Monday, March 1, 2010

Fever in Infants

One thing that is a nightmare to me is fever. The first time, the kid's body was a little warm, I was like RUN to the doctor.. then I was told that the kid's bodies are tiny and their metabolic rates, core body temperature, heartbeat and respirations are a little higher than adults and that is no cause of a concern and I am also assured that it is considered fever if and if the kid is running a temperature of above 100 degrees FH. Well, something new to me. I was considering since the kids are tiny everything should be in smaller proportions but this is a total reversal, but must agree as it comes from the doctor.

So, the first thing you do is take the temperature reliably, that is through the armpit reading which is more accurate than the forehead or ear thermometer readings.. Rectal one is the accurate but handling it is a little tricky and the already fussy kid might not allow that, so the best option is under the armpit. Clean the thermometer with an alcohol wipe or a disinfectant wipe and take the temperature from there. In some kids like mine, the head and the neck areas might be really really hot whereas the extremities, that is hands and feet are extremely cold (another reason I had a panic attack earlier on). It is perfectly normal.

Things to Do
Do not cry, do not panic, do not rush the kid.
Take control of emotions, take the temperature through a reliable instrument.
Keep cleaning the kid's body with cold water wipes. The kid wont allow it, might cry out a lot but do not give up, the only thing to bring down the temperature instantly is wiping it cold, the first external thing we need to do is cold cloth wipe.
Give acetaminophen drops (Calpol/Tylenol/Motrin) whatever the brand name is up to 4 to 6 (max) times in 24 hours in the dosage prescribed as per the baby's weight by the pediatrician. DO NOT OVERDOSE THE KID.
Do not bundle up the kid, put them in loose cotton clothes that do not stuff them up.
Allow a lot of air.

It is very vital to get the temperature down. If the temperature is around 102 or close to it, the primary task is to get it down ASAP. Never mind if you have to take the kid out in cool breeze in the middle of the night, cold cloth wipes, even cold cloth wrapping around head, anything to get it down, but again we should not overdo anything.. learn and do it per discretion.

Some people tend to rub oil on the baby's body and head at the time of fever.. DO NOT APPLY OIL ON BODY OR HEAD when the kid has fever.


Keep hydrating the kid, push in even a little sip of water/Pedialyte say a spoonful at a time.

Diet wise they might not be wanting to put anything in the mouth, do not force them.. try and make something that is palatable and appealing to their taste buds like a soup or something different than the routine. Avoid giving cold beverages. If it is accompanied by cold, give them a little warm water so that is soothing to the throat.

Give the medication on time. If in spite of everything the fever continues after 24 hours that is around 100 you need to visit a doc. However, if it is a little higher and above 101 or near 102 or so for more than an hour, better go to the hospital. If the kid also vomits and is keeping nothing down, then Pedialyte is the immediate rescue and take the kid to the hospital or ER.

Usually, fever when controlled or worked on instantly without delay is not a big concern. However, the key is not to let it go overboard. High fever for too long might lead to febrile seizures. No reason to panic but not something to relax about as well.

Home remedies:
Apply sandal paste on the forehead, it acts as a coolant. Better if you can get the natural one from sandal stick.. (saana meeda arageesina gandham).

However, if the kid is getting frequent fevers, we need to determine whether it is bacterial or viral in nature and go about it.

Dr. Sanjay's Inputs

Children below 5 years usually have weak immunity comparable to us, adults, so they commonly have these features of upper resp tract infections, which are mostly viral. Most of these infections are seasonal esp. when whether is changing. Most of these infections are not serious type like pneumonia, purulent ear discharge, meningitis, skin infections, diarrhea, cos if somebody has such serious infections recurrently then we are concerned about some congenital form of immunodeficiency. So, I feel, you shouldn’t worry, these things are bound to improve with age. Just avoid visits to crowed places, continue maintaining good hygiene. Try to keep fruits in his diet almost daily along with other essential part of diet.

One thing you must remember, fever off and on in changing weather is not uncommon. These are usually different illnesses, usually viral infections. Unless there are serious bacterial infections, in form of pneumonia, meningitis, skin infection, we usually don’t suspect any congenital immunodeficiencies. But if any fever which persists longer it’s a matter of concern. If that happens, you must do a regular 6 hour temp charting, and then discuss with your doctor. Don’t worry, as age improves, no. of seasonal infections too decreases.

Since the kid tends to dehydrate faster with such high temperatures, the focus should be on pushing in more liquids.


  1. my kid is 3 months old. will b of 4 months after 4 days. He got fever on monday & was warm. didnt measure it. then tue wed thu he was fine. fri night suddenly he had 101F fever. we gave calpol as directed. Fever came down. after 4hours he was shivering & fever was 103F. dc asked us to give him bath. But we didnt. We gave calpol again. it came down. this is going on since then. its sunday night now. he just had 105 fever 4 hours ago. given meftal P & after 3 hours given calpol as well with fever of 98. Now its 95.4 low. so cannot understand whats going on. pls help is it normal. MN

  2. Please give the kid cold bath or cold water compresses, take him to the doctor immediately. I am not a doc and so dont really know what to do. with this kind of high fevers it is very essential that you just keep wiping the body with cold water to get it down.. do let me know how the kid is doing.. Good luck.