Infant fever

Fevers are fact of life for most children. In most cases they are nothing to worry about, but it is important to monitor the symptoms closely and to seek medical advice if they persist.

What is a fever?

Fever has been defined as a body temperature elevated to at least 1F above the 'normal' of 98.6F (37.0C).

A baby's temperature normally varies by as much as 2F, depending on the temperature of his surroundings, clothing worn, degree of stress, level of activity or time of day.

What prompts a fever?

In most cases a fever is the body's reaction to an acute viral or bacterial infection. Raising the temperature helps create an inhospitable environment for viral or bacterial invaders, it also stimulates the production of disease-fighting white blood cells.

Why are babies prone to fevers?

The body's temperature control system is not well developed in babies.

Infant and childhood fevers can be caused by a number of different factors including:

• Overexertion
• Dehydration
• Mosquito bites
• Bee stings
• Allergic reactions
• Viral or bacteria infections

What are the symptoms?

Typical symptoms of a fever include coughing, aches or pains, an inability to sleep and shivering.

Other symptoms include poor appetite, lethargy and prolonged irritability.

In some cases breathing may be difficult.

What are the treatments?

Dehydration is a risk for infants, and a feverish baby should always be given lots of fluids.

A child with a temperature of less than 102F (38.8C) does not always require immediate medical attention. The child should be observed, and help sought if the symptoms appear to get worse, or the fever does not subside within 24 hours.

A child with a temperature of 102F or higher should be given paracetamol. A doctor or pharmacist should be consulted for a recommended dose.

A doctor's advice should always be sought for a child whose temperature is 104F (40C) or higher.

Children should not be given aspirin. Several studies link aspirin use in children with Reye's Syndrome a severe illness that often is fatal.

Are there danger signs?

Certain symptoms, when combined with a fever, warrant an immediate call to the doctor. These include:

• Red spots on the skin, sensitive eyes and runny nose (measles)
• Red, itchy spots (chicken pox)
• Stiffness in the neck or headache (a sign of a more severe infection)

Febrile seizures

Occasionally, a child with a fever will have a seizure. This is called a febrile seizure, and it demands immediate attention from a doctor.

The seizures do not seem to be related to the height of the fever, or to the rapidity with which it rises, but a small number of children seem to be predisposed to attacks.

About 50% of the children who suffer one febrile seizure will go on to have another one. About 33% will have a third one.

While waiting for a doctor to arrive, it is important to follow basic instructions:

• Keep the child upright and make sure they are breathing well
• Stay with the child and talk reassuringly
• Watch for changes in breathing, and make sure that the airways are kept open
• Clear the area to prevent injury
• Do not restrain as this can cause additional injury
• Try placing a soft pillow or blanket under the child's head
• Loosen clothing to prevent injury and ease discomfort
• If vomiting occurs, turn the head to the side so there is no risk of his choking on inhaled vomit