AskMeDoctor! Season 4 Episode 9: Fever in Babies & Kids: When to Hit the Panic Button?

Fevers are common among children, but new parents can be extra anxious when it happens to their newborns. After all, babies are still small and fragile and may not be able to handle a fever the way an older child can. New parents may panic if their baby is running a temperature. They may not know what to do. Thankfully, there are ways that a new parent can safely and calmly monitor their baby's condition at home and take the appropriate steps to helping their little one on the road to recovery. In this episode of AskMeDoctor!, we have Dr Chin Wai Seong, a Paediatrician from Dr. Chin Child Specialist Clinic, to help educate young parents on what to do when their baby has a fever. Q1: What is the first thing that I should do if my child has a fever? Dr Chin: First of all, when you suspect your child has a fever (feverish body, crankiness, crying), you should make sure that it's actually a fever. How? Not by using your hand, but with a reliable thermometer. There are many methods and types of thermometers, like the forehead thermometer, the ear thermometer and the classic thermometer that goes under the armpit or under the tongue. It's important to know the advantages and disadvantages for each type of thermometer. But I think for home use, the most economical choice would be the ear thermometer. But parents must know how to properly use it. So, the first thing that parents should do is to verify that it's a fever. You know, it could be a false fever, which could be caused by dehydration or being out in the hot sun while outdoors. Or it could be the mother's hand that feels warm. So, I always urge parents or families with children to always have a thermometer at home all the time. Q2: Is it true that 37.1°C to 37.8°C are low-grade fevers and I should not be worried? So when it comes to body temperature, 37.5°C and above is considered a fever. So that means 37.6°C. Then when the fever comes to 38°C, that’s what we call a moderate fever. Meaning 37.6°C to 37.9°C is considered a low-grade fever. Once the body temperature reaches 38°C, 38°C to 38.9°C, this is called a moderate fever. So once the temperature reaches 39°C, that’s what we call a high-fever. Q3: When should I be worried? At what temperature and after how many days of my child having a fever? A fever is usually highest during the first two days of the infection. Your immune system recognises an unknown enemy attacking your body and it's trying to fight back. As long as the child is active and not dehydrated, then it's okay. Some clues to look for is that they still have a lot of saliva, passing a lot of urine, and not cranky and irritable. You can hold on first. If the fever has not reduced by day three, then it's time to worry. If by day five and the fever doesn't settle, then it's probably a viral fever and you can let the child fight with their own immune system first. But if after day five and the fever is still there, that's when you should see a doctor. Especially if they are showing signs of dehydration, meningitis, drowsiness, crying or other symptoms like vomiting and diarrhoea. So if you are planning to be parents, you must be equipped with some basic knowledge on how to tackle common children's illnesses. Fever after all is not an illness but a symptom of an underlying condition which must be treated. Q4: What kinds of drinks and food should I feed my child when she is having a fever? When our child is fighting off an infection, their whole system will be a bit slower. This includes the digestive system. If your child is experiencing a fever, they may experience loss of appetite which is normal. So don’t be too worried if your child doesn’t eat the whole day. They still have glucose from their fats and other tissues to supply glucose for energy. However, you still need to monitor their water intake and make sure they get plenty of hydration. You can be lenient with their beverage choices as long as they are consuming liquid. But I must discourage canned drinks, especially carbonated ones. When our body is fighting off a fever, we tend to get bloated. Our digestive system is working a little slower and may not be able to digest food well. So if you give your child carbonated drinks, or let them drink too fast, while they're fighting a fever, they may vomit. But as far as drink preferences goes, fruit juices, yoghurt drinks, herbal teas, etc, are okay. And it does not need to just be drinks either. If your baby is old enough for solid food, watery foods like rice porridge and cereal with milk (soft diet) will suffice. But in general, they need to consume more liquids, small amounts at regular intervals. This is especially important to prevent dehydration. One way to detect dehydration is to check your baby's saliva and diapers. If your baby has a fever but has a dry mouth and has not urinated for over 4 to 5 hours, then it's not a good sign. Q5: How many days should I expect for the fever to go away completely? Generally speaking, I will advise parents to monitor the fever. It's important to remember that your body temperature will fluctuate when you have a fever. It goes up and down like a roller coaster. So, you must go along with the fever like a rollercoaster. That said, parents shouldn't treat fever medicine like a cure, because it's not. The fever will reduce and increase, so your fever management must align with these changes. Parents should give the appropriate dose of oral medicine when needed. A fever will generally come down after the third day. There should be less spiking during this time. By day four or five the fever should settle completely. If the fever has not reduced by this time, you should take your baby to see a doctor where they will do further investigation and checking. So in conclusion, day five is a critical point. Having said that, if the parents suspect the child has other symptoms like meningitis, dehydration, vomiting, diarrhoea, cannot drink and if the child is unreasonably crying or cranky, then it's best to see a doctor immediately. You shouldn't wait until the fifth day. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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