by Dr. Dan Giap Liang
Fever
Fever is a symptom and sign. It is not a diagnosis or an illness. It usually means that the child has caught an infection. Most childhood infections are viral in origin. it is important to differentiate between these two because a bacterial infection usually requires an antibiotic. Generally, the younger and sicker the child, the likelier it is bacterial in nature. Sometimes, there are other causes of fever but usually the duration is prolonged and it is more sinister and will need extensive investigations.
There are two commonly used fever medications. One is paracetamol, that has been long used and is very familiar among most parents. It is available in syrup, suppository and tablet form. It is to be used only if there is significant fever. However, lately, there have been some studies that seem to suggest excessive use may be linked with allergies. This once again highlights the fact that it is to be used only when the child has fever and it is not to be given on a regular dosing schedule. Furthermore, one has to be aware of liver toxicity due to overdosage of paracetamol.
The other fever medication, Brufen, is newer compared to paracetamol. It is relatively safe, too, and very effective. However, it too has its adverse side effects and once again, its use needs to be monitored closely by parents. Never use aspirin in children. Parents must be cautious when using traditional medications because some may contain aspirin.
Sponging the child may be comforting but never use cold water or ice. Shivering due to the cold application may raise the fever further. Tap water should suffice. Infants with fever should not be over-dressed or swaddled, as this may likewise worsen the fever. Light cotton clothing is advisable.
If the child's fever worsens and persists beyond a few days or if the child's general condition deteriorates, it is advisable to seek medical attention. Generally, infants less than six months presenting with fever should be seen by a doctor.
