Temperature in Children: What Helps with a Fever? When Should a Child See a Doctor?

Fever is not a disease; it's one of the symptoms that inform us that something is happening in a child's body. It is the body's primary defense mechanism against pathogens, where the immune system becomes more active to combat viral or bacterial invaders. However, if high fever (above 38.5°C) persists for an extended period and cannot be reduced, there is a risk of complications like febrile seizures, dehydration, decreased appetite, or constipation. In this article, you'll find answers to your questions about when to use fever-reducing medications.

Fever is a common reason for seeking medical attention. However, in about 1 out of 5 children with a fever, a clear cause cannot be identified. Most of these children have a viral illness that will resolve on its own, but it could also be due to a bacterial infection. Fever not caused by an infection is less common in children, but it's important to understand the cause of the fever.

Causes

Fever is a sign of an inflammatory response in the body and can occur in the context of bacterial or viral infections. A moderate increase in temperature up to <40°C supports the immune response. Non-infectious inflammatory reactions can also be accompanied by fever, such as rheumatic diseases like juvenile idiopathic arthritis, chronic inflammatory bowel diseases (Crohn's disease, ulcerative colitis), or Kawasaki syndrome. In these cases, it's important to consult qualified doctors Treatment in Switzerland who can make a correct diagnosis.

What You Can Do

Newborns or children under 3 months of age should be seen by a pediatricianurgently if they have a fever. If your child is suffering significantly from the fever or other accompanying symptoms or underlying conditions, you should also consult a doctor. The same applies if the fever lasts for more than a day, doesn't respond to fever-reducing medication, or if there are fever-related seizures or other signs of illness like diarrhea, vomiting, abdominal pain, and so on.

Measure the Temperature – but Do It Right

When suspecting a fever, it's essential to measure the child's body temperature promptly. The most accurate readings are obtained through rectal measurements, where a thermometer is gently inserted into the child's rectum. Here's the recommended procedure:

• Ensure the child is not overheated (from activity) and not wearing more clothing than necessary, as excessive clothing can mimic a fever.
• Lay the child on their side, with their legs pulled up, or place infants on their back.
• Moisten the tip of a digital clinical thermometer with water or apply a small amount of petroleum jelly or cream.
• Carefully insert the thermometer about one to two centimeters into the rectum and wait for the measurement signal.
• Remove the thermometer, read the temperature, and clean it.

Another method involves measuring temperature using an ear thermometer. It is important to hold the device correctly so that the infrared beam reaches the eardrum. To do this, gently pull the earlobe back and upward. It's also worth noting that earwax and drafts can distort the readings.

Another method for cooperative children aged 5 and older is measuring the temperature under the tongue. This should be done no sooner than 10 minutes after eating or drinking, and the child should breathe through their nose during measurement. Oral measurements typically read about 0.3–0.5°C lower.

Note: Forehead and ear thermometers, as well as measurements in the armpit, are less accurate.

When to Lower the Temperature?

Fever plays an important role in infections by speeding up metabolic processes and supporting the immune system. Therefore, it's not always necessary to combat fever; in fact, studies have shown that fever-reducing medications often prolong the course of infectious diseases. On the other hand, very high temperatures are harmful. If the fever rises above 39°C, the increased metabolic workload on the heart and circulatory system can be detrimental. So, many doctors recommend fever-reducing medications for children with heart or lung conditions earlier than for healthy children.

But when should parents give a fever-reducing medication to their child?

However, there are no general recommendations for temperatures below 40°C. Besides the measured temperature, the child's overall condition is crucial, which is why parents need to closely monitor the child. If the child is alert and drinking enough, a temperature up to 39°C may be acceptable. For those in diapers, regular checks of diaper wetness are essential to ensure the child is getting enough fluid. Dry mucous membranes, such as dry lips and a sticky feeling in the mouth, are also good indicators that the child may not be receiving enough fluids. If in doubt, always consult a doctor.

Fever Medications: Yes or No?

If immediate relief is needed, fever-reducing medication can be considered. Suppositories are a suitable option for young children who cannot swallow.

Most of these medications contain a mildly pain-relieving and fever-reducing substance called paracetamol, which has well-documented effectiveness and safety. However, it's crucial to strictly follow the recommended dosages, as overdosing on paracetamol can harm the liver.

Ibuprofen is another commonly used fever-reducing substance that is considered safe and works similarly to paracetamol. However, ibuprofen for children is often available in syrup form and is typically suitable for children six months and older.

Under no circumstances should you give your child acetylsalicylic acid (ASA), for example, in the form of aspirin, without consulting a doctor, as this substance can lead to Reye's syndrome, a very rare but often fatal condition affecting the liver and brain.