My child has a fever - mom is a pediatrician

… and off to the emergency room?

Finally the time had come: my good friend – a young mother who was still fairly new, and I – a young doctor who was fairly new and still childless – wanted to go out together again after what felt like an eternity. (Now you will ask yourself: A young mother and a doctor are going out? Ha! How do they do that? How can they find an appointment? – Yes, sometimes small miracles happen …)

Everything was organized, the babysitter ordered … and then my friend said that she felt that her son was "not quite right". Aaaaber: he is not really sick yet. Yet.

And just in case, this wonderful mother had made the perfect arrangements. She had prepared a piece of paper on which the babysitter was given precise instructions on how to proceed. Namely if the little one gets a fever. The instructions were (apart from the fact that she should of course call the mother):

“At 38.5 ° C: give suppositories. Drive to hospital at 39 ° C. Call the emergency doctor at 40 ° C. "

I was shaken.

You have to say: I wasn’t a mother yet. I was the doctor who was constantly woken up at 2 or 3 at night because of "a little fever". (If I had slept at all …) And it was completely incomprehensible to me how to something like that could write.

Today I would still not on I got the idea to write a note like this, but I know a few thoughts from my own experience …

The fever is so high … my child has something dangerous?
What if the fever rises even higher? How high?.
I am now giving a suppository … no, but not … I am still waiting … or at least …

Fortunately, the pediatrician sits in my head, who reminds me:

Fever is an important function of our body, that helps fight infection. The fever itself is not the disease.

An example: a child is sick, for example sore throat, and feverish.

If we lower the fever now, the sore throat will not go away. So the child is still sick. Only then you notice that less.

However, our body can fight the sore throat much better if it develops a higher temperature.

So it does not make sense to suppress the fever and to think: this will help my child (faster) get well. Rather the opposite.

The child is healthy when the illness is gone (here the sore throat) and not when the fever is gone. And if we keep lowering the fever, we disturb the body’s defense work. So it’s about treating the CAUSE of the fever!

Now there may be questions like:

Yes, but when can I lower the fever??

I would not make the question of lowering fever dependent on the temperature, but rather on the condition of the child.

(Warning: this of course applies to children who are otherwise healthy, that means, for example, that they have no metabolic disease or disturbed temperature regulation due to another underlying disease. However, I assume that parents of these children will be advised by doctors who are specially experienced with these diseases and know that different rules apply to your child. If you are not sure: please always ask!)

If the child – an otherwise healthy child – is still relatively alert at 39.5 ° C, you need not routinely lower the temperature.

However, if the child is impaired and so weak that, for example, he no longer wants to drink, and if he also loses liquid due to diarrhea or vomiting, you can give him some relief by lowering the fever. Or help him calm down better at night.

What can happen if the fever keeps rising??

The fever does not rise indefinitely in otherwise healthy children. We have a center in the brain that regulates the temperature and cannot rise above about 41/42 ° C. Temperatures above 42 ° C, which would be dangerous for the body, arise from other causes, such as heat stroke in a heated car.

The child is not necessarily well in the context of normal fever: restlessness, malaise, fatigue, fever fantasies etc. occur, but the fever itself is not dangerous. (It could be the disease behind it, so you should have your child examined sooner or later depending on age and condition – see below).

Aaaber: What about febrile seizures? You get that if you fever too high?

Anyone who has ever had a febrile seizure knows how threatening it can look. No parent wants to experience something like this a second time.

Unfortunately, you probably have an inherited tendency to develop febrile seizures (or not). So: one tends to have febrile seizures, the other doesn’t. Comforting: That grows out. There is only a slightly increased risk of still suffering from seizures later, i.e. after infancy.

In schoolchildren with a high fever, no more febrile seizures are to be expected. And if you do not tend to develop febrile seizures, you will not start to suddenly cramp because you have a fever of 40 ° C for the first time.

A child who is prone to febrile seizures can even with a very low fever already have a febrile seizure. Or even with "just a little infection" or after a vaccination. The fever doesn’t have to go up.

It was previously common to tell the parents of such children after the first febrile seizure that they should always lower the fever early, from around 38.5 ° C. This is now out of date: parents should have an emergency suppository at home that can interrupt an extended seizure, however Lowering fever doesn’t help.

Attention: If a child has a febrile spasm: be sure to see a doctor (You can also call the emergency doctor!). There are more serious illnesses that can be behind a seizure and that must be excluded. (But again, fever is not the cause.)

And when should I go to the doctor when my child is feverish??

If an infant has a temperature above 38.5 ° C, it should be examined. (Of course, if the child appears sick or has other worries, certainly earlier. And note where you measured: 38.5 in the buttocks can sometimes only be 38.0 in the ear.) The examination on the same day – but in peace and without flashing lights.

Larger children can also have a fever for 2-3 days without having to go directly to the pediatrician. It is often not immediately apparent what the cause of the fever is anyway.

Of course it is different, if there is pain or other symptoms besides the fever, the pediatrician will be happy to help.

In summary:

I hope that with this article I could contribute to that

Fever is not automatically reduced immediately if the child is well
it is understood that fever is not a disease, but a sign that our defense function is active and even helps the body to fight back a disease better
one or the other emergency doctor intervention is spared for all involved: the parents, the doctor, but above all also the child.

By the way: my friend asks to mention that she can now withstand a relaxed three-day fever for her second child at 40 ° C. I should like to mention that what I’m doing here ….

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It’s a great post. Your friend’s note is so awesome. Honest. Ick can understand them. The conversation "suppository yes or no" is also great. It is exactly like that. &# 128521; Lg, Dajana

Thank you, I’m happy &# 128578; Yes it is… &# 128578; Lg, Johanna

Great blog start article, Johanna! This is what … &# 128578;

best regards
Holger

Thank you … if the expert says I am of course particularly pleased with mic &# 128521;

Plus "e" at the end of the class ….

Thank you for the great text! But what exactly does "prolonged seizure" mean? What febrile seizures do I have a suppository for? If it continues until I get the suppository? Best regards, Pauline

Hello Pauline, thank you for your contribution and the good questions – very attentive &# 128521; 2 options: 1. If your child has not yet had a febrile seizure, you will certainly not have the appropriate medication at home and will probably call the emergency doctor. In any case, look at the watch to indicate how long the cramp lasted. When the emergency doctor arrives, the cramp is usually already over. If your child still cramps, the emergency doctor will give you a medication. Of course, it should also be examined, because in the event of a seizure – especially if it is the first one – one must rule out more serious causes. Option 2: You have suppositories (a so-called benzodiazepine) at home because you already have febrile seizures. Then you will surely deal with the situation a little more relaxed – even if it is still a terrifying sight again. The cramp usually doesn’t last very long, but if your child still cramps after 3 minutes, it is recommended that a benzodiazepine be given. After 1-3 minutes, the cramp should be over. If the cramp lasts 5 minutes or more, the risk of a so-called “status epilepticus” increases, which is a seizure over 30 minutes. In terms of the duration of a seizure, a total distinction is made between whether it lasts more or less than 15 minutes and thus (among other criteria) distinguishes an uncomplicated from a complicated seizure. The distinction is made so that forecasts can be made. To describe all of this would now go a little too far and is secondary for you in the acute situation. At the moment of the febrile seizure, it is important for you as a mother: look at the watch, give suppositories (benzodiazepine) after 3 minutes, and when the seizure stops and you have already been tested for febrile seizures, an inpatient examination is not necessary. If the cramp doesn’t stop despite the suppository, or for some reason you have an uncomfortable feeling despite experience: Call an emergency doctor. And also: keep calm and help your child with it as best as possible … I hope that I could help you with it. Best regards, Johanna

Thank you very much for the detailed answer! And thanks for the blog, I’m looking forward to more articles. Greetings from Berlin,
Pauline

Well written and so it was – on all points. We are going through an seemingly endless period of fever and I also know the conversation "Suppositories yes, no, yes, oh, I’m still waiting! or now? "Too good. But it really is like that, with each child you become more relaxed and with the third child you can endure a few days with a body temperature of 40+ …

Thank you, Sandra…. yes, with the first children there is still practice, then you become more and more relaxed, and I wonder when you’ll be toootally relaxed… from the 5th / 6th. child. &# 128521;

Thanks for that! I often get a big look when I tell casually that my daughter has a 39.5 fever and I don’t give a suppository, just because she is "in a good mood". But I also gave one at 39 because she wasn’t feeling well. You really have to weigh it up, but this instant knocking down is really nonsense.

Yes, weighing is just the great art that you sometimes have to learn. But it already seems to work for you &# 128578;

My daughter had a temperature of 38.2 ° at 6 weeks. Thank god we were like going to the hospital! We stayed there for 10 days. Urinary Tract Infection.
Just on the sidelines ….

Thanks for your contribution! You bring a great example of what is very important for me to express: the level of the fever and the fever itself is not the decisive factor. What is important is what is behind it. In your case, the urinary tract infection. Your child had an illness that was not particularly hot and had to be treated in the hospital. Another child has a very high fever, but the disease (e.g. 3-day fever) is straightforward and goes away on its own. That is why it is so important to have a child examined if he is not doing well. If a child is as small as your daughter, it is of course more difficult for parents to assess how he is doing than with a larger child. Therefore, let a doctor look at it once more. You don’t have to call an emergency doctor; You can go to the hospital if the pediatric emergency service is there or if you expect (as I said with such a small child) that the child will be admitted to the hospital.

The article was great. Our daughter is 18 months and was operated on for the third time in January on the brain (tumor). We have now had a fever of 3.5 weeks. Most days with suppositories because she was really bad. On good days we let them fever at +39. The doctors were not sure whether it was a central fever or other reasons. After two weeks, more detailed examinations were finally carried out and bacteria were found in the wound … Thank God the fever is gone, but the bacteria are still there despite ten days of antibiosis.

I have two other children, where I now let myself feverishly relax. &# 128515;

Dear Jule, that sounds like a very hard time … I wish your daughter and you as a family all the best and lots of strength!

Hi there
Is there actually a pain reliever that is not antipyretic at the same time? Because, for example, with a middle ear infection, I would like to relieve the pain of my daughter but not actually lower the fever.
best regards

Hello Ela,
great question, thanks! I know the problem only too well… Unfortunately, it really is that you don’t have such a large selection of non-prescription medications. Earache can really hurt a lot, and what helps is ibuprofen or acetaminophen (although I have had better experience with the pain so far with ibuprofen). They are both antipyretic. Much stronger medication (opioids) would not be antipyretic and strong against pain, but it would in no way simply be given for ear pain. I do it with my children so that when I have an earache I try first whether a warm cherry stone pillow or an onion sachet is good for them. It works now and then, but mostly the pain is so severe that I have to give a pain juice. Even if the fever is reduced as a “side effect”. It is more important to me that the children don’t have to suffer. For the pain I have already tried drops that can be dripped directly into the ear canal and that can work there and I have also tested homeopathic remedies, but neither has helped my children. best wishes back!

So I usually let my two dwarfs feverish during the day, even high. But it is important that everyone involved gets enough sleep at night.
There is then, not always, but always, two hours before going to bed the "fever juice", usually. Ibuprofen and everyone will get 6-8 hours of sleep. I think that’s incredibly important!

Fever is important, but you shouldn’t demonize antipyretic drugs either.

Hello Susanne, yes, a good night’s sleep is worth a lot – for everyone involved ;-)) I don’t think much of "demonizing", the medication can be really helpful. It is important to me to deal with it very consciously and to think about what to use when and why. And that’s what you do with your method. Greetings and happy Easter!

Thanks for the article! For the first time, I’m mom and I don’t know how to dress my feverish nine-month-old baby at night. .. Rather thinner or thicker than normal? And windows open for fresh air?

Hello, rather thinner when the temperature is high. You can then feel whether it is sweating on the back of your neck or under your clothes, and if so, put it on again more airily. I wouldn’t open windows overnight. Fresh air is great, but ventilation in the room should be done as strong shock ventilation, windows properly open, but in time you will go to another room with your child. And then leave at night. Best regards and all the best for you!

THANKS for the article. I agree. Still a question: from how much temperature can I make wraps?

Hello, wraps are there to lower the temperature and make your child feel more comfortable. As with medication, I would not specify a fixed temperature here either. Do not wrap if your forehead is hot but your arms and legs are cold, or if your child has chills. Not even for babies or toddlers who otherwise cool down too quickly. If nothing speaks against it and your child has a fever and is hot on the legs, you can do the wraps as it feels comfortable.

Great article, we have almost 4 days over 40 degrees behind us. I was only at the doctor’s on the second day, who then wrote down my feverish juice. I have a question about that, after the first dose, the fever went down super quickly, but when she slept, she suddenly had 34.5 degrees (measured in the ear, so maybe it was 35.5 degrees), that’s it normal?

Otherwise I tried to make her feverish!

Hello Franzi, thanks for your comment! The temperature seems very low to me, I would suspect a measurement error. This can often happen in the ear. If you want to be sure, measure again rectally, so in the butt. Of course, is rather unpopular with the children, and need not necessarily be. If the fever has gone down well, you will already notice the difference if you just feel your forehead and it is important how your child is doing. So if it sleeps peacefully, I would just leave it alone &# 128578; best wishes back!

I also have a question. My child has to vomit as soon as the fever rises too quickly. Therefore, we lower early (but usually only notice the fever after the first pass). A sleeping child that is spewed out of sleep is not a solution.

Will it grow together again sometime? It happens more often?

Hello, your observation is that your child will throw up if the fever rises too quickly. I suspect that this is irrespective of the illness it is currently suffering from? Younger children in particular react with their stomach when they are sick. Vomiting can of course occur when there is a gastrointestinal infection, but vomiting can also occur with completely different causes, for example with otitis media, sore throat, respiratory infections, etc. … Pain is also often indicated in the abdomen, even if the disease is caused by one elsewhere (or anywhere in the body). As I said, these are rather younger children, and that is actually growing. That a child like you described is spewed out of sleep because of a fever (and not just because of a gastrointestinal infection) is certainly less common than the examples I gave you above. It is always important that the child is examined to see if another cause of the vomiting is found. If the child is otherwise healthy and there are only harmless infections, you can be confident that this will also grow.

Thanks for the summary of the information.
I have two children with febrile seizures – just complicated once. Always face the dilemma.
Now try to avoid lowering as far as possible. The renewed rise in temperature after Nurofen or Paracetamol is just always so violent and difficult to predict in time. I’m measuring every few minutes.

Incidentally, the first cramp actually occurred about 3 hours after giving Nurofen. So really does not help against febrile seizures!

Great text, I would sign immediately! My daughter only gets a suppository if she is really bad regardless of how high the temperature is. So it happens that she gets a suppository at 38.5 and not at 40. You can tell how his child is doing &# 128578;

Thank you &# 128578; And I’m always happy when I read that mums like you pay more attention to how their child is really doing than always look at a thermometer. &# 128578;

Yes, and what about child sick days? I have to submit a copy of this to the employer with a medical certificate, but not to us with a separate application that I submit over the duration of the absence. Means: I have to see a doctor with the child, so that I don’t lose my job because of my excused absenteeism.

Or do I overlook something?
Sure, in my case, I can also bridge my free days a week super … but strange for the employer if I bring Mo-Die nen child certificate, Wed-Thu free and bring a child certificate from Fr.

Hello, um, I’m not quite sure where your lack of clarity comes from. Of course you go to the doctor if you need a certificate. Why shouldn’t you do that? Do you read that somewhere in my article? If you find a suitable position, please let me know so that I can express myself more clearly. You write: "Or am I missing something?" Maybe you weren’t calm enough to read the article. Maybe do that again if you have a quiet minute and then give me feedback.

Thank you for this article! My daughter has been fevering for 4 days now (influenza) and I am always faced with the decision to lower or have a fever. I let feverish more, everything sounds logical and plausible. Thank you! VG

With pleasure &# 128578; and get well soon to your daughter!

I also find the article totally appropriate. Speaks to me from the soul!
I almost never give antipyretic, I did it at night (my big son is almost 5) because I had the impression that he would not be able to sleep otherwise. That also worked in this case.
What annoys me personally is that I have to justify myself not only to those around me, but also to pediatricians if I don’t give anything that reduces the temperature. As if you had no right to listen to or watch the child if you hadn’t given a suppository and didn’t want to do it. I wish more doctors had your attitude and would not always make you feel like you are making the child suffer unnecessarily. If my son is in pain or tortured, I give him something. But not just that. And to be honest, it was never necessary except for once. Usually it is enough to make him feverish and to support him with rest and drinking a lot.
Well, your article reaffirms me to continue to do so and to take my stand a little bolder at the next funny doctor contact.
thanks for that!
Ps. My pediatrician supports my approach and I am very happy with him. I refer to general practitioners and emergency services on weekends …

That pleases me! I would also like to say to the general practitioners or the emergency service at the weekend that this is certainly partly due to the fact that, for example, the hospital service is often a little more inexperienced, in the situation also does not know the child and / or concerns have to do something wrong. In addition, it is unfortunately often very time-consuming to explain to parents that they can have a fever, which is often difficult to do in emergency services. And then some may get used to some template an … In the emergency service it can be so stressful that one or the other said may come across more strictly than it may be meant. Of course there are also those who simply have a completely different opinion. I often hear that e.g. Interfering with older relatives or neighbors, which can be very exhausting … Then all that helps is to put your ears on the draft ;-))

Hello I am no longer a child but I have been fevering for almost 2 weeks and I have not treated it because I know that it is not bad and it was due to the cold and my certain doctor is an antibiotic man, which I thankfully rejected is the ingwa and onion A really best natural antibiotic took two days but got well even without medication. The only important thing is to take enough water. I have nothing against doctors but I don’t like those who always prescribe chemistry because of everyone. Nature is better.

Thank you for the article! You are much calmer.