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Kailangan Ba Pagpawisan? How to Safely Manage Your Child's Fever

A pediatrician's guide on fever management plus the warning signs that he needs to see a doctor.
PHOTO BYShutterstock

A child with a fever can be a scary experience for first-time parents. So we asked pediatrician and infectious disease specialist Dr. Carmina Arriola-Delos Reyes how we can prepare and what we need to keep in mind. We’ve compiled her important points:  

Fever is a symptom 
Yes, fever is not an illness. “When we say that a child has a fever, it refers to a body temperature that is higher than normal. It's a signal that something might be wrong within the body."

A fever may indicate that your child's body is trying to fight off infection due to a virus or a bacteria. Other conditions can also cause an increase in body temperature, but not necessarily point to an illness. The high temperature can be due to heat from the sun while your child is at play. Temperature can also increase after feeding your child or after vigorous physical activity.

Take the temperature from your child's armpit
Dr. Delos Reyes, who recently gave a talk at "Smart Parenting Mom Workshop: Raising Toddlers," recommends using an axillary thermometer, which means you use your baby's armpit to take his temperature. (More information on the different types of thermometers can be found here.) With an axillary thermometer, a reading above 37.5 °C is considered a fever. A mild fever is anything between 38 to 39°C, a high fever is 40 to 41 °C, and extremely high fever is 42 °C and above. 

Be careful of the "para pagpawisan" notion. 
Some Pinoy parents cover up their child in long-sleeved shirts with the belief that sweating will make the fever go away or lower a child's temperature.

“Bundling a child who is less than 3 months old with too many clothes or blankets can increase the child's temperature slightly, so this isn’t good practice. But a rectal temperature greater than 38.5 °C is not likely related to bundling, and the child will need to be evaluated by a doctor,” says Dr. Delos Reyes.

Teething should not cause fevers. 
“There is little scientific evidence to support the widespread belief that teething causes fever,” says Dr. Delos Reyes. “Although it's hard to disprove this notion completely, it is always prudent to search for other causes of fever most especially if the temperature has reached 38.5 °C. In such cases, fever should not be attributed solely to teething, and other causes of the fever should be searched.” 

Fever is a normal response to immunization. 
The fever usually arrives within 24 hours after the shot. However, if the fever is persistent, have your child evaluated by his doctor.

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When to worry
According to Dr. Delos Reyes, you don't have to panic yet if your child fever lasts than fives days, and he's eating and drinking normally. A viral infection, like a cold, often causes a fever that goes away on its own.

“The height of a child's fever is not always the best indicator of whether or not the child needs to be treated and evaluated. Ang mas importante is to observe for warning signals. See how your child behaves and appears,” she adds. 

Warning signs include:

  • Eating and drinking very little
  • Changes in behavior, (e.g. lethargy)
  • Diarrhea or constipation
  • Dark, very little or painful urination
  • Severe vomiting
  • Persistent sore throat 
  • Persistent headaches
  • Confusion, stiff neck
  • Ear pain
  • Breathing problems
  • Rashes

Your child needs to see a doctor if:

1. Your child with a fever is below 3 months old.
Whether the fever is high or low, infants with a fever should be taken to a doctor immediately. “The very young have very minimal symptoms. The only sign of a serious infection may just be a fever,” says Dr. Delos Reyes. With this age range, all fevers should be evaluated by a doctor.

2. The fever has lasted more than 5 days or a temperature above 39.4 °C
Bacterial infection may cause a high fever that lasts more than five days, says Dr. Delos Reyes, which may require antibiotics to treat. 

3. Seizures accompany the fever. 
“Fever and seizures can be a sign of meningitis in your child,” says Dr. Delos Reyes. It warrants immediate medical attention. When this happens, put the child on his side to avoid aspiration or choking. Do not put anything in the child’s mouth, and bring your child to the nearest medical facility. 

4. The fever happens to children with chronic medical problems
It includes children with heart disease, cancer, lupus, sickle cell anemia and others.  

How to manage your child’s fever
Give your child a lukewarm sponge bath to make him feel comfortable. However, Dr. Delos Reyes advises against adding alcohol rub to the sponge bath because this can be absorbed by the body and lead to toxic effects. 

Keep your child's room comfortably cool as well and dress him lightly, advises the American Academy of Pediatrics. Encourage her to drink fluids; even popsicles will help. Your child doesn't have to be lying down all day as well. He can move around your home, just as long as he does not overexert himself -- which means no running.

Never give aspirin to treat a child’s fever, however. Aspirin has been linked to the rare but very serious condition called Reye’s syndrome in children. 

Also, ibuprofen, mefenamic acid, and other nonsteroidal anti-inflammatory drugs should not be given to children suspected of dengue fever, according to Dr. Salvacion R. Gatchalian, vice president of the Philippine Pediatric Society, as these can aggravate symptoms in dengue patients. The safest medication to treat high fever related to dengue is paracetamol, according to Dr. Gatchalian.

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