Fever and pain are part of baby’s growing up process no matter how healthy your little one is. It doesn't mean you've done anything wrong ! Fever is an increase in body temperature and is a natural defence mechanism against germs and infection. A fever is a symptom of another illness so you need to find out the cause. Understanding what causes a fever and knowing what to do when it happens will help you deal with it confidently.
Common causes of a fever in babies
- Infection which could be bacterial or viral (there will be a separate article about this topic)
- Post immunization
- Teething can cause mild fever in some babies
- Over heating especially if left in the sun or heated environment for too long.
- Over heating from insufficient fluid intake
Signs of a fever
- Forehead and body feels hot to touch
- Flushed cheeks
- Irritable, restless and crying
- May refuse to feed
- Very smelly breath
When you have a baby you MUST have a thermometer which will give you an accurate reading of your baby’s temperature so that you will know what to do.
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Types of thermometers
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Comments and how to use
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Clinical thermometer
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Not recommended for children because it is made of glass and contains mercury. Never use the oral or rectal route for small children.
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Digital pacifier baby thermometer
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I cannot comment on this as I have never used it
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Digital thermometer
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Can be used in the armpit for small baby or orally for older children. Takes about 2 minutes to register the temperature.
Follow the instructions recommended by the manufacturer
Some babies do not like being held this way for so long
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Plastic strip thermometers (small plastic strips that you press against your child's forehead)
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Not reliable as it only tells you that the baby has a fever but not the actual temperature reading which is very important for small children
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Electronic ear thermometer
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Measures the tympanic temperature - the temperature inside the ear canal
Electronic ear thermometers are not recommended for infants younger than 3 months because their ear canals are usually too small.
Follow the instructions recommended by the manufacturer.
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Digital forehead thermometer
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Easy to use and quite accurate
Follow the instructions recommended by the manufacturer.
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Below is a list of the temperature reading and what you can do when your baby has a fever but it is best to check with your baby’s paediatrician first to make sure that there is nothing more serious. Most books recommend adding or subtracting 1 degree from the reading depending on the method you use to take the temperature. I find this very confusing therefore I just use the reading plus the signs that I see to take the necessary actions.
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°C
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°F
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What it means
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What to do
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36.0
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96.8
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Normal
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Nothing
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37.0
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98.6
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37.2
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99.0
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37.4
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99.3
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Low grade fever
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* See below on treating a fever
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37.6
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99.7
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37.8
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100.1
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38.0
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100.4
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High fever
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Check with paediatrician
* See below on treating a fever
Tepid sponge baby
Use Chinese massage
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38.2
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100.8
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38.4
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101.2
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38.6
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101.5
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38.8
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101.8
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39.0
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102.2
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39.2
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102.6
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39.4
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102.9
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39.6
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103.3
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39.8
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103.7
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Very high fever
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Check with paediatrician
May need Panadol suppositories
Tepid sponge baby
Use Chinese massage
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40.0
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104.0
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40.2
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104.3
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40.4
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104.7
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40.6
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105.1
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Treating a fever
This will depend on the cause of the fever and how old your baby is. The initial steps to take are:
- Keep your baby cool with light clothing
- Make sure the room is cool
- Give baby plenty of fluids
- Check his temperature and make a note of the reading and time
- Give him his ‘fever medicine’ as prescribed by the doctor.
‘Fever medicine’ as most parents call it are medicines used to reduce the baby’s temperature. Never give children aspirin to treat fever or pain.
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Name of medicine
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Panadol or Paracetamol (known as acetaminophen in USA) is used to relieve pain and fever. May be used for post immunization fever.
The paediatric version of paracetamol syrup contains 120 mg of paracetamol per 5ml (teaspoon). Sugar-free versions are available . It may be added in cough, cold or flu medicines so check the leaflet before giving additional Panadol.
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Calpol Infant Suspension is a liquid paracetamol suitable for infants aged 2 months plus
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Nurofen or Ibuprofen is stronger than Panadol and is used if the fever is very high which cannot be treated by Panadol. A word of caution here. It can cause gastric pain in some children therefore do use this very sparingly.
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Other signs which need urgent medical attention include:
- Baby is unusually drowsy or has difficulty waking
- A fever with cold and clammy feet and hands
- If baby looks blue or pale
- Baby has difficulty breathing or breathing faster than normal
- Baby is floppy
- A rash, especially a purple, blotchy one anywhere on the body
- If your baby has a fit
Tepid sponging to reduce fever
If your baby has a temperature over 40°C, you can sponge bath him to bring the fever down but you must use tepid water and only sponge the forehead, temples, armpits and legs.
When baby has a very high fever and you sponge the body it may cause shivering which can lead to the temperature going up further instead of coming down. After sponging dress baby in light clothes to keep him cool. Do not wrap baby to make him sweat as babies do not sweat well.
Traditional massage with dough made from flour and egg white. I find this method very effective especially when the fever is very high and cannot be reduced with medications or tepid sponging. Do not use refrigerated eggs.
Mix the flour and egg white together to form a dough. Use the dough to massage the whole body starting from the face and working down to the toes. Once you have finished, baby will start to sweat. It is important that you keep wiping the sweat off so that baby does not catch a chill. Do not use fan or air conditioner until baby has stopped sweating which will take about 20 minutes. Sometimes baby will start having little red spots after the massage. This is normal so do not panic. The fever will come down very quickly and if it goes up again the next day, massage once more and most times the fever will have settled. This method can be used for older children and adults but you will need more dough.
Traditional Chinese cooling drinks
The Chinese believe that the body can become internally over heated especially if not drinking sufficient fluids or over eating ‘heaty’ food especially toddlers who love eating biscuits. A sign of overheated body is baby’s breath is very smelly. The recommended treatment is to give ‘Leng Yong’ drink which is very effective but this can only be given twice only. Other cooling drinks are barley (use the big grain barley which is less cooling compared to the small grain normal barley), Seven Stars tea which also has a cleansing effect to rid the body of toxins. You can check with your medical hall assistants for their recommendations.
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