Fever in Children: What Every Parent and Doctor Should Know.

 Introduction

Fever is one of the most common reasons parents take their child to the doctor. It can be scary, especially when a child is very young or the fever is high. However, fever itself is not a disease—it’s the body’s natural response to infections.

For parents, understanding when to worry and how to manage fever at home is essential. For junior doctors, a systematic approach to fever helps in diagnosing and treating children effectively. This post will cover what every parent and doctor should know about childhood fever.

What is a Fever?

Fever is a temporary rise in body temperature, usually due to an infection. A child is considered to have a fever if their temperature is:

 • ≥38°C (100.4°F) rectally (most accurate in infants)

 • ≥37.8°C (100°F) orally

 • ≥37.5°C (99.5°F) under the armpit (axillary)

Fever itself is not harmful—it helps the body fight infections. However, the cause of the fever is what matters.

Common Causes of Fever in Children

Most fevers are caused by:

✔ Viral infections (flu, common cold, hand-foot-mouth disease, etc.)

✔ Bacterial infections (ear infections, pneumonia, urinary tract infections)

✔ Post-vaccination response

✔ Teething (mild fevers only, usually <38°C)

While most fevers are viral and resolve on their own, some require medical attention.

When Should Parents Worry?

As a parent, you should seek medical help if your child has:

 • A fever in a baby under 3 months old (>38°C is considered serious)

 • A high fever (>39°C) that doesn’t respond to medication

 • Lethargy, difficulty waking up, or unusual drowsiness

 • Fast breathing or difficulty breathing

 • Persistent vomiting or refusal to drink fluids

 • Seizures (febrile convulsions)

 • A rash that doesn’t fade when pressed (possible meningitis)

If in doubt, always consult a doctor.

Approach to Fever (For Junior Doctors)

A child presenting with fever requires a structured assessment:

1. History-Taking:

 • Onset & duration (sudden or gradual?)

 • Associated symptoms (cough, rash, vomiting, diarrhea, ear pain?)

 • Recent sick contacts?

 • Immunization status?

 • Travel history?

2. Physical Examination:

 • Vitals: Temperature, heart rate, respiratory rate, oxygen saturation

 • Look for signs of serious illness: Meningeal signs, dehydration, respiratory distress

 • Localize the infection: Check ears, throat, lungs, skin, and abdomen

3. Investigations (If Needed):

 • Mild viral fever: No tests needed

 • Prolonged fever (>5 days): CBC, CRP, blood culture

 • Suspected UTI: Urine analysis

 • Severe cases: Blood culture, lumbar puncture (if meningitis suspected)

4. Management:

 • Viral infections: Supportive care (hydration, rest, fever control)

 • Bacterial infections: Antibiotics only if indicated

 • Severe cases: Hospitalization if sepsis, meningitis, or dehydration is suspected

How to Manage Fever at Home (For Parents)

 • Keep your child hydrated: Breastfeeding, formula, or small sips of water (if age-appropriate)

 • Dress them lightly: Avoid overdressing or heavy blankets

 • Use fever-reducing medication if needed: Paracetamol (Acetaminophen) or Ibuprofen (if older than 6 months)

 • Monitor for red flags and seek medical help if needed

⚠ Avoid:

❌ Over-the-counter antibiotics (not needed for viral infections)

❌ Aspirin (risk of Reye’s syndrome)

❌ Ice baths or alcohol rubs (can be dangerous)

Conclusion

Fever is the body’s defense mechanism, not an illness itself. Most fevers are mild and resolve without treatment, but knowing the warning signs is crucial. Parents should focus on comfort and hydration, while doctors should take a systematic approach to diagnosing and managing fever.

If you found this post helpful, share it with other parents and healthcare professionals! Feel free to leave any questions in the comments.