How do I know if my child's fever is dangerous? Signs to look out for — and when to go to the hospital
Fevers themselves aren't dangerous — but they can be a sign of an infection.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.
As winter settles in and flu season looms, parents are confronted with challenges in their children's health. Fevers in children can be a cause for concern, but understanding the basics can help parents navigate this common problem.
Yahoo Canada spoke with Dr. Alia Sunderji, a pediatric emergency medicine physician in Toronto, to empower parents with the knowledge they need to effectively manage fevers.
Here's what you need to know about causes, symptoms and treatments of fevers — and when to go to the hospital.
What's a normal body temperature for a child?
Understanding what constitutes a fever is crucial. Dr. Sunderji emphasized a fever is considered a temperature above 38 degrees Celsius.
However, body temperature can vary, particularly in infants who are often bundled. Parents are urged to focus less on specific temperature readings and more on how their child behaves once their fever is treated.
"The most important thing for parents to know is how to measure the temperature of their child accurately and treat the fever effectively," Sunderji claimed.
While a child may feel warm at 37.5 degrees Celsius — it's not considered a fever.
What causes fevers in children?
Fevers can stem from various causes, with infections being the primary trigger.
Sunderji highlighted while fevers can be indicative of an infection, they don't necessarily pinpoint its severity or whether it's caused by a virus or bacteria.
How to measure a child's fever?
There are four main ways to measure a child's temperature:
Rectally
Orally
In the ear (tympanic)
Under the armpit (axillary)
For infants under the age of two, the best way to measure a temperature is rectally. For a child of any other age, oral temperature measuring works.
How do I know if a fever is dangerous? Signs to look out for
Fevers themselves aren't dangerous. But, they're most commonly a sign your child is fighting an infection.
That's why Dr. Sunderji wants parents not to focus on the number on the thermometer.
"A high fever doesn't help us decide whether a child's infection is mild or severe, whether it's caused by a virus or bacteria," the doctor explained. She added even a child with a low temperature of 38 degrees can be very sick.
"How the child looks and how they behave, particularly once the fever is treated, is more important than the number read by the thermometer," the doctor claimed.
Common symptoms that come with a fever include:
Tiredness
Pale or flushed appearance
Faster breathing
Rapid heart rate
Loss of appetite
However, some symptoms may be indicators that the child may be seriously ill. These would be a sign it’s time to take them to the emergency room:
Inconsolable, crying constantly
Lethargic or difficult to wake up
Appear pale or in pain
Dehydration (unable to keep down any fluids, not peeing often or have dry lips)
A stiff neck
Difficulty breathing
Any fever in a child under the age of three months is a reason for immediate medical attention.
A child with a fever who has recently travelled, or has a known congenital disease or chronic condition, should be evaluated as well.
In some cases, a child should be assessed but doesn't necessarily require a run to the ER. These would include:
If the fever lasts longer than three days
If the fever went away and then came back
If they are on an antibiotic and the fever hasn't gone away
How to treat a fever at home?
The first step in managing a child's fever is giving them acetaminophen (Tylenol) and/or ibuprofen (Advil). Then, parents should observe their child’s behaviour and assess their behaviour, hydration and breathing once their temperature normalizes.
"Parents are often surprised when I tell them that you can give Tylenol and Advil together or one hour apart," Sunderji said.
She explained if a child's fever doesn't go down after one dose of Tylenol within an hour, you can give them an Advil. What matters is that the time between each dose of medication remains consistent. "As long as you maintain the number of hours between the same medication, like Tylenol is administered every four to six (hours), ibuprofen or Advil every six to eight hours, then you're safe."
Encouraging hydration is also key in managing a fever, to compensate for the fluids lost by sweating. Parents can mix apple juice and water, for example, to help their child drink more.
"Parents get very distressed when a child doesn't want to eat, but as long as they're drinking and urinating well, that can be reassuring."
Sunderji reiterated it's important for parents to know how to measure a temperature accurately, but the child's behaviour and other visible symptoms — once the fever is treated — are a better indicator of how sick the child really is.
