What is fever?
Your baby is wailing, her skin is scorching, and your heart is about to break. But don't worry. Fever — elevation of the body's temperature above normal — seldom does harm. Normal body temperatures in a well child can range from 97.7 degrees F / 36.5 degrees C to 100 degrees F / 37.8 degrees C. Babies have higher temperatures than older children, and everyone's temperature tends to go up during the day and down after midnight. In general, a baby isn't considered feverish unless her temperature is over 100 degrees F / 37.7 degrees C in the morning or over 101 degrees F / 38.2 degrees C in the evening.
Why do people get fevers?
Fever is part of the body's way of fighting infection. Macrophages, the "clean-up" cells of the body, are constantly on patrol. When they find something that doesn't belong — such as a virus , bacterium or fungus — they mop up as much as they can. At the same time, they call for help, signalling to the brain to raise the body's temperature. The heat kills some types of bacteria directly. It also seems to speed up the body's production of white blood cells and chemicals that kill germs.
Babies often get fevers after receiving immunisations; a fever may also accompany a severe cold, flu, sore throat, ear infection, respiratory illness (like pneumonia), croup, viral illness, and urinary tract infections.
How can I tell if my baby's fever is serious?
More important than the actual temperature is your child's behaviour. If she has a fever of 104 degrees F / 39.7 degrees C, is feeding well, responsive, and easily comforted, you have less reason to worry than if her fever is 102 degrees F / 38.7 degrees C, she's crying inconsolably, and she's limp and unresponsive. Call the doctor if your baby is acting oddly, has a history of seizures or a chronic illness, or just because you're worried — GPs expect to hear a lot from new parents. Call immediately if:
• A child younger than three months has a temperature of over 100 degrees F / 37.7 degrees C
• A child between three and six months old has a temperature over 101 degrees F / 38.2 degrees C
• A child older than six months has a temperature that reaches 103 degrees F / 39.2 degrees C
• Any fever lasts more than three days.
What is a febrile convulsion?
If your child's temperature rises suddenly, causing her to turn pale, stiffen, twitch uncontrollably, and perhaps even lose consciousness, she's having a fever-induced seizure, known as a febrile convulsion. It's frightening to watch, but it rarely harms the child. Although they may seem to last forever, these seizures usually continue for only 20 seconds, and rarely more than two minutes. In the event that a convulsion lasts more than four minutes, call for an ambulance or take your baby to the Accident and Emergency department immediately.
While she's having the seizure, don't restrain your baby in any way. Just loosen any tight clothing and remove anything in her mouth, such as a dummy or food. (She won't swallow her tongue.) Call your doctor when the seizure has finished.
How do I detect a fever?
Parents can usually tell if their child has a fever by touching or kissing her brow (studies show that this method is accurate about 75% of the time). Use a thermometer to get an exact reading. Don't use an oral (mouth) thermometer until your child is three years old. If your baby is too young to have a thermometer in her mouth, a temperature reading taken from her armpit will be accurate enough to tell if she has a fever. Hold the bulb end of the thermometer in the child's armpit with her elbow against her side for about five minutes (the newer digital thermometers beep when they've finished the measurement). Underarm readings register one or two degrees lower than internal readings, so make the adjustment upwards.
What can I do to treat my baby's fever?
You don't need to treat a fever unless your child is very uncomfortable, or if she's had febrile convulsions in the past. Here are some fever-soothing measures:
• If your child has a fever, you can give her a dose of paracetamol suspension such as Calpol or Disprol to bring down the temperature. Follow the dosage instructions carefully, and talk with your doctor first if your baby is under three months old. Your doctor may recommend ibuprofen instead, but never give a baby or child under 12 aspirin, which has been linked to Reye's syndrome, a rare but potentially fatal illness.
• Dress your baby in light, cotton clothing (don't bundle a baby to burn out the fever).
• Keep her room cool. If necessary, place a fan near the cot, and use only a sheet or light blanket for covering.
• Give lots of fluids. Small babies need plenty of what they usually drink — breast milk or formula. If you've already introduced other drinks, offer ice lollies, clear soups, or diluted fruit juice.
• Try a sponge bath. Put your child in a shallow bath of lukewarm water, and rub her body, one area at a time, with a lightly wrung flannel or sponge. Don't dry her off; let the water evaporate. This will reduce her fever in 10 to 20 minutes.
What shouldn't I do?
• Don't restrict your child to bed. Although she shouldn't be allowed to over-exert herself, moderate activity is fine.
• Don't starve a fever; sick babies need plenty of calories and liquids.
• Don't worry too much. Some babies may have a fever and act perfectly fine, others may suffer a little, but with the right care, you'll find your baby back to normal soon.
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