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These New Fangled Celsius Thermometers Centigrade (or celsius, to use the modern name) is a more rational system of temperature measurement than Fahrenheit.  It takes the freezing point of water as zero degrees and the boiling point as 100 degrees, dividing the interval into a hundred parts. Fahrenheit takes the freezing point to be 32 degrees, and the boiling point at 212, dividing the interval into 180 parts. However, most of us are used to expressing fever in Fahrenheit, and find Celsius difficult to comprehend.  To convert Celsius temperatures into Fahrenheit, multiply by 9, divide by 5, and then add 32.  Or, enter the Celsius temperature into the first box below, and click the button. Enter the Celsius temperature: The temperature in Fahrenheit is:
When to Rush to Your Doctor No response to fever medication (high fever). A child less than 3 months old. Seizures (fits). Breathing difficulty. Fever more than 3 days. Child dull, abnormally sleepy. A rash. Refusal to eat and drink. Confusion, delirium, or excessive crying. Repeated vomiting, or profuse diarrhoea

Fever in Children

Fever isn't all bad.  It is a defense mechanism of the body, and actually helps us fight disease.  Some germs, for example, do not grow well at higher temperatures, and the defense systems of the body perform better.

What is considered fever?

If your child's temperature is more than 100.4 degrees Fahrenheit measured rectally, or more than 100 degrees Fahrenheit measured in the mouth, or more than 99 degrees Fahrenheit measured in the armpit, she has fever.  A common mistake is to keep an armpit thermometer for one minute.  This will give a falsely low result; a correct measurement in the armpit needs four to five minutes.  Not easy in a crying struggling child, but more feasible during sleep.

Is fever a problem?

Fever is a warning sign - an indication that something is wrong.  A quest for the cause of any fever is important, especially in young children.  The causes of fever range from trivial and self-limited viral infections to life threatening bacterial infections, cancers, and auto-immune disorders that cause long term sickness.

By itself, fever, especially in an older child, does no harm.  In younger children, it may cause loss of fluid from the body, resulting in dehydration.  Children also lose their appetite when feverish.  Between the age of 6 months and 6 years, children may suffer from fits, known as  febrile seizures  .

Another particular problem is hyperthermia -- the uncontrollable rise of body temperature to very high levels (106 F and beyond).  This condition can lead to brain damage and death, if not promptly treated.  Apart from these two specific conditions, fever, on the whole, is fairly harmless in itself.

Managing a fever

Apart from drugs to reduce fever, what is needed?

• Adequate nourishment.  Children, especially those very young, lose their appetites when feverish.  Special efforts need to be made to ensure enough food intake.  Try offering a meal at the time a drug has reduced the fever.  Children can generally be allowed to eat what they like.
• Hydration.  It is essential to ensure that the child does not become dehydrated.  For children less than three months of age, frequent breast feeding will suffice.  Older children require more liquids.  Too much plain water is hazardous; try buttermilk, fruit juices, diluted dal, coconut water, etc.
• Sponging.  Wiping the bare body with a wet cloth and allowing the water to dry brings down the temperature quickly.  However, if it sets up shivering and goosebumps, the purpose is defeated (use lukewarm water, not cold).  Young children do not tolerate sponging well.  Never use alcohol, as it can be absorbed through the skin.
• Rest.  School absence till the fever has been down for 24 hours is sensible.  Children tend to get playful when the fever subsides, but this is not generally harmful.

Many drugs are available to treat fever in children.  Paracetamol (acetaminophen) is generally considered the safest, and there is no good reason to use anything else.  Other drugs include aspirin, ibuprofen, nimesulide, and mefenamic acid.  They usually offer a slightly longer duration of action than paracetamol, at the cost of more side effects.  Aspirin is no longer used for fever in children, because of its association with Reye's syndrome, a serious illness.

Fever is a signpost, pointing to a disease process in the body.  Finding the cause should be a priority.  It is inappropriate (and even dangerous) to simply supress a fever with drugs.  Especially in young infants, fever should be evaluated by a medical specialist, to rule out the presence of dangerous illness.

Last revision: July 15, 2007

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