Fakta och råd om feber hos barn – direkt av barnläkare. För många föräldrar är 40-gradersstrecket en magisk gräns. För en barnläkare finns det inga magiska temperaturgränser. Här får du läsa om vad du ska göra när barnet har feber och hur du skiljer farlig feber från ofarlig.
When is fever dangerous?
Fever itself is not dangerous, not even if it goes up to 41-42 degrees. Fever is because the body has an acute inflammation - which is the immune system's way of fighting an infection. Infections in children are usually self-healing, but may require treatment in hospitals. In some cases, infections in children are dangerous and require immediate treatment in the pediatric area.
Signs of serious infection in children with fever
A child with a serious infection seems ill. The child may be tired and lethargic or limp in the body and should go to the paediatric emergency room for assessment. Infants are hard to read, but an infant who has lost interest in eating must go to the paediatrician for assessment immediately. It may be a sign of serious infection.
All children get tired when their fever spikes, so it is the children who do not have normal fever spikes that could have a serious infection.
The combination of headaches, photosensitivity, vomiting and fever can be signs of meningitis, an infection that can be serious and require immediate hospital care.
Infant with fever
Babies under three months have small margins and it can be difficult to judge for those who are not experienced. Be vigilant when taking an infant who has a fever to the ER. The older the child becomes, the easier you can read it, and a feverish 6-month-old baby who eats and urinates doesn't need the ER. Therefore, the health center or local community doctor is a better option if you feel you need an assessment.
Colds are the most common cause of fever in children
The most common cause of fever in children is a cold. If the child has a cough, sore throat or moderate cough then the child is likely to have a cold. The wisest thing is to wait at home as long as the child drinks and urinates.
High fever can be a urinary tract infection
Renal pelvic infections are not a very common infection in children, especially in children under one year of age. Renal pelvic infections require antibiotic treatment, but children do not need to be particularly ill or have any urinary tract symptoms. So a child with over 38.5 degrees of fever for more than a day without cold symptoms needs to pass a urine sample for culture. You can do this at a health center or local emergency room. For infants, it is most appropriate with a baby cut.
Fever and swollen eyes can be sinusitis
Fever and a one-sided swollen eye are often signs of an ethmoiditis, sinusitis in children. The children do not need to be particularly ill or affected, but antibiotic treatment (often intravenous) is required and often also an X-ray examination of the eye socket to detect any complications.
Fever and struggle to breathe
Fevers and difficulty breathing or intense coughing may be due to colds, asthma, pneumonia or influenza. Look for a health center, local or pediatric emergency room depending on how difficult the child is finding it to breathe.
How much fever matters?
Over 38.5 degrees is what we usually say at the ER. 38.0-38.4 are normal limits. Below 38.0 is not a fever. As a paediatrician we have absolute temperature limits, we do not compare with the child's normal temperature, although we know that children can vary in their normal temperature where some are just below and some just above 37 degrees.
High fever over 39 degrees during winter is often flu.
When should I give antipyretics?
Fever itself is not dangerous to the child, even if it is very high. Thus, there is no reason to give an antipyretic just because the child has a fever. Unfortunately, antipyretics do not protect against febrile seizures, even if this was previously believed (it is now well researched), so this is not a reason to give them either. I give antipyretics to my children and the children in the pediatric ward in the following cases:
1. If the child is lethargic and uninterested in the surroundings it may be appropriate, to be able to distinguish between seriously and less seriously ill children.
2. If the child is so tired from the high fever that it cannot cope with fluids, this often helps with a fever reduction.
3. Om barnet är gnälligt eller säger att det har ont i halsen eller örat eller kroppen ger jag också alvedon eller ipren. Men då inte för att sätta ned tempen utan för att lindra smärta.