Fever In children

When your child’s forehead feels warmer than usual, (s)he probably has a fever. A fever usually means that your child’s body is fighting an infection. This can be serious in children under 6 months of age, and you should immediately take the child to a healthcare provider.

Fever in children may not require treatment if there is no sign of distress (very high fever, crying or headache); continue to give the feverish child water and allow them to wear light clothing. You can treat fever in children with paracetamol for children older than 2 years old or Ibuprofen syrup in children up to 6 months. Do not give aspirin to a child; it can cause a severe drug reaction (Reye’s syndrome).

Bacterial, viral or parasitic infections are the most common cause of fever in children. The body raises its temperature to fight the infection. The following are common causes of fever in children:

• Malaria.
• Thypoid.
• Flu.
• Chickenpox.
• Upper respiratory tract infections (e.g. infection of the throat).
• Diarrhoea.
• Teething.
• Routine vaccination.

Fever in children usually goes away by itself. See a healthcare provider immediately if:

• Your child is less than 3 months old and has a temperature of 38^oC or higher.
• Your child is between 3 – 6 months old and has a temperature of 39^oC  or higher.
• The fever persists for more than 24 hours and refuses to go away.
• Your child is vomiting, is unresponsive, has a stiff neck or will not take food.
• Your child is dehydrated. Pinch the skin at the back of their hand between your fingers. If the skin doesn't snap back quickly, they may be dehydrated.

If you do not have thermometer to measure your child's temperature, feel their forehead with the back of your hand to see if it feels hotter than usual. Also note if your child is shivering and sweating, which can also be sign of fever.

You can prevent malaria, one of the most common causes of fever in Nigeria, by sleeping under a long-lasting insecticide-treated net (LLIN), spraying residual insecticide indoors and wearing clothes that cover your limbs.

In most cases, you may not prevent fever in children, but you can take steps to prevent complications like seizures. Self-care and adequate treatment will prevent complications.

Fever may be mild or be a sign of a more serious illness. The following tips can help you know what to do if your child has a fever:

Self-Care Tips

• Keep your baby hydrated by giving them breast milk or formula, even if they do not seem thirsty. Give older children clean water to keep their fluid levels up.
• If the room is warm or hot, open the windows a little to ensure gentle ventilation and circulation of air.
• Seek medical advice before giving your child any medicines. Never give aspirin to children. Aspirin can cause a dangerous drug reaction in children.
• Do not rub your child’s body with alcohol or use cold water for bathing your child. It can make the fever worse.

Medical Treatment

• Paracetamol is available in liquid form for children that are 2 years or older. The dose is usually based on how much they weigh. Do not give more than 15mg per Kg weight four times a day. Your healthcare provider can provide instructions.
• Ibuprofen is available for younger children (6 months and above) and can be used in place of paracetamol. Do not use both medicines for your child at the same time.
• Capsules that can be inserted into the anus (suppositories) can be used if the child is vomiting or having difficulties swallowing.
• If the fever is caused by an infection (e.g. malaria or bacterial infection), your healthcare provider will diagnose it and prescribe the appropriate medicines.

Fever is a common symptom in children and usually resolves on its own. You may not need paracetamol or ibuprofen if the fever is not causing much distress to your child. Do not use cough and cold medicine mixtures for children under 2 years. Take significant caution when using cough medicines for children under the age of 4 as a combination of these medicines can cause serious adverse reactions in children under 4 years. Ask your healthcare provider if it is safe before using herbs on babies.

If you child has shaking fit (convulsions) while it has a high temperature, place them on their side, do not try to hold them or put anything in their mouth, and stay with your child until the shaking stops. It can be upsetting to watch your child experience a shaking fit, but it does not cause damage to your child.