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What to do when my baby has a fever?

Penny avatar By Penny Blunden

Penny avatar Penny Blunden

Penny is a Registered Nurse, specialising in Paediatrics. She has over ten years of experience working with children, and also has a Masters of Nursing.

She has always had a passion for working with children, but she has grown to love the family-centred care that is unique to Paediatric Nursing. As a Mum to two young boys, she knows first hand that when a child is sick it impacts the family unit dramatically.

Unfortunately, there aren't many guarantees in parenting, but you can be sure our little ones will get sick from time to time — especially in their first few years of life. We also live in a society full of easily accessible (mis)information, it’s hard to work out what is supported by substantiated evidence.

Penny founded Sick Happens in 2018 to empower, support and reassure parents when caring for their families in moments of sickness. The aim of Sick Happens is to provide education with empathy; delivered in a way that is easily digested and understood.

www.sickhappens.com.au

Fever seems to be the most misunderstood symptom of sickness in children. Perhaps there is a lack of knowledge, education and recognition, but parents and health professionals alike all seem to have differing opinions and treatment suggestions for fever.

No wonder parents are anxious and confused when it comes to fever!

What to do when my baby has a fever?

So, let’s clear this up a bit and chat about:

  • What is a fever?
  • When is a fever concerning?
  • What are some practical tips that you can do to support your child?

What is a fever?

A fever (also known as pyrexia) is defined as a body temperature >38ºC (100.4º Fahrenheit). It is a rise from ‘normal’ body temperature in order to fight infection. Physiologically, fevers inhibit bacterial growth and viral replication, resulting in an enhanced immune response. Simply put, this means that the fever stops the infection growing.

A fever is always a symptom of an underlying illness, and this is what parents should ultimately be focused on; not the fever itself. Let me say that again — the fever is not the problem, the illness that is causing the fever is the problem. Try to shift your focus from the ‘number’ to recognising the symptoms if sickness in children.

Parents often get caught up in this ‘number’ — they often believe that the higher the fever, the more serious the illness. But, this is not always the case. A child with temperatures above 40ºC does not necessarily make them ‘sicker’ than a child with a temperature of 39ºC. Yes, they will most likely be more uncomfortable with a higher temperature, but this shouldn’t be confused as it being more dangerous.


When is fever concerning?

There are a few instances when a fever is concerning.

They are:

If your child is three months of age or younger.

If your baby under three months of age has a fever, they need immediate medical attention. Do not pass go, do not collect $200. This is because newborns have immature immune systems, and are at greater risk of developing a serious infection. They are still building on strengthening their immune systems, and they are not equipped with the ability to fight off an infection like older children.

In addition, newborns often have “vague” symptoms when they are unwell. For example, they may be more sleepy, or more upset than usual. These symptoms can be really tricky for parents to recognise when they are quite “normal” behaviours for a newborn. As a result, if your newborn has a fever, they need immediate medical attention, even if they appear “well.” This is one of the only times that health professionals will say that a fever (even without other symptoms) is concerning.

If your baby has additional concerning symptoms of sickness

For babies older than three months of age, if the fever is the only symptom they have, you do not have to ‘treat’ it. A fever will not harm your child, or cause any damage. It is a natural immune response. In fact, it shows that their immune system is working effectively. However, these are some concerning symptoms of sickness that would require medical attention alongside a fever:

  • Signs of difficulty breathing
  • Signs of dehydration (such as reduced wet nappies)
  • Refusal to feed (breastmilk or formula)
  • Signs of lethargy (this is much more than being tired)
  • Presence of a rash
  • Convulsions
  • Pain that is unrelieved with simple analgesia such as paracetamol.

If your parenting alarm bells are going off

Learn to trust your intuition.

Learn to listen to those gut instincts.

You know your baby better than anyone, and you know when something isn’t quite right.

Always trust yourself, and your parenting ability — no matter how “new” you are to this parenting gig.

Back yourself, speak up, and advocate for your little one — even when you don’t know what is wrong!


What are some practical tips parents can do to support their child with a fever?

The main aims of fever management (in children older than three months) are:

  1. Providing comfort and;
  2. Maintaining adequate hydration.

Not all fevers need to be “treated” with antipyretics (medications that reduce fever). However, if you believe your child is in pain or discomfort, you can most certainly give these medications to make them more comfortable. A child that is in pain is unlikely to drink, and one of the main aims of managing fever is to avoid dehydration. So, giving medications such as Paracetamol can aid in providing comfort, and thus allowing your little one to continue to stay hydrated.

Dress your little one in loose, breathable fabrics and wraps. You do not need to strip your baby off to cool them down. Cool baths and showers are also not recommended. Focus your attention on maintaining adequate hydration instead.

When our little ones are unwell, they may be disinterested in feeding or drinking like they usually would. Try to offer small feeds, but more frequently if this is happening. The more often you can offer liquids (breastmilk or formula for young babies), the more change you will have of keeping your little one hydrated.

If you are ever unsure if your little one has symptoms that are concerning, or you just aren’t quite sure what to do, contact one of the many 24/7 helplines available to parents within Australia. Healthdirect is an Australian Government service that has a 24 hour health advice line that you can call for support and reassurance (1800 022 222).


Some useful articles and publications on fever

Barbi, E., Marzuillo, P., Neri, E., Naviglio, S. And Krauss, B. (2017). Fever in Children: Pearls and Pitfalls. National Center for Biotechnology Information (NCBI). https://www.ncbi.nlm.nih.gov/p...

NSW Health. (2018). Policy Directive: Children and Infants with Fever - Acute Management. https://www1.health.nsw.gov.au...

The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: Febrile child. https://www.rch.org.au/clinica...

Penny avatar

About Penny

Penny is a Registered Nurse, specialising in Paediatrics. She has over ten years of experience working with children, and also has a Masters of Nursing.

She has always had a passion for working with children, but she has grown to love the family-centred care that is unique to Paediatric Nursing. As a Mum to two young boys, she knows first hand that when a child is sick it impacts the family unit dramatically.

Unfortunately, there aren't many guarantees in parenting, but you can be sure our little ones will get sick from time to time — especially in their first few years of life. We also live in a society full of easily accessible (mis)information, it’s hard to work out what is supported by substantiated evidence.

Penny founded Sick Happens in 2018 to empower, support and reassure parents when caring for their families in moments of sickness. The aim of Sick Happens is to provide education with empathy; delivered in a way that is easily digested and understood.

www.sickhappens.com.au

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