A Few Basic Things About Fever Management In Children
Let's clear up a few basic things about FEVER in healthy children who do not have pre-existing medical conditions
1 - There is no number on the thermometer that corresponds with a trip to the emergency department. No not even 40 C.
The severity of a fever does not generally correspond with the severity of illness. Fever is just a number on the thermometer. We have to look at the child to really assess the severity of illness. A child with 38.5 laying around, cranky, lethargic, vomiting, is sicker than a child with 39.5, walking around, playing, a little achy, drinking fluids with rosy cheeks.
2 - Fevers do not need to be treated with medications generally.
Fever is the body's way of fighting infection. To put it simply, a virus invades the body. It comes in with 50 copies of itself. It then starts using your body as a copy machine to make more copies of itself and invade your body further. The body gets very upset by this, the immune system activates the metabolism and the temperature rises. A lot of pathogens cannot survive at a temperature higher than 38.5. When the temperature is rising, it stops the virus from making more photocopies of itself. If you don't give medication the fever will keep the virus at having only 100 copies of itself, let's say. The body can easily take over the 100 viruses and fight back. You get better quicker. Verses, giving Paracetamol and Ibuprofen around-the-clock, suppressing the fever response. The virus can now replicate to millions and billions of copies, because there is nothing stopping it. Now you end up being sicker for days and days.
Moral of the story:
Let the children understand that they will be sore, they will have a headache, they might have a bellyache, they will not feel good, but you will not give them any medications. Unlimited screen time, fluids, chicken noodle soup, cold smoothies, and unlimited love is the prescription. Cold compresses and lukewarm (not cold) baths are a great choice as well. The fever will be done in 24 hours. The illness will be done in 2 to 3 days max.
If you cannot stand it, and you are giving your children Paracetamol and Ibuprofen around the clock you'll be dealing with this illness for 7 to 10 days at least. The body now has to get rid of million/billion virus particles. That takes some time. That is a lot of days missed from school and work.
Exceptions: ••if the child refuses to drink and it is in danger of getting dehydrated or laying around like a dish rag (not just tired which is a normal response to fever) please use medicine to reduce fever. •• If child is less than 3 months old, has a fever >38, discuss with paediatrician immediately.
Fever - FEARS
1 - Fear of fever for causing brain damage.
In a normal child with a normal functioning brain it is not possible for fever to cause brain damage. The brain protects itself. The brain starts the fever to protect the body from invading viruses/bacteria. It will not raise the temperature enough to hurt itself. Brain damage occurs only with external factors such as hyperthermia from heatstroke or other external sources where the brain is not in control.
2 - Fear of febrile seizures.
The risk of febrile seizures is 1 in 20 children at the age of 6 months to 5 years. Usually the febrile seizure occurs before you even know the child is sick. They're usually playing doing fine and all of a sudden, they are having a seizure. As the seizure progresses it will be noted that the child is febrile. It is not the height of the temperature, it is the rate of rise. For example, when the fever goes from 37 to 39.5 in a less than 20 minutes it can lower the seizure threshold. Meaning, the speed with which the temp goes up causes irritation to the brain, thus seizure. It is NOT that the fever is 40 or going to 40.5 OR that the fever lasts for 1-2 hrs that is the problem. In a healthy child with a normal brain, NOT the number, and NOT the duration of fever, but the rate of rise causes seizure. Out of fear of a child having a febrile seizure parents will alternate Paracetamol and Ibuprofen. Many studies have been done on this topic. Yes, even in kids known to have febrile seizures. No study has ever shown that alternating Paracetamol and Ibuprofen reduces the risk of a seizure. Alternating these medications only leads to overdosing and stressing kidneys and liver in an effort for parents to make themselves feel better.
Moral of the story:
•• Normal brains do not damage themselves with the fever they created. •• febrile seizures, though horrible, are generally benign, and CANNOT be prevented with alternating doses of Paracetamol or Ibuprofen. And are rare occurrences!!!!!!!