The increased heat production during fever is caused by accelerated metabolic processes throughout the body and reduced circulation in the skin. This is why children often appear pale and their skin feels cold at the beginning of a fever.
In extreme cases they may shiver and their muscles may tremble. This continues until the fever reaches the level targeted by the body. In many illnesses, fever provides one of the greatest supports for recovery. Every child experiences fever differently, with different accompanying symptoms. So what can parents do? First of all, some confidence and practical experience are needed in assessing fever. Confidence comes from experience and trust. If we are uncertain and fearful, this is not good for the child.
Where should fever be measured?
In small children, the most accurate way to measure fever is rectally. The child should lie comfortably on their side. Make sure the tip of the thermometer disappears completely into the rectum.
Babies and younger children should preferably lie on their backs. Hold their legs gently by the ankles with one hand while holding the thermometer like a spoon in the other hand, supporting your little finger against the buttocks. This prevents injury if the child suddenly moves. With traditional mercury thermometers, one to two minutes are sufficient.
If abdominal inflammation is suspected (for example appendicitis), the temperature should also be measured under the armpit to determine the difference. Make sure the tip of the thermometer is placed in the center of the armpit and that the upper arm rests against the chest. The shoulder and arm should be covered.
Underarm measurements should be taken for five minutes. This method is somewhat less accurate. The actual body temperature (the so-called core temperature) is approximately 0.5°C higher than the temperature measured under the armpit. Nothing needs to be added to or subtracted from the rectal measurement, because it closely corresponds to the body’s internal core temperature.
Attention! In appendicitis, the difference between rectal and underarm temperature measurements is usually greater than 0.5°C.
Many adults measure temperature orally. In this case it is advisable to keep a separate thermometer for this purpose and label it clearly. The duration and accuracy of oral measurement are similar to rectal measurements.
Important!
Body temperature up to 37.5°C is considered normal.
Temperatures up to 37.9°C are considered elevated temperature.
Only temperatures above 38°C are regarded as fever.
Overheating may also occur due to excessive external warmth if the child cannot release heat properly. In babies this can be helped by removing hats or diapers.
Temperature may also rise above 38°C after vigorous physical activity. In such cases, repeat the measurement after half an hour of rest.
How high we should allow fever to rise always depends on the situation. However, there are exceptions: if a newborn has a temperature above 38°C for more than a few hours, medical examination is essential, especially if the baby is not feeding and appears unwell. A child whose fever rises above 40.5°C, or whose temperature fluctuates more than 1.5°C without fever-reducing medication, should also be examined by a doctor.
What should we do in different situations?
If the child seems “different somehow” or “doesn’t look right,” observe their movements, eyes, facial expressions, nostrils and breathing more carefully. Check the temperature by touch on the forehead, temples, trunk and limbs, and also feel the abdomen. Measure the fever for one or two minutes as described above; in case of abdominal pain, measure under the armpit for five minutes as well. If symptoms seem unusual, consult a doctor.
If the limbs — especially behind the knees — are cold and the thermometer shows 38.5°C, we can be sure the fever will continue to rise. The body is still releasing less heat at the periphery than it is producing centrally. While the fever is rising in this way, cooling compresses should never be used. It is more helpful to apply warm arnica essence or lemon juice compresses to the wrists. In addition, keep the child warmly covered and offer small amounts of tea.
Attention! The limbs only become warm once the fever stops rising and the body begins releasing excess heat.
Once the limbs are fully warm, leg compresses or gentle washing may be used above 39°C. Starting pleasantly warm, evaporation itself helps the body release excess heat through the skin. At this stage, as well as during the final phase of fever rise, suppositories made from natural substances (Chamomilla comp., Aconitum/China comp., Viburcol) may also have beneficial effects.
Attention! Cool washings or lukewarm baths should only be used if they are comfortable for the child. Make sure the body can release excess heat properly. Cover the child more lightly than during the rising phase of fever.
The rising phase of fever is usually accompanied by discomfort, and children may sometimes vomit. Headache and abdominal pain are also common, but often improve once the fever reaches its peak. Therefore, food should never be forced; only offer small amounts of lukewarm tea.
What should children eat during high fever without diarrhea? Plenty of fluids (tea or diluted milk with a little sugar, or lukewarm diluted sour cherry, blackthorn, lemon or orange juice), light foods without potatoes, with little fat and protein. Avoid oily seeds, chocolate and similar foods. It is natural for the child’s weight not to increase during these days; any lost weight is usually regained quickly afterward.
Clothing and blankets should always match both the room temperature and the fever. Avoid drafts, but ensure sufficient fresh air. During ventilation, keep the child well covered and possibly put on a hat or sweater. Even in summer heat, cover the child lightly with a thin cotton cloth. Always make sure the limbs stay warm and the child feels comfortable.
Restless children may uncover themselves, get up and want to run around despite fever. An adult should always stay nearby, singing, humming, telling stories or simply working quietly close to the child.
A portable wheeled crib can also be very useful, allowing the mother to move the child around the apartment while carrying out daily tasks.