fever

What is fever?

Children suffer from fever far more often than adults. Even with small, harmless health disorders, their body temperature rises.

Fever is not a disease, but a protective reaction of the body against infections. The increase in temperature causes the body to mobilize its defenses and to act against a wide variety of pathogens on its own. Viruses and bacteria can reproduce less with fever than with normal body temperature. When a child is feverish, it helps itself, so to speak. High fever (above 39 ° C) can severely impair important bodily functions and is a very great burden for the organism.

The hypothalamus in the brain functions as a "control center" for maintaining the optimal body temperature, which is normally between 36.6 ° and 38 ° Celsius. In the event of an infection, this setpoint can be adjusted by certain messenger substances in the body. Then a "healthy" body temperature of 37 ° Celsius can be felt as too cold. The body reacts with chills and creates a fever so that certain metabolic and defense processes can run faster. This mechanism can sometimes fail in babies, so they can be seriously ill even if they do not have a fever.

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In most cases, you can tell from the outside that the child has a fever. The face is hot and red, the eyes look tired, the skin on the body cool and pale. Some children are fussy with fever and have little appetite. If fever is suspected, the body temperature must be measured immediately.

Healthy children have a body temperature between 36.5 ° and 37.5 ° Celsius. If the temperature is between 37.6 and 38.5 ° Celsius, the child has an elevated temperature. In some children, temperatures between 38.0 and 38.5 ° Celsius can indicate an illness. From 38.5 ° Celsius one speaks of fever, at over 39 ° Celsius the child has a high fever. One speaks of hyperthermia when the temperature exceeds 41 ° Celsius.

The body temperature fluctuates depending on the time of day. In the morning the temperature is usually 0.5 ° Celsius lower than in the early evening. In children who run wild and are physically active, the body temperature is often increased.

Young infants can have severe infections without developing a fever. At this age, parents should therefore see the pediatrician without a fever if the child

has an unusual skin tone,
don’t want to drink two meals,
Rash shows,
repeatedly vomits,
Has diarrhea or
behaves differently than normal, e.g. is particularly lethargic and reacts little.

In a child who is younger than three months, parents should consult a pediatrician from a body temperature of 38 ° C. If the child is older, then they should have it examined at temperatures above 39 ° C. Parents should introduce their child to the pediatrician even if the fever occurs in batches or repeatedly, for more than a day in a child under two years of age or for more than three days in an older child.

Measure fever without pain

A thermometer measures most precisely in the intestinal exit (rectally). For insertion, you should smear the tip with white petroleum jelly so that the metal slides more easily. Place your child on his lap on his lap or with his legs pulled up sideways in bed so that he does not tense up. As soon as you feel resistance or after about 2 to 2.5 cm, you should stop. Do not leave small children alone with the thermometer, but hold the thermometer until the signal sounds.

Measurements in the mouth require the child to participate well and should only be carried out in children aged five and over – ideally 20 to 30 minutes after eating or drinking. The tip of the thermometer should be placed under the tongue and the child should breathe through the nose during the measurement process. Body temperature measured under the armpit is the least accurate in smaller children. This method should therefore only be used for older children or adolescents with reliable armpit closure during the measurement. With an ear thermometer there is a risk that ear wax or drafts will distort the result.

What to do if you have a fever?

If the child has a fever, one should regularly measure the temperature, make a note of the values and notify the pediatrician when visiting. At a slightly elevated temperature, no antipyretic measures are required. If the temperature rises significantly above 39 ° C, parents can, in consultation with the pediatrician, use antipyretic agents (e.g. with ibuprofen or paracetamol). It helps / help e.g.

antipyretic suppositories or juices suitable for children,
Calf wrap (except for chills),
damp, lukewarm washcloth on the forehead,
drink a lot so that the body does not dry out,
Change bed linen, towels etc. frequently,
Adhere to bed rest.
If the fever is high, do not wrap the child too warmly so that it does not overheat.

Parents, in particular, must not give acetylsalicylic acid (ASA), especially to young children, because this may trigger fatal Reye syndrome, a rare liver and brain disease.

When should you contact the pediatrician??

A pediatrician should be consulted or called if:

the fever persists for more than a day,
the fever does not decrease despite suppository and calf wrap,
other symptoms such as diarrhea, vomiting, abdominal pain, rash, etc.,
the fever with a febrile seizure,
despite effective antipyretic measures, the child is still significantly impaired

The examination by a pediatrician can clarify why the child has a fever in 90% of the cases. Most often are otitis media, sore throat, cough, gastrointestinal infections or "typical" childhood diseases, such as Three-day fever is the cause.

In rare cases, if more serious infections (e.g. pneumonia, blood poisoning, meningitis) or other non-contagious diseases (such as metabolic diseases, rheumatic diseases, immune defects) may be the cause, the pediatrician must carry out further examinations (e.g. X-rays, blood tests).

Technical support: Dr. Ulrich Fegeler

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