Fever in Children

Fever is defined as a rise in body temperature above the normal daily variation. The measurement of body temperature varies depending on the site, time, and the child's age. In childhood, an axillary (underarm) temperature above 37–37.2°C, tympanic (ear) temperature above 37.8–38°C, and rectal temperature above 38°C are considered fevers.

In hospitals and clinics, tympanic digital thermometers can be used to measure temperature in children over four weeks old. However, at home, it is recommended that parents use digital thermometers to measure axillary temperatures. Tympanic measurements with infrared thermometers are not recommended due to a high error rate associated with the device.

Fever often causes significant fear and anxiety among families. In reality, fever is a normal physiological response to infection pathogens entering the body and plays an important role in fighting infections.

Due to the fear of febrile seizures, both families and healthcare professionals tend to lower the fever or intervene immediately. However, studies have shown that reducing fever does not affect the frequency or number of seizures or the use of antipyretics or antibiotics. Although families may perceive these seizures as febrile, they typically do not cause harm or leave any lasting effects on the child.

Fever helps the body fight microorganisms and is beneficial in controlling infections. It increases metabolism, heart rate, and respiration. Therefore, if there is an underlying cardiac or lung disease, it may exacerbate these conditions. In otherwise healthy children, intervening in cases of high fever can aid in controlling the infection.

How to Reduce Fever?

• Physical cooling alone is not sufficient.

• Medications containing paracetamol can be administered every 6 hours.

• Ibuprofen can be given at a dose of 5–10 mg/kg every 6–8 hours. It should not be given to children with chickenpox, poor oral intake, dehydration, or stomach problems.

• The combined use of ibuprofen and paracetamol is not recommended due to increased side effects on the liver and kidneys. Moreover, combined use has not been proven to be more effective than using each medication separately.

• Metamizole (Novalgin) is not used as an antipyretic in childhood due to the risk of agranulocytosis.

• In a febrile child with stable general condition, it is acceptable to wait 24–48 hours with antipyretic treatment.

If the child's general condition, mood, and appetite improve when the fever subsides, there is no need to fear the fever. However, medical attention is necessary if the child:

• Is under 3 months old

• Has vomiting, diarrhea, or difficulty with oral intake

• Experiences respiratory distress, groaning, rapid breathing, or cyanosis

• Has seizures

• Appears ill even after the fever subsides

Emergency departments are not solely fever-reducing centers; they are facilities where patients are examined, and necessary tests and treatments are administered. Every parent should know how to manage their child's fever. It is important to remember that the underlying cause of the fever is more significant than the fever itself. Fever is, in fact, a good defense mechanism.