All About Fever

Fever is a symptom and not a diagnosis or a medical condition. The most common cause of a fever in children is an infection; mostly viral but in some cases a bacterial. One of the challenges in evaluating children with fever is trying to determine the cause, or at least to make sure it is not due a bacterial infection. This distinction is important, as viral infections do not need antibiotic treatment, but bacterial infections usually do. More rarely there are other, so called "non infectious" causes of fever, but in this circumstance, the fever persists for prolonged periods of time(weeks or even months) rather than just for a short period coincident with a current infection. Fever is part of the overall picture. In general, the younger the child, the sicker looking the child and/or the longer the fever persists, the higher the chance of a bacterial infection. Also as important as the degree of fever is how a febrile child generally looks. A sick looking child with a low fever may be more ill than a very well, active child with a higher fever.

Taking A Child's Temperature

There are 3 ways to take a child's temperature:
Rectal: this is the most exact reading and is recommended for children less than 5 years of age
Oral: (by mouth): recommended for children older than 5 years of age
Axillary: (armpit): this is the least precise way to measure the temperature

The Normal Body Temperature

The average (normal) body temperature is usually 98.6º F (37ºC), rectally. However there are ranges of normal temperatures depending on how the temperature is measured:

The normal temperature range when measured rectally is: 36.6º - 38º (C), or 97.9º - 100.4º (F)
The normal temperature range when taken by mouth is: 35.5º to 37.5º (C), or 95.9º - 99.5º (F)
The normal temperature range when taken from the armpit is: 34.7º to 37.3º (C), or 94.5º - 99.1º (F)

What Body Temperature Is Considered To Be Fever?

A child is considered to have a fever if:
The rectal temperature is greater than 38º (C) or 100.4º (F),or
The oral( by mouth) temperature is greater than 37.8º (C ) or 100º (F),or
The armpit (axillary) temperature is greater than 37.2º (C) or 99º (F)

Measures To Help Lower The Fever:

Lowering the temperature with Acetaminophen or Ibuprofen can help your child feel better and be less irritable. It usually takes up to 60-90 minutes for the fever to go down. If fever medication does not bring the temperature down, the child could be given a lukewarm sponge bath. Do not use cool or cold compresses or baths and never use alcohol sponging. Also children with fever should not be overdressed.

WHEN TO CALL YOUR DOCTOR ABOUT YOUR CHILD'S FEVER

Worrisome or alarm signs needing immediate medical attention include:

• the fever is higher than 39.5º C(103ºF)rectal or
• the child appears unwell or unusually ill (this applies even when there is no fever) or
• persistent fever(more than 3-4 days) or
• the child is less than 6 months of age

Information provided on this site is designed to be an educational aid only. It is not intended to replace the advice and care of your child's physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition, always consult a physician.

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Could my baby be sick? How to read your baby's sick signs

When they're too little to tell you how they're feeling or what's hurting, parents have to read some other signs to know if their bub is sick. Sydney GP Dr Ginni Mansbergr has the following must-read tips for parents of littlies.

What's their temperature?

For babies and toddlers, their body temperature is like their health barometer. If they're sick, it's very likely their temperature will shoot up – and it can happen in a flash, says Dr Mansberg.

She advises all parents to ensure they have a decent thermometer in the house – her preference is the digital ones that go in the ear – so they can know for sure what their bub's temperature actually is.

• Find out here the best ways to take a baby's temperature

"The touch-test is just not accurate enough. A baby can feel like they're burning up but be 37°C. GPs love a parent who can turn up to an appointment with a fairly accurate record of their baby's temperature," she says.

Fever facts

• Anything over 37.5°C is a fever.
• Any fever in a baby under the age of three months should be investigated by a doctor as soon as possible.
• Any temperature over 38.5°C in a baby under six months old should be investigated as soon as possible.
• If a baby is over six months old you can observe and see how your baby is the next day.
• A fever is the body's way of combating germs so if your baby is not suffering too much don't jump straight in with analgesics.

"Sometimes babies can have a fever and not be showing any signs of being sick," says Dr Mansberg. "If they're over three months old and still taking in fluids and not being listless and crying a lot, you don't need to see the doctor straight away.

Are they dehydrated?

This is another key sign to look out for because dehydration can be deadly, says Dr Mansberg. Again, when your littlie can't tell you what's going on, parents need to be very observant because the effects of dehydration can take hold very quickly in babies under two years.

And the easiest dehydration symptom to spot is the number of wet nappies. "If parents notice that their bub is doing hardly any wee, or what is in the nappy seems very yellow and concentrated, then it sounds like baby is dehydrated," says Dr Mansberg.

Other things to check include:

• The moistness of the mouth
• If they are floppy or listless
• If their fontanelle seems especially sunken, although that can be hard for even the most observant parent to spot, says Dr Mansberg

"If babies are off their milk or having diarrhoea, then the chances of them becoming dehydrated are very high," she says. "If they are showing any signs then parents should head straight to the doctor. Babies don't need to be very dehydrated to end up on a drip."

What's that rash?

With their links to serious illnesses like meningococcal and meningitis, it's understandable that rashes cause lots of anxiety in parents. But there are many viruses, allergies and conditions that can cause rashes in babies.

Dr Mansberg says that if a rash is accompanied by a fever, it's advisable to seek immediate medical advice. "GPs would be on the look out for a purply, blotchy rash all over baby's legs – but any parent concerned should go straight to their doctor."

Another common cause of viral rashes is roseola. It's a mild virus which also causes babies to have a temperature and feel unwell for a few days. Rashes are also symptoms of measles and rubella which can have complications, so if on doubt, see your GP.

Is baby listless, whingey or unresponsive?

This is usually a giveaway that baby is not well at all, particularly when accompanied by a fever. If your baby is under three months old, you need to head straight to the doctor.

"This is one of the main signs a GP looks out for because if the baby has a fever too then this show the baby is quite sick," says Dr Mansberg.

Ongoing diarrhoea

"Diarrhoea is not the issue," she says. "The big issue is whether the diarrhoea is causing dehydration and, in a baby or toddler, that is very serious."

Dr Mansberg says a bout of gastro in a baby can often lead to ongoing but not serious diarrhoea caused by lactose intolerance. "Babies can have diarrhoea for up to a month after having a tummy bug and if that's the case I would advise parents to take their babies off lactose for a while."

Abnormal crying

This one can be a tricky sign to read for parents, says Dr Mansberg. "If your baby screamed in pain when having their immunisations, that's probably the closest parents have got to hearing a cry in pain."

A high-pitched, moaning cry or whimpering is a sign of meningitis, according to Australia's Meningitis Centre. As a rule of thumb, if the crying does not sound normal to you, seek medical attention immediately.

Trust your instincts

Most of the time parents can sense when all is not well with their bubs. If a parent has any concerns at all they should always contact their doctor. "It's what GPs are there for – and if you have a small baby your doctor should be able to see you that day, particularly if your baby has a fever," says Dr Mansberg.

She advises parents to not be fobbed off or sent home without answers by GPs or hospital emergency rooms. "If your baby has a fever and is obviously not well, then something needs to be done. Research has found that many babies get sent home when they actually have serious bacterial infections like pneumonia or a urinary tract infection. Don't be afraid to ask questions or for more investigation."

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