Fever- to Treat or not to Treat?

In general, fever is a normal, healthy response of the immune system to an infection in the body. The height of the fever itself is no indicator of the severity of the infection and fever itself is an important part of the body’s fight against the infection. It is important to note that fever itself, less than 41.7 degrees is not dangerous and does not cause any brain damage or other problems whatsoever. Because fever is an indicator of infection, it is important for the doctor to figure out what is the CAUSE of the fever and what is the severity of the infection, but again fever is a symptom of a infection and not a problem in and of itself.

It is important to note that temperature fluctuates throughout the day. The average temperature is 36.5 in the morning and close to 37.5 in the evening/night. Fever until 38 degrees may be caused by exercise, excess layers of clothing or external heating such as baths, saunas, Jacuzzis etc.

While there remains a debate in the medical literature as to whether teething causing fever, if it does cause fever, it is low grade not rising above 38.5.

Most fevers are the result of viruses, which will cause body temperature to be between 38 and 40 degrees. The virus and its fever will usually go away within 2-5 days.

Fever, in and of itself, does NOT need treatment. In fact, fever is an important element of the immune system in fighting against viruses and bacteria. If a child is excessively irritable or sleepy, then one should reduce the child’s fever. In all cases of fever, it is important to increase fluid intake and to decrease the amount of layers of clothing in order to allow the heat radiate appropriately from the skin. Do not wrap a baby in a blanket, and with an older child use only a thin blanket. There are a number of medicines that can be used to reduce fever including Ibuprofen (Advil, Nurofen), or Paracetamol (Acamol, Aldalor). Ibuprofen tends to last longer and will usually reduce fever faster than other fever-reducing alternatives.
Ibuprofen may be used in children older than six months, on condition that the child does not suffer from any blood clotting problems and the child’s pediatrician has not given any other reason not to use the medication. (Besides from these limitations, there is no difference in side effects between Ibuprofen and Acamol products. It is forbidden to use aspirin for children without a doctor’s express recommendation that aspirin be used. Aspirin in children can cause Reye’s syndrome, which involves acute liver failure and severe brain disease.

If a fever goes above 40 degrees, or the child is irritable, one can reduce fever by used a warm bath: fill the bathtub with 2-5cm of water only. Check that the temperature of the water is between 29-32 degrees. Check that the room temperature in the bathroom is around 24 degrees. Do NOT use cold water or alcohol as these will cause the body temperature to drop too rapidly and will cause the child to have shaking chills and in response will cause the body actually to rapidly ELEVATE the temperature.

A small percentage of children will have seizures from fever. These fevers are scary to watch, however, if they are “simple” febrile seizures (lasting less than 15 minutes and there appears to be the whole body moving and not a single limb which is shaking), and they do not return within 24 hours, then there is no danger with these seizures. The likelihood of a seizure is not dependent on the height of the fever, but rather how fast the fever develops (which is usually unpreventable).
Note well: Every baby less than 3 months of age with a fever over 38.0 needs to be checked immediately by a physician. Fever at this age can be a sign of serious infection. Do not give Acamol or other fever reducing substance prior to being checked. In addition, if a child looks very sick, then independent of the age and the height of the fever, they should see a doctor immediately.

Fever should not be checked with an ear thermometer or with a mercury based thermometer. All other thermometers are considered safe.