Fever in children: When is a temperature too high?


Seek medical attention if the body temperature hits 38°C or higher for infants younger than three months, or 39°C for an older child.

PARENTS are naturally anxious when their child comes down with a fever, especially first-time mums and dads.

When is a temperature too high? Should the child see the doctor?

According to Gleneagles Hospital Penang consultant paediatrician Dr Khamini Ramanujam, a child is deemed to have fever when his temperature hits 38°C (or 100.4°F).

This happens when the body’s internal “thermostat”, or hypothalamus in the brain, raises the body temperature above normal levels – typically as a natural defence to fight an infection.

Parents should use digital thermometers to take temperature readings, as these are the quickest and most accurate. For newborns up to three months old, it is best to take temperatures rectally (in the anus).

For children aged between three months and three years, temperature readings can be done rectally, from the ears or armpits.

For children five and above, it can be done orally, from the ears or armpits.

As fever is a natural part of childhood, Dr Khamini said it is important for parents to know when it is something they can manage at home and when they should seek urgent medical attention.

“You should see your doctor if the temperature hits 38°C or higher for infants younger than three months, or 39°C for an older child.

“Important symptoms parents should look out for are refusal to eat, inactivity, diarrhoea and vomiting, breathing difficulties, irritability, and pain while passing urine.

“Parents should also look out for signs of dehydration like lethargy, lack of tears when crying and reduced urine output.

“If you notice these symptoms, get your child to a doctor immediately,” she advised.

Dr Khamini said the most common causes of fever in children in Malaysia are viral infections.

Common causes of fever include upper respiratory tract infection, post immunisation and teething.

The most common causes of fever in children in Malaysia are viral infections, said Dr Khamini.The most common causes of fever in children in Malaysia are viral infections, said Dr Khamini.

Fever can also be due to underlying inflammatory conditions like Kawasaki disease, malignancies or connective tissue disease.

The two most serious infections parents need to be aware of are meningitis and septicemia (blood infection). Even though it may be uncommon, symptoms can quickly worsen, and urgent medical attention is required.

Sometimes, a fever can be caused by something as simple as overdressing (particularly in young infants) or the child being in a hot environment.

Children can develop febrile seizures when they have high fever. It is important to give them paracetamol, keep them hydrated and in a cool environment to prevent such seizures.

“During fever, your child can be given paracetamol along with fluids such as water, soups, juices, ice-lollies or jello to avoid dehydration,” said Dr Khamini.

“Don’t force them to eat if they don’t feel like it. Let them eat what they want in moderation. Ensure they get adequate rest, so it’s best to keep them out of school, nursery or daycare. Keep them in a cool environment and avoid under- or over-wrapping them in clothing.”

Children will inevitably develop fevers during their childhood, and most will recover and return to their normal selves within a few days.

It is important to recognise the dangerous or worsening symptoms and consult your doctor immediately, or head straight to the hospital emergency department.

Emergency departments of hospitals are one of the most important components of the healthcare system. They are open 24 hours and well-equipped to handle all medical emergency.

Patients will be immediately evaluated using the triage system – which prioritises cases based on urgency and number of resources required using categories of red (critical), yellow (semi-critical) and green (non-critical).

All life-threatening conditions will be of utmost priority, followed by the other categories. In addition to the doctors and nurses in attendance, a multidisciplinary team of specialists are always on call to attend to all cases.

Gleneagles Hospital Penang prides itself in the emergency care and management of these conditions:

> Cardiac emergencies

> Neurological diseases

> Obstetric and gynaecological emergencies

> Medical emergencies

> Paediatric emergencies

> Respiratory emergencies

> Ear, nose and throat (ENT) Emergencies

> Ophthalmology emergencies

> Urology emergencies

> Trauma and any other emergencies.

KKLIU: 2429/2021 (Expiry Dec 31, 2023)

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