Your little one’s forehead feels warm and her cheeks are flushed. Should you call the doctor? Before you start panicking, here’s what you should know about fever in babies and toddlers, says EVELINE GAN.
Your little one’s forehead feels warm and her cheeks are flushed. Should you call the doctor? Before you start panicking, here’s what you should know about fever in babies and toddlers, says EVELINE GAN.
1. It’s not a fever until the thermometer reads 38 deg C.
That is, if you’re going by your baby’s rectal temperature (taken in her bottom), according to the American Academy of Pediatrics (AAP). A body temperature of 38.5 deg C and above is considered a high fever.
The normal body temperature can range from 36.1 to 37.8 deg C, says Dr Leo Deng Jin, an associate consultant at the department of emergency medicine at KK Women’s and Children’s Hospital (KKH).
Not only do babies and younger kids have a higher body temperature than adults, it can also vary throughout the day for different reasons, from being over-dressed to the time of the day, experts say.
Even the device and method you use to measure your little one’s temperature can make a difference. For example, a temperature reading taken in the bottom tends to be higher than in the underarm. You may also get slightly higher readings from infrared thermometers compared to electronic ones, Dr Leo says.
2. Rectal readings are the most spot-on.
No one likes sticking a thermometer into their little one’s bottom. But it provides the most accurate readings for babies, particularly those under the age of three months, as well as toddlers up to the age of three, says Dr Michael Wong, deputy medical director at Raffles Medical.
For accuracy, take the temperature twice each time.
Digital ear thermometers, which use infrared rays, aren’t recommended for newborns. They are for babies older than six months, older kids and adults.
Armpit temperatures are the least accurate. And don’t bother feeling your baby’s skin to check if she’s having a fever – it’s not accurate as it depends a lot on your own body temperature, says Dr Wong.
According to him, your child has a fever if her:
• rectal temperature is above 38 deg C.
• oral temperature is above 37.5 deg C.
• underarm temperature is above 37.3 deg C. • ear temperature is above 37.8 deg C.
3. Don’t just focus on the numbers; look at the symptoms.
It’s hard to remain calm as her temperature climbs. But a high reading on the thermometer doesn’t necessarily mean her illness is serious, says Dr Leo.
Likewise, don’t dismiss a low-grade fever as a minor issue, warns Dr Wong. After all, a fever is not an illness, but usually a symptom of an infection.
Instead of focusing solely on the numbers, look at other signs to determine how sick your baby is: is she still playing and eating well? See a doctor if your baby’s fever rises above 40 deg C or goes on for more than 24 hours, the AAP advises.
Dr Wong advises that you take your little one to the doctor if she:
• feeds poorly.
• is vomiting.
• looks lethargic or drowsy.
• is very young, especially younger than three months old.
• has breathing difficulties.
• looks sicker than before.
• has stomach pain and discomfort.
• has a rash.
• produces less urine than usual.
4. Your two-month-old is heating up; head straight to the hospital.
A hospital stay is usually required for babies under three months old who are running a temperature. That is because the younger the baby, the higher the chance of getting a serious bacterial infection, such as a blood stream infection, urinary tract infection or meningitis (brain infection), Dr Leo explains.
If that happens, it is important they get the right tests and treatment in time. Plus, symptoms of a serious illness tend to be more subtle in very young babies, which is why doctors are generally more cautious and may recommend additional tests for this age group, Dr Wong adds.
For babies older than three months, Dr Leo advises seeing the general practitioner first to see if the child’s condition warrants a visit to the emergency department.
5. Bundling up your feverish baby does more harm than good.
Your little one is shivering while nursing a fever? Don’t wrap her up, say the experts.
“When parents see their babies shivering, their usual reaction is to cover them with blankets. This would only trap more body heat, causing the body temperature to stay high,” Dr Leo warns.
Like adults, babies and children often feel cold or shiver during a bout of fever. Dr Leo explains that this occurs when the body tries to produce more heat to raise its temperature during illness to fight an infection.
Even if your baby isn’t sick, overwrapping can cause her temperature to be slightly above normal, especially in Singapore’s hot climate.
“A blanket might be suitable if your baby is at an air-conditioned mall, but not outdoors on a sunny day,” Dr Leo says.
Ditch the swaddle, long-sleeved pyjamas and thick blankets. Opt for light clothing and offer plenty of fluids. Bring your baby’s fever down with medication as instructed by her doctor, and then sponge her, Dr Leo advises.
6. Sponge her using room-temperature water.
Bringing a high fever down with ice or cold water sounds logical, but the AAP advises against it. Doing so may cause chills or shivering, further raising her body temperature.
KKH advises using tap or lukewarm water instead. Apply the cool compress to the forehead, nape of neck, armpits, neck and groin area, for no more than 30 minutes at a stretch.
Stop sponging your child when she starts shivering. Keep the room environment cool and well-ventilated.
7. You may reuse fever medications, but check the dosage.
Syrup paracetamol or ibuprofen can be kept in the refrigerator for up to six months or three months at room temperature, according to Dr Leo.
But note the expiry date and storage instructions on the medicine bottle. You will also need to know exactly how much medication to give your baby, which is based on her weight, and not age. The dose prescribed when she was six months old may not be suitable for her several months later.
To be safe, Dr Leo advises calling the clinic or pharmacist to check the correct dosage, especially if her weight has changed significantly since the last doctor’s visit.
You should never give your little one over-the-counter medications. For example, aspirin is not safe for kids under the age of 18 years, as it can cause a rare but serious illness known as Reye syndrome, Dr Wong says.
PHOTOS: MASTERFILE
