The Child With Fever - What Parents Should Know

Christoph Aring Christoph Aring

All parents are familiar with a feverish child. It can be very scary and for many a natural thought is-lets go see a doctor and have  some meds prescribed  soon!  

A feverish child changes its behavior, screams, cries, may shiver, has cold extremities with marbled skin, breathes faster and can even can have a  so called febrile convulsion. The child does not want to eat, drinks only a little bit, maybe vomits and may have diarrhea.  The younger they are , they long  for mom or dad, and nobody gets a lot of sleep during these nights. Children who are being weaned from breastfeeding might want to drink breastmilk only .Usually the child snuffels, in young babies this makes it even more difficult for the baby to suck or drink, they cough in increasing intensity for 3-4 days and then usually fever stops while the other symptoms will persist in most oft the kids for another week.

Of course all this is mostly caused - -by so called viral respiratory infections-the so called common cold.(or URTIS-upper respiratory tract infections) More than 500 „cold“ viruses are known!

No medicine substantially alters this course of disease. Antipyretics like paracetamol, ibuprofen, aspirin alleviate the  pain and the uncomfortable effects of fever.

Cold sirups or expectorants might help breathing and reduce coughing but nothing really shortens the course of disease. Antibiotics do not cure viral infections- many studies find hat antibiotics are prescribed too often-especially in children. They need to be reserved for cases when they are really needed.  

We pediatricians describe such illnesses as trivial infections. The vast majority (but not all!) are caused by the mentionned viruses. Of course specific symptoms will develop depending on the organ mostly affected. (upper airways, lungs, tummy etc)

It must be noted however that the differentiation between viral and bacterial infections can be quite challenging-even for doctors.


Most children, young or older, contract several infections that cause the feverish illness described above during childhood. 7-10 infections per year at the age between 3 and 5 can be quite normal.  It is understandable for the parents  to be  afraid and t focus on fever as the main symptom to be treated immediately and give antipyretics. This is unnecessary, except the child needs special care because of achronic disease. Of course caregivers want to help the child – antipyretics alleviate symptoms, calm the restless children down, help them to sleep, but they also do have  side effects (possibly higher risk to develop allergic disease later in life, damage liver and kidneys). Fever is one tool of the defense system human beings have in fighting the unnumerable microorganisms that invade us with every  breath we take and anything we take in by our mouths. Again, most of them are viruses. If the body temperature raises above 39°C, viruses slow down and stop their replication – this is the chance for the body’s immunsystem to boost and neutralize the invaders.  The duration of a feverish episode depends on the amount of virus in the body. (and also the immune systems abailabilty to fight it)   Medical complications of fever happen at  body temperatures above 41°C, then active physical and medical fever reducing therapies are indicated. Febrile convulsions (20% of all healthy preschool children) are not dependant on the temperature, they may happen at temperatures like 38 °C as well.  The body needs a lot of energy to raise its temperature, shivering (muscle activity) and reducing blood flow through arms and legs (marble, cold skin) are all mechanisms of this process.


So the first thing, parents should do once their child gets a fever, is to comfort the child, cancel all dates, watch the child carefully, the younger they are the closer,  secure fluid intake, and allow your child to fight the virus with fever and its competent immune system and chaperone it through the illness in due time. The probability of an uncomplicate course of illness is high. It is a different story if  your child is a newborn or younger than 3 months , in this case you should look for medical assistance immediately  to check for bacterial infections which might need early antibiotic treatment. And, above all, families should comply to the standard vaccination schedules, this is the best preventive health care that saves lives and has reduced severe complications of common illnesses significantly.


So, after all: fever – are we at is mercy ? Yes – as a natural reaction inborn to all human beings (and animals) to protect the body against acute invasion of microorganisms – of course your child gets sick and suffers, but it will recover – this is normal, the child’s immune system learns with each illness.

Any infection lasting longer than 4-5 days, any infection with more severe symptoms (seizure, child stops drinking/.eating, unexplained rashes (although mostlky harmless), any signfikant deterioration which you as parent will notice - it is of course advisable to see your Paediatrician or GP.