Fevers

Treatment

A child with a fever usually won’t need to take fever-reducing medication. In fact it is best to allow the fever to run its course because this is the bodies natural immune system fighting off the virus or infection. A fever actually helps the body destroy its microbial invader. It also stimulates an inflammatory response, which sends all kinds of substances to the area of infection to protect the area, prevent the spread of the invader and start the healing process.

In a study of 72 children, those who weren’t given drugs known to reduce fever recovered faster. Likewise, a study of 56 people infected with one of the viruses that causes the common cold found that those who took certain fever-reducing drugs remained infectious for longer.

The decision to use fever reducing medication should be primarily based on managing your child’s comfort.

When to see a doctor

See your child’s regular health-care provider or go to the nearest Emergency Department right away if your child has a fever and:

Your child is less than three months old.
You have recently returned from travelling abroad.
Your child develops a rash that looks like small purple dots that do not go away when you apply pressure with your fingers (blanching).
Your child is not able to keep down any fluids, is not peeing and appears dehydrated.
Your child’s skin looks very pale or grey, or is cool or mottled.
Your child is in constant pain.
Your child is lethargic (very weak) or difficult to wake up.
Your child has a stiff neck.
Your child has a seizure associated with fever for the first time or a long seizure associated with fever.
Your child seems confused or is showing changes in behaviour.
Your child does not use their arm or leg normally or refuses to stand up.
Your child has problems breathing.
Your child cries constantly and cannot be settled.

See a doctor within one to two days if your child has a fever and:

Your child is between three and six months old.
Your child has specific pain, such as ear or throat pain that may require evaluation.
Your child has had a fever for more than three days.
The fever went away for more than one or two days and then came back.
Your child has a bacterial infection that is being treated with an antibiotic, but the fever is not going away after two to three days of starting the antibiotic.
Your child cries or has pain when peeing.
You have other concerns or questions.

Myths about fever

It can be very scary as a parent or caregiver to see your child with a fever. There are many myths about fever, and some of these myths may make you more worried than you need to be. If your child has a fever, the most important thing is how your child looks and acts, not the number on the thermometer.

Myth: Fever needs to be treated with medication

The fever is a sign that the body is fighting off an infection. The fever itself is not dangerous and does not need to be treated. Children with a fever are often uncomfortable, so medication should be used to make your child more comfortable when they have a fever. If your child is comfortable with a fever (either awake or sleeping) you do not need to give them fever medication.

Myth: The exact number of the temperature determines how sick my child is

The most important part of assessing a child with fever is how the child looks and acts, especially after treating the fever with medication. For example, a child who appears well but has a high temperature is less concerning than a child who only has a mild fever, but who appears unwell or not waking up properly or able to drink fluids. Some viral illnesses like the flu may trigger high fevers, while some serious bacterial infections may be associated with an abnormally low body temperature. Just because a fever is higher or lower, does not help the health-care provider to decide which child needs antibiotics. It is useful to measure your child’s temperature so you can keep a record of the number of days of fever.

Myth: Fevers cause brain damage

One of many parents’ biggest worries is that a high fever can cause brain or organ damage. Fevers caused by infections are less than 42°C (107.6°F). These fevers do not cause brain damage. Only a persistent body temperature greater than 44°C (111.2°F), which a person might get from heat stroke or after exposure to certain street drugs or medications, such as anaesthetic or some psychiatric medications, can cause brain damage.

Myth: Fevers are bad for children

A fever is a sign that the body’s immune system is fighting an infection. Fevers help to fight infections because many germs do not survive as well at slightly higher body temperatures. So, most fevers have a beneficial effect despite your child’s discomfort. The main reason to use medication is to make the child feel better.

Myth: Fevers should always respond to ibuprofen or acetaminophen

These medications help make children feel more comfortable but may only reduce the fever by 1°C to 2°C (2°F to 3°F) and may not bring the temperature down to normal. Sometimes a fever continues even after giving ibuprofen or acetaminophen. Just because the medication does not bring your child’s temperature down to normal, does not mean there is a more dangerous cause to the fever.

Myth: Fevers should respond quickly to antibiotics

Antibiotics are only useful in treating bacterial infections. The antibiotic will start working to fight the bacteria as soon as your child takes it, but it may take two to three days before the fever goes away. Antibiotics will not make your child feel better or make their fever go away if they have a viral infection. Since most infections in children are caused by viruses, an antibiotic will be of no use in these cases.

Myth: Treating the fever will prevent febrile seizures

In all the research that examines ways to prevent febrile seizures, treating the fever with medications will not prevent febrile seizures and it is not necessary to use medications for this purpose. Febrile seizures usually run in families and are more likely to happen at the beginning of your child’s infection. Sometimes febrile seizures happen before you even know that your child is getting a fever.