When should you worry?

Fevers are common in children, but how much do you really know about treating them? We asked an expert.

Once the baby years are over, parents get less panicky about every fever their child suffers. But did you know that you shouldn’t use a fever strip thermometer or sponge your kid for more than 30 minutes at a time? Dr Grace Lim, a paediatrician at Thomson Paediatric Centre, shares her insights on this common childhood illness and when you should raise the alarm.

What’s considered a fever?

A person’s normal body temperature varies with age, general health, activity level, and time of day. It is highest between the late afternoon and early evening, and lowest between midnight and early morning. A fever is a body temperature that is higher than the normal range of 36.4 and 37.5 deg C. Most paediatricians consider a temperature above 38 deg C as a sign of a fever.

Why do they occur?

A fever is usually a sign that the body is fighting an illness or infection. These are usually due to viruses, which can clear up without treatment but, occasionally, it is a sign of serious bacterial illness. How high the fever is does not indicate the severity of the illness.

What are the symptoms?

Your child may feel warm, appear flushed, sweaty or be more thirsty than usual. Some children feel fine when they have a fever. Viral fevers can last five to seven days. Most children will have other symptoms of the illness that is causing the fever.

Examples include earache, cough, a sore throat, rash or a stomach ache. High fever itself does not cause brain damage. However, a small percentage of children between six months and six years old may have seizures with high fever.

Which type of thermometer is best?

Always use a digital thermometer to check your child’s temperature. While other methods such as pacifier thermometers or fever strips are available, they are not recommended. The following are three types of digital thermometers:

• Digital multi-use thermometer The underarm method is useful for screening at any age, rectal is suitable for babies from birth to three years, and oral for kids above four years old. The sensor is located at the tip of the thermometer, whichtouches the part of the body in order to read the temperature.

• Tympanic thermometer For those aged six months and older. It reads infrared heat waves released by the eardrum.

• Temporal artery thermometer For children three months and older. It reads infrared heat waves released by the temporal artery on the side of the forehead.

Which home remedies are safe?

Those for children include getting them to drink plenty of  fluids, wearing light clothingand keeping them in a cool and well-ventilated room. You can also do tepid sponging by removing your kid’s clothing and covering him with a towel. Then, wet a sponge or towel with lukewarm water and sponge his body from front to back.

Also use a cold compress and apply it to his forehead, back of the neck, armpits and groin. Do not sponge for more than 30 minutes and stop if your child is shivering or turning blue. Remember: overwrapping your little one, coupled with a hot environment, can cause his body temperature to increase slightly above the normal range.

When should I take him to a doctor?

Seek medical attention when:

• His fever rises above 40 deg C repeatedly.

• He is younger than three months old and has a temperature of 38 deg C or higher.

• The fever persists for more than 24 hours and he is younger than two years old.

• The fever persists for more than 72 hours and he is older than two years old.

• He has difficulty breathing.

• He has decreased urine output and is eating poorly.

• He is suffering from repeated vomiting or diarrhoea.

• He has an unexplained rash.

• He has a stiff neck, severe headache or a seizure.

• He looks ill, drowsy or irritable.