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Fever in childrenThis factsheet is for people who want to know more about childhood fevers. Average body temperature varies from 36.5 to 37.5°C. A fever is an abnormally high body temperature. Children frequently develop fever, usually due to viral infections that clear up on their own. But occasionally high fever can be a sign of a more serious illness. What causes a fever?Fever is not an illness in itself. It is a sign of other problems in the body, and is usually caused by a viral or bacterial infection. It is thought to be part of the body's natural defence mechanism. Fever can be a symptom of a wide variety of illnesses. For example, certain blood disorders, breathing problems, or inflammatory disorders may cause fever. Fever can also be caused by dehydration and some childhood immunisations. All these conditions trigger the immune system (the body's defence system) to produce chemicals. These chemicals affect a part of the brain called the hypothalamus, the heat-regulating centre in the brain. SymptomsFever means having a body temperature at least 0.5°C above normal on two recordings taken at least two hours apart. As well as having a high temperature, children with a fever are often:
They may also complain of a headache or aches and pains. A rapidly rising fever may cause chills - periods of shivering. In some children between six months and six years old, a sudden increase in body temperature can lead to seizures (fits), which are called febrile convulsions. During a febrile convulsion, part or all of the body may shake and twitch, and the eyes may roll back in the head. Although simple febrile convulsions can be frightening they usually last less than 15 minutes and the child makes a full recovery within an hour. Taking a child's temperatureA satisfactory temperature reading can usually be obtained by placing a digital display thermometer in the child's armpit, directly against the skin, and holding the arm gently against the chest. The reading will be 0.5°C lower than it would be if the temperature was measured with a thermometer in the mouth (oral). This should be taken into consideration when assessing the child's fever. Digital thermometers usually give a reading within a few seconds. Remember to clean the thermometer after use. Another option is a digital aural thermometer that measures the temperature in the ear. A clean cover is placed over the thermometer and the tip is placed in the ear. Pressing the button activates the thermometer and gives an immediate reading. These are now used routinely in hospitals and by GPs and give very accurate readings, but they are expensive to buy. Forehead thermometers and forehead strips, which can be held on the child's forehead, are not very accurate, but give a general idea of the child's temperature. It is best to read a child's temperature before giving any fever-reducing medicines. Treating a feverIn most cases, fever is due to a viral infection and will get better within a day. There is some debate about the best action to take if your child has a fever. Many parents and carers spend a lot of time trying to bring fevers down in children, the theory being that this will decrease the chance of febrile convulsions. But some experts suggest that the fever helps the child to get better, and that it should be left to run its course. Although there is still no definite advice, researchers have looked at the small number of studies on this subject and have come to the following conclusions.
Sweating and shivering can cause dehydration so encourage your child to drink enough. But the actual amount can be hard to gauge. Generally, urine should be pale yellow - if it's darker your child may need to drink some more. He or she will need to drink more if they have diarrhoea or vomiting. Check your child's temperature regularly to check that the fever is under control. When to call a doctorIt can be hard to know when to call your GP or out-of-hours service, as parents often worry that they will be dismissed for making a fuss. Generally, if in doubt, contact a doctor for advice. NHS Direct nurses can give advice 24-hours a day on 0845 46 47 and is a good place to start if you're not sure what to do. Their website (www.nhsdirect.nhs.uk) advises that you contact your GP or go to hospital if your child:
Always seek medical advice if your child develops a fever soon after an operation, or after recently returning from foreign travel. Could it be meningitis?Although it's a rare illness, parents should be aware of the signs of meningitis. Fever is one of the symptoms of meningitis, but there are others to look out for. These include:
The symptoms of meningitis are less specific in children under six to 12 months. Any parent who is worried about their child should contact a doctor straight away. For more information on meningitis, please see the separate BUPA factsheet, Meningitis. Further information
Sources
Published by BUPA's health information team, healthinfo@bupa.com, December 2006.
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