Fever: Everything you need to know
Fever is an increase in body temperature due to various causes, the most common of which is infection (viral or bacterial).
It is not a disease but the result of a specific biological process.
In general, fever means a temperature above 38ºC. Slightly different values may be obtained depending on where you take the temperature: (mouth, armpit, ear, forehead or rectum).
- Measurements from the armpit, ear and forehead are easier, but less accurate.
- In most cases, fever can be treated at home. Its height is not always the most important evaluation criterion.
On the contrary, behavior and clinical condition are of particular importance. It is important for parents to know when a child with a fever needs to be given antipyretics or evaluated by a doctor and when it is reasonable to observe the child without treating the fever.
Thus, a child over three months of age who has a rectal temperature of less than 38.9°C and who is otherwise healthy does not require antipyretics.
A doctor’s evaluation is recommended in the following cases:
- Infants under three months of age who have a rectal temperature ≥38°C, regardless of the infant’s presentation, should not receive antipyretics until they have consulted their doctor.
- Children aged three months to three years who have a rectal temperature ≥38°C for more than three days or who appear ill (e.g. restless or having difficulty feeding) or who simply have a rectal temperature ≥38.9°C.
- Children of any age 1) whose oral, rectal, ear or forehead temperature is ≥40°C or ≥39.4°C in the axilla 2) who have recurrent fevers for more than seven days 3) who have febrile seizures or a new skin rash 4) who there is a chronic medical problem such as heart disease, cancer, lupus, or sickle cell anemia.
Giving an antipyretic is recommended in cases of severe concern, although it is not necessary or if there is an underlying medical problem (cardiac, pulmonary, neurological). In children who have had febrile seizures in the past, treating the fever has not been shown to prevent seizures, but it is still a reasonable precaution.
The most effective way to treat a fever is to use a medicine such as acetaminophen or ibuprofen.
Aspirin is avoided in children under 18 years of age due to concerns that it may cause a rare but serious illness known as Reye’s syndrome.
Paracetamol can be given every four to six hours as needed, but not more than five times in a 24-hour period. Ibuprofen can be given every six hours and not to children under six months of age.
Doses should be calculated based on the child’s weight (not age).
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