Fever: what helps your child now
Children often suffer from febrile infections. When to treat fever and what medications help
Hot forehead? Our experts explain what you should do if your toddler has a fever
It feels like it always comes together at the weekend or in the middle of the night, or both. Fever. And with every tenth of a degree that the thermometer shows more, the child often becomes flabby and we parents become more restless. This information now helps:
Nothing bad in itself! Because fever is not a disease, it shows that the immune system works. So it’s a warning sign of illness – most common in childhood for infection with viruses or bacteria. Fever means that the body temperature rises – to over 38 degrees.
"What is important for the definition is not the mere value, but the condition of the child", says Professor Michael Weiß, chief physician of the children’s and youth clinic at the children’s hospital in Amsterdamer Strasse in Cologne. If, for example, a child has romped outside in the sun and the parents measure 38.1 degrees, this is not a fever. On the other hand, if a child has a runny nose, hot forehead, red cheeks, cold hands and is ill, the 38.1 degrees indicate a fever.
If bacteria or viruses penetrate the body, the body tries to ward off the pathogens: it increases its temperature, because then the intruders can no longer reproduce so well. "So fever arises to deal with a crisis situation", explains White.
Children often fever with no clear cause. Widespread viruses or bacteria trigger about 90 percent of all fever conditions, which may be uncomfortable for the person concerned, but are usually harmless.
Very typical in the first years of life: otitis media, bronchitis, tonsillitis, gastrointestinal infection, cystitis – or the very banal cold. In about ten percent of fever cases, there are more serious infections such as pneumonia or meningitis. Rarely are there chronic diseases such as rheumatism.
Because a newborn’s immune system does not yet have any antibodies against many pathogens. Therefore, every time an unknown pathogen penetrates, the mechanism starts to get the intruder ready. "The immune system exercises", says white. When they first come into contact with a virus or bacterium, the little ones usually react with a high fever.
"In the event of a second or third contact, the reaction is less violent due to the immunological protection that is already in place", the pediatrician explains. The fight against the pathogens often lasts only three days (the fever is often higher for this), but five to seven days are absolutely fine.
"Classic rectal measurement is still the most accurate", says pharmacist Bernhard Eiber from Roth near Nuremberg. Important: Insert the clinical thermometer gently, but far enough into the anus, so that it reliably measures the core body temperature. Ear thermometers work well for older children who no longer tolerate fever measurement in the buttocks. "However, there are big differences in quality", says Eiber. Therefore, be sure to seek advice from the pharmacy!
The same applies to forehead thermometers, which measure the temperature over the skin using an infrared sensor. They are suitable for babies with very small ear cups or for children with otitis media for whom ear thermometers are not suitable. However, the measurement only gives a clue. Eiber advises young children not to measure in the mouth or under the armpits. "Both methods are relatively error-prone and too imprecise", he says.
Fever alone is not life-threatening for otherwise healthy children, but it can indicate a serious illness. This happens very rarely, and small patients then show other symptoms. For example, they are no longer accessible or have a stiff neck.
In babies in the first year of life, a fever reaction to an infection is sometimes delayed or not at all. They show in another way that something is wrong: their general condition deteriorates, for example they do not want to drink, they become very pale and are very sleepy.
It depends on the age and condition of the child. "If infants under three months have a fever of more than 38 degrees, parents should immediately go to the doctor with their child – if necessary also to the emergency service or to the children’s clinic", says pediatrician Michael Achenbach from Plettenberg.
The reason: Usually, babies of this age are well protected from banal diseases such as flu infections by protecting their mothers’ nests. "So there is a greater chance that there is a more serious cause behind the fever in such small children", explains Achenbach.
Children between the ages of three months and one year should also go to the pediatrician by the next morning at the latest, one to two year olds if the fever persists for more than a day. The following applies to older children: if the fever persists for more than three days, the child appears very ill or apathetic, the condition suddenly worsens, the child no longer drinks and threatens to dry out, or the fever in the presence of a bacterial disease despite taking an antibiotic after 48 Hours, a doctor should examine the child. Or also when other symptoms of illness are added and parents are simply worried.
If the child suffers from it! "It is not the temperature on the clinical thermometer that is decisive, but the condition of the child", says Achenbach. Means: If little ones are very tired, don’t want to drink anything anymore, can’t sleep because of the fever or the circulation slows down, they should be given an antipyretic.
If the child is reasonably fit, parents can let them fever. "If the fever is suppressed, the body cannot fight the pathogens so effectively", says Achenbach. Some infections then last even longer.
"Paracetamol and ibuprofen are the right remedies for children", says pharmacist Bernhard Eiber. For small babies, the pediatrician usually prescribes paracetamol. "The active ingredient is approved from a body weight of three kilograms", says Eiber.
Children can be given ibuprofen from three months and weighing six kilograms. It is more anti-inflammatory than paracetamol and decongestant. "Ibuprofen is therefore very useful for otitis media", so Eiber. Disadvantage: It attacks the stomach lining. "For stomach ache, I would therefore prescribe acetaminophen", says Achenbach.
Important for both active ingredients: observe the age-appropriate dosage! Agents with the active ingredient acetylsalicylic acid are taboo. "They can have dangerous side effects in children", so Eiber.
Small babies usually have suppositories. They are easy to administer and act quickly. "As soon as children can sit, they can be given juice", says Achenbach. It can be dosed more precisely. "Doctor or pharmacist can calculate the correct dose based on weight to the nearest milliliter", said the expert. This is not possible with suppositories. Basically, however, the following applies: Parents should give what they and their child can best cope with.
In principle, yes. "But a doctor should always order that", says pharmacist Eiber. Some doctors recommend alternating ibuprofen and paracetamol when the fever rises quickly and the time interval until the next dose is not yet over. "But there should also be three to four hours between paracetamol and ibuprofen", says Achenbach. His tip: make a note of the time at which the child took which medication.
"If you have an infection, you should keep calm if possible", says Achenbach. The heartbeat is increased, the body is more burdened by the infection. There is nothing wrong with a quiet ride in the stroller. Kita children should be free from fever for a day before going back to the facility.
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