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Caring for Fever in Children

Fever is one of the most common reasons why we see children coming to our clinics. The most common causes are usually a viral infection. Some of the most common viral infections we see are respiratory infections, diarrhoeal illnesses, Hand Foot Mouth Disease and so on.


Why do Fevers Occur?

Fever is your body's natural fighting response to viruses and bacteria. By raising the body's temperature, it activates your immune system and makes it harder for viruses and bacteria to survive in your body. Therefore, your fever is actually helping you recover. When your fever finally goes away it is usually because you have successfully eradicated the disease.

How can you manage your child's Fever?

We treat fevers in children to help them feel more comfortable. Treating the fever does not alter the natural course of fevers or help them to recover any faster. Therefore, if your child is already comfortable, you may omit giving fever medications.

For febrile children who are visibly uncomfortable, here are some tips to bring down their temperature:

1. Medications (provided your child has no allergies):
Serve the doctor prescribed dosage of paracetamol and/or ibuprofen. Paracetamol can be given every 6hours and can be given on an empty stomach. Ibuprofen should be given only after meals as they can lead to gastritis symptoms otherwise.

2. Sponge your child
This is optional but if you wish, sponge with room temperature water for 5-10mins. This is only recommended if your child's temperature is above 39.5 degree Celsius, or above 38.5 degrees Celsius in children with a history of febrile fits.
You do not need to sponge your child with ice water or cold water as that can be very uncomfortable or shocking to your child.

3. Keep your child cool with thin clothing and cool the room. Do not wrap your child in thick blankets.

4. Drink lots of fluids to avoid dehydration. Your child's rate of fluid loss increases, the higher their temperature and the longer the duration of the fever. They should be drinking more fluid than they normally do.

When should parents be worried?

Consider bringing your child to the emergency department if they:
- Have a temperature of more than 41.0°C, or above 38.0°C for those less than 3 months old
- Have a fever for more than 5 days
- Are drowsy or difficult to awaken. Fever may make children sleep more, but they should awaken easily and be able to respond to you.
- Seem confused or delirious
- Are irritable and cries constantly and you cannot settle them.
- Have any difficulty breathing
- Start to develop pale or blue skin or have unexplained bruising spots
- Have a fit (seizure or convulsion)
- Are not able to drink adequate fluids and has significantly less urine output than usual. Not peeing/having a wet diaper for more than 6 hours is taken as a sign of severe dehydration.

How can i prevent fevers?


Hand hygiene is key in preventing infections in your child.

Ensure that your Child's Vaccination is up to date as the Singapore's Childhood Immunisation Schedule ensures that children are protected from deadly diseases.
Yearly influenza vaccines are recommended in children especially those between 2-6 years old, or those with underlying cardiac/kidney/lung diseases including asthma.
Eligible Singaporean children pay $0 for Influenza (Flu) Vaccine in our CHAS accredited clinics.

Check out vaccination subsidies here.

Sources:
The above information is adapted from Health Hub
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