Your child and fever
by Dr Penny Adams and Dr Felicity Bidencope

Diagnosis of childhood illness can be tricky for parents with small children, who are unable to tell them “where it hurts”. Children may be irritable and restless, or quiet and withdrawn, with parents unable to pinpoint the problem.

The signs of illness in children can be quite subtle and different to those in an adult.
These signs may include lethargy, irritability, vomiting, diarrhoea, crying more than usual, loss of interest in their food, a rash, pallor or a fever.

Fever is a defence mechanism the body uses to fight infections, and it is therefore frequently associated with childhood illness.

A body temperature that is consistently above the normal temperature range is called a fever. Every child has his or her own normal temperature range, which can be affected by the surrounding temperature, the time of day, physical activity, and the age of the child.

Generally a child is said to have a fever if his or her temperature is greater than 37.5 degrees Celsius.

A fever may indicate a mild illness such as a cold or flu, or more serious illness such as tonsillitis or pneumonia. It is only one of many signs associated with childhood illness.

Fever alone does not necessarily require treatment and parents should not develop “fever phobia”. Fever actually helps the body’s immune system work quickly, and higher temperatures discourage the multiplication of bacteria and viruses.

If, however, your child has discomfort with the fever, it is very reasonable to treat him or her with an appropriate dose of paracetamol or ibuprofen (based on the child’s weight).

When using these medications, it is important to treat the symptoms, not the fever. Exceeding the proper dose (or frequency of dosage) of any anti-fever medication can be toxic to a child's liver and kidneys so it is important that parents - and, in particular, new parents - consult their family doctor to determine the correct dosage for their baby or young child.

Bathing your child or placing them in front of a fan is no longer recommended for the treatment of fever, as lowering the skin temperature can actually increase the core temperature of the child.

Fever can act as an important warning sign of serious disease. All infants under twelve months with a fever higher than 38.5 degrees Celsius must be seen by a doctor. If they are less than three months old, they will require assessment in a hospital. Unexplained fever in a child (that is with no other symptoms, such as those of a cold, or another ailment) should always be reviewed by your family doctor, as possible urinary tract infections (which can cause a fever but no other symptoms) need to be excluded.

As with most childhood illnesses it is important to discuss your child’s symptoms with a doctor and receive advice regarding appropriate action. The presence or absence of a fever is one of the factors your doctor will consider, along with any other symptoms, to determine the cause of your child’s illness.

It is very important to trust your parental intuition and instincts. You know your child better than anyone else. But do not be afraid of a fever – use it as just one guide to assessing how your child is – and only treat the fever if your child is uncomfortable with it.

Fever plays an important role in the healing process, and sometimes the best medicine is just to let it run its course. However, if you are worried about your child’s fever (whether or not they have any of the indications of illness mentioned in the first paragraph) always seek advice from your family doctor.