Fever in children is usually harmless. A feverish child can usually be cared for at home. The causes of fever can be many- It is important to recognize signs of illness that need medical attention.
At a glance
- A body temperature of 38.5 degrees or higher is called a fever; for infants under 3 months of age, the temperature is 38 degrees or higher.
- fever in children is usually harmless and overcome in 2 to 3 days.
- A feverish child can usually be cared for at home.
- About every 100. Child with fever has a serious illness that needs medical attention.
- Fever rarely rises above 41 degrees and is only harmful in exceptional cases.
Notice: The information in this article cannot and is not intended to replace a doctor’s visit and should not be used for self-diagnosis or self-treatment.
Why does a child have a fever?
Children react to pathogens more often and faster with fever than adults. Children are said to have a fever when their body temperature is at least 38.5 degrees- in infants up to 3 months already from 38 degrees.
For many parents, concern for their child grows as the fever rises. Fever is one of the most common reasons for a child to be brought to the doctor’s office or to an emergency room. But most children have a harmless viral infection. They can be cared for at home and are healthy again after 3 days at the latest. Their body defeats the viruses by itself.
Out of every 100 children with a fever, only about one has a serious illness that needs medical attention. In most cases, the cause is a bacterial infection, for example in the lungs.
What symptoms does a child show when he or she has a fever??
Often you can see it in children when they have fever. Typical signs are: The child has a reddened face and seems tired. The eyes may be glassy and the skin pale. Even if the forehead or neck feels hot If the infant feels sick, this may indicate a fever. Some children cry quickly or have no appetite.
A visit to the doctor’s office or emergency room is necessary if:
- the fever rises to over 39 degrees, in the case of infants to over 38 degrees.
- The fever occurs in episodes or repeatedly.
- it lasts longer than 3 days.
- the child has a febrile seizure.
- It has a stiff neck, seems listless, is restless or confused.
- the child vomits, has diarrhea or abdominal pain.
- it has a skin rash.
- the child does not want to drink for a longer period of time.
- he is worse since the previous visit to the doctor.
What are the causes of fever in children?
Several things can cause a child’s body temperature to rise even though he or she is not sick: for example, if he or she is particularly excited, raging violently, or dressed very warmly. One reason is that children sweat less and later in warm weather than adults. Even when a baby is teething, it can have a fever.
In most cases, however, fever is caused by pathogens. It is then a sign that certain metabolic and defense processes run faster. This is the body’s attempt to fight off the pathogens. So fever is not a disease.
Fever can have the following causes:
- viruses or bacteria: They can lead to a cold, an ear infection, a urinary tract infection, or a gastrointestinal infection, for example. They can also cause typical childhood diseases such as measles,rubella,scarlet fever or chickenpox.
- A vaccination: because the child’s immune system is developing defenses against the pathogens that the vaccination will later protect against.
- Thirst fever: In this case, children are feverish because they have not drunk enough and are dehydrated. This can also happen if a child vomits a lot and has diarrhea.
- Sunburn, sunstroke or skin diseases such as hives.
Rarely, the causes are serious illnesses such as pneumonia, meningitis, appendicitis, a joint or bone marrow infection.
Very rarely, fever is caused by metabolic diseases, rheumatic diseases, or allergic reactions to food and medicines.
If fever occurs after a long-distance trip- even if it was several weeks ago-, it is important to point this out to the doctor. A specific examination can clarify whether and with which pathogen the child could have been infected during the trip.
What is the course of fever in children?
Several parents are concerned that high fevers can become life-threatening. However, fever is only harmful in exceptional cases, such as when it rises above 41 degrees. But this rarely happens.
Fever may lead to a lack of fluids. ÄMedical help is necessary if the child refuses to drink. It may also be needed if the following signs of fluid deficiency persist for a longer period of time:
- A fontanelle is sunken in infants.
- The mouth and lips are dry.
- The eyes are sunken.
- Tears are absent.
- The child looks bad.
Especially in children between 3 months and 5 years, the fever sometimes leads to a febrile convulsion. A simple febrile seizure can seem frightening. It is usually harmless and takes only a few minutes. Nevertheless, a visit to the doctor is advisable after a febrile convulsion.
Are children’s fevers dangerous?
In the following video you will learn which typical children’s illnesses there are and how they manifest themselves.
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How is fever detected in children?
Healthy children have a body temperature between 36.5 and 37.5 degrees. It changes during the day: in the evening the temperature is usually 0.5 degrees higher than in the morning. An elevated temperature is considered to be between 37.5 and 38.5 degrees.
One speaks of fever starting from 38.5 degrees, with babies under 3 months already from 38 degrees.
There are several ways to measure body temperature. Especially for young children, it is important that it goes down quickly- and measuring involves as little effort as possible to dress, undress, or hold still. Mothers and fathers often first feel with their hand whether the child’s forehead or neck feels hot feel.
The body temperature can be measured exactly with a clinical thermometer best three times a day. Measurements with a digital thermometer in the buttocks are most reliable. Many parents also use an ear thermometer or a forehead thermometer. Measuring in the mouth or under the armpit only makes sense when a child is at least 4 years old. How long a reading takes depends on where and with which thermometer you take the fever. The instruction manual provides more detailed information.
For more in-depth information on issues related to fever in children, such as how to measure the fever correctly, see health information.
How to treat fever in children?
Agents that reduce fever are often unnecessary.
However, treatment with fever-reducing medicines such as acetaminophen or ibuprofen as suppositories or juice can be helpful in:
- high fever above 39.5 degrees.
- if the child feels very unwell.
The dosage of the medicine can be found in the package insert. The dosage depends on how old the child is and how much it weighs. If the fever does not go down within one to 4 hours despite the medication, you should ask a doctor for advice.
The active ingredient acetylsalicylic acid (ASA) is not suitable for children and adolescents because it can trigger a rare, dangerous side effect: the so-called Reye syndrome.
Home remedies such as cold calf compresses or lukewarm baths are popular- but they cool the body only from the outside. If these home remedies are beneficial to the child, there is nothing wrong with them. But it is unclear whether they actually help against fever.
A child with fever should not be wrapped up too thickly. Otherwise, heat may build up in the body.
What else can you do when a child has a fever?
Most febrile children can be managed well at home. There is nothing wrong with home care if:
- there are no signs of a serious illness.
- The doctor has diagnosed a harmless infection.
A child who has a fever needs adequate fluids. It is therefore important that the child drinks regularly- even if it is still breastfed. Children sense quite accurately what is good for them. That’s why it helps if you listen to their needs and ask them, for example, "What would you like to eat or drink??“
Child may play all day despite fever. As long as it does not run wild, it is perfectly fine. However, a child with a fever cannot go to the toddler group, kindergarten or school. This is true even if the child appears otherwise healthy. Because it could infect other children.
Children with fever almost always get well again by themselves. The best remedies are usually time, rest, and loving care.
References
- Chiappini E, Bortone B, Galli L, de Martino M. Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II. BMJ Open 2017; 7(7): e015404. Retrieved 18.05.2020.
- Lim J, Kim J, Moon B, Kim G. Tepid massage for febrile children: A systematic review and meta-analysis. Int J Nurs Pract 2018; 24(5): e12649. Retrieved 18.05.2020.
- Massignan C, Cardoso M, Porporatti AL, Aydinoz S, Canto GDL, Mezzomo LAM et al. Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics 2016; 137(3): e20153501. Retrieved 18.05.2020.
- Meremikwu M, Oyo-Ita A. Physical methods versus drug placebo or no treatment for managing fever in children. Cochrane Database Syst Rev 2003; (2): CD004264. Retrieved on 18.05.2020.
- Meremikwu M, Oyo-Ita A. Paracetamol versus placebo or physical methods for treating fever in children. Cochrane Database Syst Rev 2002; (2): CD003676. Retrieved on 18.05.2020.
- Mewasingh LD. Febrile seizures . BMJ Clin Evid 2014: pii: 0324. Retrieved on 18.05.2020.
- National Institute for Health and Care Excellence (NICE). Fever in under 5s: assessment and initial management. NICE Clinical Guidelines; CG 160. 05.2013. Retrieved 18.05.2020.
In collaboration with the Institute for Quality and Efficiency in Health Care (IQWiG). Status: 28.08.2020