°C)
• axillary (under the arm): 99°F (37.2°C)

How Can I Help My Child Feel Better?

No treatment is needed if a child is still playing and drinking normally and doesn’t have pain. 

Treating a fever with medicine isn’t needed if a child is still playing and drinking normally and doesn’t have pain. Give medicine only when a fever causes a child discomfort or keeps them from drinking.

While kids have a fever, keep an eye on them, help them to rest, and keep offering fluids to drink. They need to drink a little extra to make up for the fluids they lose from sweating.

Home Care Measures

Medicines

If your child is uncomfortable from a fever or not drinking fluids well, you can give one of these medicines:

• acetaminophen (such as Tylenol or a store brand)
  or
• ibuprofen (such as Advil, Motrin, or a store brand). Do not give to children under 6 months old.

Follow the package directions for how much to give and how often. If you don’t know the recommended dose or your child is younger than 2 years old, call the doctor to find out what to use and how much to give.

• If your child has any medical problems, check with the doctor to see which medicine to use.
• Unless instructed to by a doctor, never give aspirin to a child. Such use is linked to Reye syndrome, a rare but serious illness.

Do not give any medicine for fever to infants younger than 3 months old unless instructed to by a doctor.

Staying Comfortable

If your child has a fever:

• Have them wear lightweight clothing and stay covered with a light sheet or blanket. Heavy clothes and blankets can keep the body from cooling, which can make your child uncomfortable.
• Keep the room at a comfortable temperature — not too hot or too cold.
• Make sure they get plenty of rest. Staying in bed all day isn’t necessary, but a sick child should take it easy.
• They should stay home from school or childcare until their temperature has been normal for 24 hours.

Lukewarm sponge baths to lower a fever generally are not recommended. In fact, sponge baths can make kids uncomfortable from shivering. Never use rubbing alcohol (it can cause poisoning when absorbed through the skin) or ice packs/cold baths (they can cause chills that can raise body temperature).

Food and Drinks

Offer plenty of fluids to avoid dehydration because fevers make kids lose fluids faster than usual. Oral rehydration solutions (like Pedialyle, Enfalyte, or store brands) are a good choice. You also can give water, soup, ice pops, and flavored gelatin. Avoid drinks with caffeine, including colas and tea, which can make dehydration worse by making kids pee more often.

Let kids eat what they want (in reasonable amounts), but don’t force it if they don’t feel like eating much.

When Should I Call the Doctor?

The temperature that should trigger a call to the doctor depends on a child’s age, the illness, and whether they have other symptoms. You might ask if your doctor has specific guidelines on when to call about a fever.

In general, call the doctor if your child is:

• younger than 3 months old with a rectal temperature of 100.4°F (38°C) or higher
• 3 months or older with a temperature higher than 102.2°F (39°C)
• any age but has a health problem like cancer or sickle cell disease and has a fever

Also call if a child 3 months or older has a fever and:

• refuses fluids or seems too ill to drink enough
• has lasting diarrhea 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 (like a sore throat or earache)
• still has a fever after 2–3 days
• has a rash
• has pain while peeing

Get emergency care if your child shows any of these signs:

• crying that won’t stop
• 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
• in an infant, the 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 doesn’t get better when the nose is cleared
• leaning forward and drooling
• seizure
• moderate to severe belly pain

What Else Should I Know?

All kids get fevers, and in most cases they’re back to normal within a few days. For older babies and kids, the way they act can be more important than the reading on your thermometer. Everyone gets a little cranky when they have a fever. This is normal and should be expected.

But if you’re ever 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 with no fever, always call your doctor for advice.

Medically reviewed by: Melanie L. Pitone, MD

Date reviewed: November 2022

When to seek help and treatment

A fever can occur in toddlers for a variety of reasons. While not all fevers are serious, certain conditions that cause high temperatures in toddlers need urgent medical attention.

A fever usually means that a child’s body is fighting off an infection. However, there are symptoms a person should look for when a toddler has a fever.

Read on to learn when a toddler with a fever needs urgent medical attention, as well as treatments and potential causes.

According to the American Academy of Pediatrics, a child’s normal body temperature should be between 97ºF (36ºC) and 100.4ºF (38ºC).

Children and babies can have higher temperatures than adults, as they have a larger surface area compared to their body weight. Toddlers also sweat less and have a faster metabolism, which can cause them to have a higher body temperature.

According to a 2019 article, a fever alone is rarely harmful and does not typically exceed 105.8ºF (41ºC). While fevers higher than this temperature can be dangerous, they are rare.

Febrile seizures

A febrile seizure is a seizure that occurs when a toddler has a fever. Although they may seem alarming, they are not dangerous and typically last a few minutes.

The National Institute of Neurological Disorders and Stroke notes that these types of seizures occur in 2⁠–5% of children below 5 years old.

Symptoms of a febrile seizure include:

• loss of consciousness
• uncontrollable shaking of legs and arms
• eye rolling
• stiff limbs
• twitching in one area of the body

If a toddler’s febrile seizure lasts more than 5 minutes, or the child does not seem to be getting better, seek immediate medical attention.

The Food and Drug Administration (FDA) recommends contacting a doctor if a toddler experiences a fever of 102ºF (38.8ºC) or more.

A parent of caregiver should also contact a doctor if the toddler has:

• other signs of illness, such as rash
• a fever that lasts for 5 days or more
• a fever that does not reduce with acetaminophen
• a cough that lasts for more than 3 weeks
• persistent ear pain
• signs of dehydration

Learn more about signs of dehydration in toddlers.

A review from 2019 noted that only 1 in 100 children with a fever will require urgent medical attention. However, an individual should seek urgent care if the toddler experiences:

• difficulty breathing, including nostrils widening with each breath
• wheezing
• fast breathing
• shortness of breath
• ribs showing with each breath
• excessive crankiness or sleepiness
• symptoms seeming to be getting worse
• excessive crying
• fever that comes and goes
• blue or grey lips

Additionally, meningitis is a serious condition that can cause fever in toddlers. A person should take the child to the emergency room immediately if they experience fever along with any of the following symptoms:

• headache
• stiff neck
• dislike of bright lights
• sleepiness
• trouble waking up
• nausea
• irritability
• vomiting
• lack of appetite
• lack of energy
• a rash that does not fade under pressure — use a glass to test for this

A caregiver does not always need to reduce a fever. A fever lower than 101ºF (38ºC) does not require treatment unless the toddler is uncomfortable.

Fever occurs due to the body reacting to contracting a viral or bacterial infection. Bacteria and viruses can thrive at the body’s normal temperature — by increasing its internal temperature, the body can help kill the infection.

While certain drugs can help lower a child’s fever, they do not treat its underlying cause.

To help make the toddler feel more comfortable, a person can:

• ensure the child drinks plenty of water
• put cool, damp cloths on the foreheads, wrists, and calves
• dress them in loose, light clothes
• give them medication, such as ibuprofen or paracetamol

When giving a toddler medication to treat their fever, a person should ensure they give the correct dose. The FDA recommends that an individual speaks with a doctor before giving medication to a toddler below the age of 2 years.

Nationwide Children’s Hospital says that a person can also give the child a sponge bath if they have a fever over 104ºF (40ºC) and are vomiting and unable to keep the medicine down. To do this, a caregiver should place the child in a bath with lukewarm water of approximately 85–90ºF (29–32ºC) and sponge the water over the skin.

If the child is unable to sit in the bath, a person can lay a lukewarm, wet washcloth:

• on the stomach
• on the groin
• under the armpits
• behind the neck

Parents and caregivers should be aware of the following when treating a toddler’s fever:

• do not rub a toddler down with alcohol, as the skin may absorb it, leading to coma
• do not put a toddler in a cold or ice bath, as this can cause shivering and increase their temperature
• do not undress the toddler
• do not delay seeking medical attention for a toddler who appears very ill
• do not give a toddler any medication not meant for a child

A person should also avoid giving aspirin to children as this can increase the chance of developing Reye’s syndrome.

A person can take a child’s temperature in a variety of ways, including:

• Forehead temperature: Although this is appropriate for children of any age, using it in direct sunlight can affect temperature readings.
• Mouth temperature: This is suitable for those above the age of 4 years. A person places the tip of the thermometer under the tongue and waits until they hear a beep. To get an accurate reading, individuals should wait for 30 minutes after the child has had anything hot or cold to drink.
• Ear temperature: This is appropriate for those older than 6 months. When using an ear thermometer, aim the tip slightly diagonally toward the face.

A person should take the child’s temperature three times a day, if possible.

There are many reasons why a toddler might have a fever. Possible causes include illness due to viruses or bacteria, such as:

• the common cold
• urinary tract infections
• ear infections
• rubella
• mumps
• measles
• scarlet fever
• chickenpox
• gastroenteritis

Other causes include:

• having a vaccination
• sunburn
• dehydration

There are many reasons why a toddler might have a fever. This symptom is a byproduct of a child healing from acquiring an infection, and it does not necessarily need treating. However, a caregiver can provide home care to help the infant feel more comfortable.

Seek medical help if a toddler has a fever of 102ºF (38.8ºC) or more.

Many conditions can lead to a toddler experiencing a fever. If a parent or caregiver has concerns about the toddler’s temperature, they should speak with a doctor.

causes, symptoms, diagnosis and treatment

Contents

• 1 Fever in children: symptoms and effective treatment
  • 1.1 Fever in children: everything you need to know
    • 1.1.1 Causes
    • 1 .1.2 Symptoms of fever
    • 1.1.3 Diagnosis
    • 1.1.4 Treatment
  • 1.2 Related videos:
  • 1.3 Causes of fever in children
  • 1.4 Symptoms of fever in children: how to recognize them
  • 1.5 Best methods for diagnosing fever in children
  • 1.6 How to take the temperature in children correctly
  • 1. 7 Treating fever in children: advice and recommendations from doctors
  • 1.8 Home remedies to reduce fever in a child
  • 1.9 The dangers of self-treatment of fever in children
  • 1.10 Prevention of fever in children: how to reduce the risk of illness
  • 1.11 When should I see a doctor if my child develops a fever?
  • 1.12 Treatment of fever in children of different age groups
  • 1.13 Maintaining a child’s health after treating a fever
    • 1.13.1 Nutrition
    • 1.13.2 Sleep
    • 1.13.3 Additional hygiene
    • 1.13.4 Reducing physical activity

    900 05 1.13.5 Follow your doctor’s advice

  • 1.14 Question -answer:
    • • 1.14.0.1 What are the causes of fever in children?
      • 1.14.0.2 What symptoms indicate a fever in a child?
      • 1.14.0.3 How is fever diagnosed in children?
      • 1.14.0.4 What is the most effective treatment for fever in children?
      • 1.14.0. 5 Is there any special treatment for fever in infants?
      • 1.14.0.6 What if the fever does not go down for a long time?

Learn about the symptoms and treatment of fever in children. In our article you will find useful information and tips on caring for a sick child.

Very often children suffer from colds that cause fever. This may be expressed as a fever. Fever is the body’s natural response to illness. It may be accompanied by malaise, headache, sleep disturbance and loss of appetite. However, it is not always easy to recognize the cause of this condition and treat it correctly. To do this, you need to know the main causes, symptoms, diagnosis and treatment of this disease.

Fever in childhood can have many causes, including infections, allergic reactions, and a number of other factors. It can be caused by viral or bacterial infections, or by drug or food allergies. Another reason could be heat stroke. It is very important to correctly diagnose the cause of the fever in order to prescribe effective treatment.

In addition to the above causes, symptoms of fever may include loss of appetite, vomiting, nausea, profuse sweating, headache and trembling. When children develop a fever, measures must be taken to prevent the risks of possible complications such as seizures and dehydration.

For a correct diagnosis, it is necessary to consult a pediatrician. He needs to tell all the symptoms of the child and conduct an examination. To alleviate the condition of the child, means to reduce the temperature, local therapy and recovery can be used. One way or another, the main goal is to treat the disease, carry out preventive measures to prevent its recurrence and maintain the health of children.

Fever in children: everything you need to know

Causes

Fever in children can be caused by various reasons. Some of them are associated with infectious diseases, such as SARS, influenza, bronchitis and pneumonia. Others may be due to some other cause, including allergic reactions, genetic diseases, and rheumatism. In addition, some medicines and vaccines can also cause a child to have a fever.

Symptoms of fever

The main symptom of fever is fever. In addition, the child may develop general weakness and fatigue, soreness in the muscles and joints, headache, loss of appetite and drowsiness. In some cases, accompanying symptoms such as cough, nasal congestion and runny nose may occur.

Diagnosis

A doctor can use several methods to diagnose fever in children. One of them is the measurement of body temperature. In addition, a blood test may be ordered to help determine the cause of the fever. In some cases, additional diagnostics may be required to identify hidden causes of fever.

Treatment

Treatment of fever in children may depend on the cause. To reduce body temperature, drugs based on paracetamol or ibuprofen can be used. It is also recommended to provide the child with peace and drinking regimen. If the fever is caused by an infectious disease, antibiotics may be needed. It is important to see a doctor to get the right treatment.

Related videos:

Causes of fever in children

Fever in children can be caused by a variety of causes, including infectious diseases, allergic reactions, and health problems. Less common causes include side effects from medications, excess heat, or exposure of children to high temperatures.

Infectious diseases are the most common cause of fever in children. This includes the flu, SARS, sore throats, pneumonia, and other illnesses caused by bacteria, fungi, or viruses. Certain types of infections can also be caused by food poisoning or insect bites.

Allergic reactions . Fever can occur in response to an allergen such as dust, pollen, pets, or a food substance. Allergic reactions leading to fever may be seasonal, intermittent, or occur in contact with certain substances.

Health problems . Children with disorders related to the heart, kidneys, or immune system may experience involuntary seizures accompanied by high fever. High temperatures can also result from sunstroke, dehydration, or obesity.

In all cases, if the child’s body temperature rises, it is necessary to consult a doctor for qualified medical assistance.

Symptoms of fever in children: how to recognize them

Fever is an increase in body temperature above normal, which is accompanied by symptoms such as sweating, chills and weakness. Children may have other symptoms than those seen in adults.

Usually the first symptom of fever in children is an increase in body temperature. It can be accompanied by seizures, that is, the temperature can rise and fall. When the temperature rises, the child may become sensitive or irritable. In young children, an increase in heart rate and breathing may occur.

Other symptoms that may indicate a fever in children are headache, loss of appetite, nausea and vomiting. The child may experience general weakness, fatigue and muscle pain. With prolonged high temperature, convulsions and delirium may occur. Some children may develop skin spots, rashes, and pain in the abdomen and head.

If your child has any of the above symptoms, see a doctor. The doctor will diagnose and prescribe treatment depending on the cause of the fever.

Best methods for diagnosing fever in children

Diagnosis of fever in children is carried out using various methods. One of them is the measurement of body temperature. To do this, you can use electronic thermometers, mercury thermometers or infrared thermometers.

For additional diagnostics, a blood test is required. As a result of the analysis, it is possible to establish the cause of the fever. For example, if the cause is an infectious disease, then an increased number of white blood cells can be detected in the blood.

Diagnosis of fever in children may also involve x-rays or ultrasound. These methods allow you to check for the presence of inflammatory processes and determine their location.

Diagnosis should take into account the child’s age and comorbidities. To do this, the doctor conducts a comprehensive diagnosis, which includes a visual examination of the child and a general analysis of his condition.

How to take the temperature of children correctly

High body temperature is one of the main symptoms of various diseases in children. Correct and accurate temperature measurement is an important task for monitoring the health of the baby.

The classic method of taking temperature in children is a rectal measurement using a medical thermometer. In this case, the thermometer is inserted into the rectum to a shallow depth and kept there for no more than 3 minutes.

However, this method may cause discomfort to the child and requires special hygiene measures. Therefore, other temperature measurement methods are also widely used. For example, measuring the temperature in the armpit, in the ear or on the forehead with infrared thermometers.

When choosing a method for measuring temperature, it is necessary to take into account the age of the child, his state of health and individual characteristics of perception. In any case, you must follow the instructions for use of the chosen thermometer and handle it carefully after use.

• Medical thermometers are recommended for temperature measurements in children.
• Select the measurement method based on the child’s age and health condition.
• Follow the instructions for use of the thermometer and clean it after use.

Treating fever in children: doctor’s advice and advice

Fever is the body’s natural defense mechanism that helps fight infection or inflammation. However, when the body temperature rises to 38 degrees and above, this can lead to a significant deterioration in the health of the child. The treatment of fever in children is reduced to lowering body temperature and eliminating the cause of its occurrence.

1. Decreased body temperature. It is important to monitor the child’s body temperature and take measures to reduce it. To do this, you can use antipyretics in accordance with the age and weight of the child. You can also try lightening the room’s air-conditioning and bringing your child into a tepid bath.
2. Room humidification. Fever can lead to dehydration, so it is very important to ensure sufficient air humidity in the room where the child is. To do this, you can use humidifiers or simply hang wet towels in the room.
3. Rest and proper nutrition. Fever is stressful for the body, so it is important to provide the child with sufficient rest and drinking regimen. You also need to monitor the quality of nutrition so that the body receives enough energy to fight infection or inflammation.

However, if a child’s fever is accompanied by other symptoms, such as severe sore throat or abdominal pain, a doctor should be consulted. Only a qualified specialist will be able to determine the cause of the fever and prescribe the correct treatment.

Home remedies to reduce fever in a child

Drink plenty of fluids. It is important to drink plenty of fluids when the body temperature rises, especially warm drinks such as tea with lemon or honey, which promote sweating and reduce fever.

Refreshing compresses. Soak a soft cloth in room temperature water, wring it out, and apply it to the forehead, wrists, and shins. Compresses help reduce the temperature and create a feeling of coolness.

Room ventilation. A fan or air conditioner can be used to lower the room temperature. One way is to temporarily place the child in a cool shower or bathroom to lower his body temperature.

Application of ice bags. Applying ice packs to the forehead, wrists and lower legs helps to reduce body temperature and creates a feeling of coolness. It is important to remember to wrap the bag in a soft cloth or towel to avoid direct contact of the ice with the skin.

Breathing exercises. Deep breathing and muscle relaxation will help reduce body temperature and reduce pain. The use of breathing exercises can be considered as an additional means of lowering the temperature.

Risks of self-treatment of fever in children

One of the risks of self-treatment of fever in children is misdiagnosis of cause and treatment. Fever can be caused by a variety of things, including infections, colds, allergies, and even certain medications. Therefore, it is important to correctly identify the cause before taking action.

Self-medication is also risky because it can lead to an overdose of drugs, which can cause unwanted side effects. In addition, misuse of medications can mask symptoms and make correct diagnosis difficult.

Some parents may also try to bring down the temperature of their children with ice packs or compresses. However, this can be dangerous, especially for young children, and may result in skin lesions or frostbite.

To avoid the risks of self-medication, you should always consult a doctor if your child develops a fever. A doctor can diagnose the cause and prescribe the right treatment to help speed up recovery.

Prevention of fever in children: how to reduce the risk of illness

Fevers can be prevented in children with simple preventive measures.

• Hygiene. Regular washing of hands and face helps to avoid infection with viruses and bacteria.
• Strengthening the immune system. Proper nutrition, exercise and adequate sleep help to increase the body’s resistance to infections.
• Vaccination. Vaccination against influenza and other diseases helps protect your child from possible complications.
• Avoid contact with sick people. If possible, avoid contact with people who have symptoms of a cold or flu.
• Room ventilation. Frequent ventilation helps to get rid of harmful microorganisms in the air.

By following these simple rules, parents can protect their children from possible health problems and prevent fever.

When should I see a doctor if my child has a fever?

Fever can be a sign of various diseases, so it is important to carefully monitor the child’s condition and consult a doctor in case of incomprehensible symptoms.

If muscle pain, vomiting, diarrhea, or other unusual symptoms accompany a high fever, you should definitely seek medical attention immediately.

If the temperature does not fall below 39 degrees for three days or the child experiences severe pain, dizziness and loss of consciousness, an ambulance must be called urgently.

You should also pay attention to the child’s age and state of health before visiting the doctor. If the baby is under 3 months old, then at a temperature above 38 degrees, you should visit a doctor immediately.

In addition, if a child has weakness, apathy and no desire to drink water, this fact may also indicate a deterioration in health and requires specialist advice.

In conclusion, it should be noted that the parent must independently assess the child’s condition and understand when a visit to the doctor is required.

Features of the treatment of fever in children of different age groups

Treatment of fever in children should be individualized and depend on the age of the child. In infants and children under 2 years of age, the temperature can only be brought down with hyperthermia above 38 degrees, since their immune system is still weak and underdeveloped. In this case, simple temperature control methods such as drinking plenty of fluids, cool compresses, and simply dressing can be used.

In children over 2 years of age and adolescents, fever-reducing agents such as paracetamol or ibuprofen may be used at the dosage indicated on the instructions. You can also apply cool compresses and drink plenty of water. However, do not exceed the recommended dosage and use several types of antipyretics at the same time.

If you have a higher temperature and other symptoms, you should see a doctor who will determine the cause of the fever and prescribe appropriate treatment, such as antibiotics for a bacterial infection.

• Important to remember:
  • Do not give aspirin to children.
  • Do not use alcohol to reduce fever.
  • Monitor the child and consult a doctor if necessary.

Keeping a child healthy after treating a fever

Nutrition

After treating a fever, it is important to monitor the child’s nutrition. Give him light foods rich in vitamins and minerals to speed up the recovery of the body. A small amount of food is recommended during the day, but it is necessary that the child eat constantly. Transmission of infection through food is not a way of transmitting fever.

Sleep

After the fever has been treated, the child needs more time to rest and sleep. Make sure your child gets at least eight hours of sleep a day and gets proper rest to boost his immune system and allow him to recover.

Complementary hygiene

After treating a fever, make sure your child brushes their teeth twice a day, washes their hands, and disinfects them after going to the toilet and before eating. This will help prevent transmission and provide a healthier environment for your baby.

Less physical activity

After a recent fever treatment, your child may be weak and tired. Be attentive to your child and do not strain him physically. Gradually update his regimen and physical activity, while communicating with a specialist along the way.

Follow your doctor’s advice

As a parent, you should take care of your child’s diet, sleep, and hygiene after fever has been treated. But don’t forget that you should also follow visiting doctors’ recommendations, such as the following follow-up appointments, to make sure your child is fully healed and there’s no need for more excited doctor calls. Also, feel free to ask questions and learn about any other tips that can improve your baby’s health.

Q&A:

What are the causes of fever in children?

Fever in children can be caused by infectious, inflammatory, autoimmune, allergic and other diseases, as well as overheating of the body.

What symptoms indicate a fever in a child?

When children have a fever, the following symptoms are observed: fever, weakness, headache, sweating, vomiting, sleep and appetite disturbance.

How is fever diagnosed in children?

Diagnosis of fever in children is based on the measurement of body temperature and analysis of symptoms. A general blood and urine test, radiography, ultrasound and other studies may also be required, depending on the proposed diagnosis.

What is the most effective treatment for fever in children?

Treatment of fever in children depends on its cause and includes the use of antipyretics, antibiotics, antivirals, immunomodulatory drugs, and drugs aimed at improving the general condition of the body.

Is there any special treatment for fever in infants?

Treatment of fever in infants requires great care and can only be done under medical supervision. Infants are usually prescribed medicines in the form of syrups or suppositories, and frequent feedings and the application of a cold compress on the forehead or abdomen are also recommended.

What if the fever does not go down for a long time?

If the child’s fever does not go down for more than a day, seek medical attention. The doctor may prescribe an additional examination and correction of treatment depending on the situation.

Fever in children. Causes of development and methods of treatment

Body temperature is regulated by thermosensitive neurons localized in the preoptic and anterior hypothalamus. These neurons are responsible for changes in body temperature in the same way as neural connections with cold and heat receptors located in the skin and muscles. Thermoregulatory responses are highly variable, mediated through a variety of mechanisms, and include directing blood flow in the skin vasculature, increased or decreased sweat secretion, regulation of extracellular fluid volume (via arginine vasopressin), or behavioral responses such as seeking warmth or cool ambient temperature. Normally, there is a circadian temperature rhythm or diurnal variations in body temperature within adjustable limits. Body temperature is lower in the morning and approximately 1°C higher in the afternoon and late afternoon.

Fever is a controlled increase in body temperature through mechanisms that regulate normal temperature. The difference is that the “thermostat” of the body is reset to a high temperature. Depending on which disease accompanies fever (infectious, connective tissue disease, malignant process), regulatory mechanisms are triggered in response to endogenous pyrogens, which, in turn, trigger the production of cytokines such as interleukin (IL) 1β and IL-6 , tumor necrotizing factor α, β-interferons and interferon-γ. Stimulated leukocytes and other cells produce lipids that also serve as endogenous pyrogens. The most well-studied lipid mediator is prostaglandin E2. Most endogenous pyrogenic molecules are too large to cross the blood-brain barrier. However, near the hypothalamus, the functions of the blood-brain barrier are insufficient, which allows neurons to contact circulating factors through a network of capillaries.

Microbes, microbial toxins and other microbial waste products are among the most common exogenous pyrogens that, when ingested, stimulate the functions of macrophages and other cells to produce endogenous pyrogens leading to fever. Endotoxin can directly influence thermoregulation in the hypothalamus and stimulate the release of endogenous pyrogens. Some substances formed in the body are not pyrogens, but are able to stimulate the formation of endogenous pyrogens. Such substances include antigen-antibody complexes in the presence of complement, as well as complement components, lymphocyte products, bile acids, and androgenic steroid metabolites. Fever can be the result of infections, vaccination, exposure to biological agents (granulocyte – macrophage – colony stimulating factor, interferons, interleukins), tissue damage (heart attack, pulmonary embolism, trauma, intramuscular injections, burns), malignant diseases (leukemia, lymphoma, metastatic diseases) , taking certain drugs (drug fever, cocaine, amphotericin B), diffuse connective tissue diseases, rheumatic diseases (systemic lupus erythematosus, rheumatoid arthritis), granulomatous diseases (sarcoidosis), endocrine (thyrotoxicosis, pheochromocytoma), metabolic disorders (uremia, gout) , genetic disorders (familial Mediterranean fever) and other unknown and poorly understood causes.

An increase in body temperature in response to microbial attack represents a response that has been observed in reptiles, fish, birds, and mammals. In humans, an increase in body temperature is accompanied by a decrease in the reproduction of microorganisms and an increase in the inflammatory response. Most of the evidence to date suggests that fever is an adaptive response and should only be treated in selected situations.

Although the nature of the temperature curve alone is not often helpful in making a specific diagnosis, observation of fever can provide useful information to the clinician. In general, a single isolated peak is not associated with an infectious disease. Such a peak can be observed with parenteral administration of blood products, drugs, certain procedures or catheter manipulations with an infected skin surface. Temperatures above 41°C are rarely due to an infectious cause. Very high fever (> 41°C) is most commonly central fever (due to CNS dysfunction involving the hypothalamus), malignant hyperthermia, drug fever, fever due to overheating.

Temperature below normal (< 36 °C) is most often associated with exposure to cold, hypothyroidism, antipyretic overdose.

Intermittent or intermittent fever (daily fluctuations in t° max and t° min of at least 1 ° C, but the minimum body temperature never drops to normal values) is defined as hectic or may be due to sepsis. The remaining persistent fever is persistent, and fluctuations in t ° do not exceed 0.5 ° C per day. With relapsing (laxative) fever, fluctuations in t ° exceed 0.5 ° C during the day, but it does not return to normal. Recurrent (relapsing) fever is separated by intervals of normal temperature, for example, in three-day malaria, fever is observed on the 1st and 3rd days ( Plasmodium vivax ), four days – on the 1st and 4th days ( Plasmodium malariae ). The biphasic nature of Bactrian camel fever indicates the presence of a single disease with two definite periods of fever of more than 1 week. The classic example is polio. Biphasic fever is also observed in leptospirosis, dengue fever, yellow fever, African hemorrhagic fever.

The dependence of heart rate on body temperature can be quite informative. Relative tachycardia, when the pulse rises in proportion to body temperature, is usually observed in non-communicable diseases or infections in which the toxin determines the clinical manifestations. Relative bradycardia (dissociation of pulse and temperature), when the pulse remains low during fever, suggests drug fever, typhoid, brucellosis, leptospirosis. Febrile bradycardia may also be the result of conduction disturbances involving the heart in acute rheumatic fever, Lyme disease, viral myocarditis, and infective endocarditis.

Most infections lead to various lesions causing an inflammatory response and subsequent release of endogenous pyrogens. The appointment of etiotropic antimicrobial therapy can lead to rapid elimination of bacteria. However, if tissue damage is severe, the inflammatory response and fever may continue for several days after eradication of all microbes.

Fever occurs in various infectious diseases with a wide range of severity. In healthy children, benign febrile illnesses include viral infections (rhinitis, pharyngitis, pneumonia), bacterial infections (otitis media, pharyngitis, impetigo), which usually respond well to antibiotic therapy and are not life-threatening. Risk groups include young children, with chronic diseases, immunodeficiency states. Some bacterial infections such as sepsis, meningitis, pneumonia, pyelonephritis, if left untreated, can be severe and have poor outcomes.

Fever without a specific focus usually presents a diagnostic dilemma for pediatricians, especially in children of the first 1.5–2 years of life, making it difficult to differentiate between serious bacterial infections and viral diseases.

Fever in children under 3 months of age always suggests the presence of a serious bacterial disease (sepsis, meningitis, urinary tract infection, gastroenteritis, osteomyelitis, otitis, omphalitis, mastitis, etc. ). Bacteremia may be due to group B streptococcus, Listeria monocytogenes Salmonella spp. Esherichia coli Neisseria 55 Streptococcus pneumonia , Haemophilus influenzae type B, Staphylococcus aureus . Children under the age of 3 months with fever, symptoms of intoxication should be hospitalized, blood cultures, urine, cerebrospinal fluid should be examined and parenteral antimicrobial therapy should be started immediately. Unlike bacterial infections, viral diseases tend to be seasonal.

Regardless of age, a fever accompanied by a petechial rash indicates a high risk of life-threatening bacterial infections. 8-10% of patients with fever and petechiae had severe bacterial infections, 7-10% had meningococcal sepsis or meningitis. The disease caused by H.influenzae type B may also present with fever and petechial rash. Treatment tactics include hospitalization, blood and cerebrospinal fluid culture, and the appointment of appropriate antimicrobial therapy.

Many physicians use the term “fever of unknown origin” for patients presenting for examination who do not have an obvious infection or a non-infectious diagnosis. In most of these children, the appearance of additional symptoms after a relatively short period of time makes the infectious nature of the disease obvious. Therefore, this term is more often used in patients with fever that is not identifiable after 3 weeks in the outpatient setting or after 1 week in the hospital.

The causes of the so-called fever of unknown origin can be infectious processes and diseases of the connective tissue (autoimmune and rheumatic). It is necessary to exclude a neoplastic process. Most cases of fever of unknown or unrecognized origin are the result of an atypical course of common diseases. Since at the beginning there may be no clinical and laboratory signs of a certain disease, the diagnosis in some cases is made only after prolonged observation. Causes of fever of unknown origin in a more detailed examination included salmonellosis, tuberculosis, syphilis, Lyme disease, atypical protracted course of common viral diseases, infectious mononucleosis, cytomegalovirus infection, hepatitis, histoplasmosis. Inflammatory bowel disease, rheumatic fever, Kawasaki disease can also cause fever of unknown origin. In these cases, it is recommended to re-examine the patient after a certain period of time.

In children under 6 years of age, fever of unknown origin is associated with infection of the respiratory or urogenital tract, localized infection (abscess, osteomyelitis), juvenile rheumatoid arthritis, rarely leukemia. Adolescents are more likely to have tuberculosis, an inflammatory process in the intestines, an autoimmune process, and lymphoma. The empiric use of antibiotics should be avoided. In unclear cases, hospitalization may be required for x-ray and laboratory examinations, closer observation, temporary relief from the anxiety of the child and parents. Once fully adequately assessed, antipyretics may be indicated for fever control and symptomatic treatment.

Fever less than 38–38.5°C in previously healthy children generally does not require treatment. If this level is exceeded, the state of health of patients worsens, and the appointment of antipyretics improves the condition. Antipyretics generally do not change the course of infectious diseases in normal children and are symptomatic. Heat production associated with fever increases oxygen consumption, carbon dioxide production, and cardiac output. Thus, fever may worsen heart failure in patients with heart disease or chronic anemia (eg, sickle cell anemia), pulmonary insufficiency in patients with chronic lung disease, and metabolic disorders in children with diabetes, congenital metabolic disorders. Moreover, in children between 6 months. and 5 years, the risk of febrile seizures is increased, and in children with idiopathic epilepsy, febrile illness may increase the frequency of seizures. Antipyretics are prescribed in high-risk patients, ie. having chronic cardiopulmonary diseases, metabolic, neurological diseases, and children with a high risk of developing febrile seizures. Hyperpyrexia (> 41°C) is associated with severe infections, hypothalamic disorders, and central nervous system hemorrhage and always requires antipyretics.

When choosing antipyretics for children, it is especially important to focus on drugs with the lowest risk of side effects. Currently, only paracetamol and ibuprofen fully meet the criteria for high efficacy and safety and are officially recommended by the World Health Organization and national programs in pediatric practice as antipyretics [1–3]. Acetaminophen, aspirin, and ibuprofen are hypothalamic cyclooxygenase (COX) inhibitors that inhibit the synthesis of PGE-2. These drugs are considered equivalent effective antipyretics. Since aspirin is associated with Reye’s syndrome in children and adolescents, it is not recommended for use in the treatment of fever. Paracetamol and ibuprofen can be prescribed to children from the first months of life (from 3 months of age). Recommended single doses: paracetamol – 10-15 mg / kg, ibuprofen – 5-10 mg / kg. Re-use of antipyretics is possible not earlier than after 4-5 hours, but not more than 4 times a day.

It should be noted that the mechanism of action of these drugs is somewhat different. Paracetamol has an antipyretic, analgesic and very slight anti-inflammatory effect, since it blocks COX mainly in the central nervous system and does not have a peripheral effect, it is metabolized by the cytochrome P-450 system. The delay in the excretion of the drug and its metabolites can be observed in violation of the functions of the liver and kidneys. If a child has a deficiency of glucose-6-phosphate dehydrogenase and glutathione reductase, the administration of paracetamol can cause hemolysis of red blood cells, drug-induced hemolytic anemia.

Ibuprofen has a pronounced antipyretic, analgesic and anti-inflammatory effect. Ibuprofen is effective against fever in the same way as paracetamol [4–6]. A number of studies have shown that the antipyretic effect of ibuprofen at a dose of 7.5 mg/kg is higher than that of paracetamol at a dose of 10 mg/kg and acetylsalicylic acid at a dose of 10 mg/kg [7]. Ibuprofen blocks COX both in the central nervous system and in the focus of inflammation (peripheral mechanism), which determines its antipyretic and anti-inflammatory effect. As a result, the phagocytic production of mediators of the acute phase, including IL-1 (endogenous pyrogen), decreases. A decrease in the concentration of IL-1 also contributes to the normalization of temperature. The analgesic effect of ibuprofen is determined by both peripheral and central mechanisms, which makes it possible to effectively use ibuprofen for mild and moderate sore throat, pain with tonsillitis, acute otitis media, and toothache [8]. An indication for the appointment of ibuprofen is also hyperthermia after immunization.

Due to its high toxicity, amidopyrine has been excluded from the nomenclature of drugs. The use of analgin in many countries of the world is sharply limited due to the risk of developing agranulocytosis. In urgent situations, such as hyperthermic syndrome, acute pain in the postoperative period, and others that are not amenable to other therapy, parenteral use of analgin and metamizole-containing drugs is acceptable.

Comparison in double-blind, randomized trials with multiple doses of antipyretics showed that the incidence of adverse events was similar between ibuprofen and paracetamol (8–9%) [3]. The results of a large randomized study of more than 80,000 children showed that the use of ibuprofen compared with paracetamol does not increase the risk of hospitalization associated with gastrointestinal bleeding, renal failure or anaphylaxis. When using ibuprofen and paracetamol in children with bronchial asthma [3], it has been shown that the use of ibuprofen, compared with acetaminophen, does not increase the risk of bronchospasm in children with bronchial asthma, with no indication of aspirin intolerance, which indicates the relative safety of ibuprofen in children with bronchial asthma .

According to the experts of IC “MAKS” (Vladimir), paracetamol and ibuprofen are most often used in pediatric practice (Table 1).

We used Nurofen for children (ibuprofen) in 95 children aged 3 months and older. up to 10 years old. The indication was fever in acute respiratory infections, acute otitis media, tonsillopharyngitis, obstructive bronchitis, bronchiolitis, pneumonia. 43 children of the first three years of life were hospitalized in the regional children’s hospital due to the severity of the condition. In 20 children, acute respiratory infections occurred against the background of mild to moderate bronchial asthma without indications of aspirin intolerance, in 37 children obstructive bronchitis and bronchiolitis were diagnosed. The average value of the initial axillary temperature was 39.1 ± 0.6 °С. Nurofen for children was prescribed at the rate of 5 mg/kg, on the first day – 3-4 times, on the second day – 2-3 times; the third day and beyond – according to indications. Most children were prescribed the drug for no more than 2 days. In 40-60 minutes after taking the drug, the temperature decreased to 37.9 ± 0.4 °C, after 90-120 minutes – to 37.3 ± 0.5 °C. Adverse events were noted in 2 children in the form of an allergic rash, in 1 child – abdominal pain, exacerbation or provocation of bronchospasm was not observed in any case. In 6 children, the effect of taking ibuprofen was minimal and short-lived: 2 children were prescribed diclofenac, 4 others received parenteral lytic mixture.