Treatment of Fever
Coughs and colds have been making the rounds since the beginning of autumn, but for many the flu season does not seem to start until early in the New Year. Often it is your child that comes down with something, and it can be upsetting to watch a little one with fever and being generally unwell. This seasonal advice will help you to understand the purpose of a fever (as associated with flu or childhood illnesses for example).
Treatment of Fever
Paracetamol (or calpol for children) and ibuprofen (and aspirin before the warnings about damage to the digestive tract) are the first reaction of most people when faced with a fever.
Get the temperature down, quickly – either from fear of what a raised temperature might do, or because work commitments need to be fulfilled. And paracetamol or ibuprofen usually does the trick. However, it doesn’t support the immune system!
I would like to explain the purpose of a fever and why it is important not to step in too soon.
First of all, a normal body temperature is anything between 36.5°C and 37.5°C (97°F – 99°F). Normal body temperature varies between individuals and also at different times of the day (or days of the cycle for menstruating women). Anything above 37.5°C (99°F) can be classed as a fever, with temperatures of 40.5°C (105°F) and higher being critical.
Different style fever thermometers give different accuracy: in the armpit gives a lower reading than in the mouth; forehead thermometers are widely acknowledged to be unreliable. Modern in-the-ear thermometers tend to give a quick and reliable reading and are especially useful for babies and small children. But be aware that the temperature on the side a child has been lying on may be reading too high. We even had a high temperature reading of Teddy’s ear once – after he had been held tightly by my feverish daughter!
Fever is a healthy reaction of the immune system, e.g. when faced with ‘invaders’ like bacteria or viruses. The rise in body temperature is unfavourable to most germs and it speeds up the production of white blood cells and mobilises them to get to the site of an ‘attack’ quickly. Usually pulse rate and breathing are increased; both help to provide more oxygen to the body quickly. It’s like the body has entered a competition of who is going to win this race!
Sometimes really healthy and robust individuals (most commonly children) throw the most dramatic fevers. This is usually a good sign – a sign that the body is in a really fit state to enter the competition and get rid of the ‘attackers’ fast and furiously, i.e. win the race. For the same reason we don’t often see hugely elevated temperatures in the elderly, because their overall constitutional state is often so weakened that their system can’t be challenged too much. You don’t see many 80-year-olds running in races!
In most fever cases it is more important to check how the patient is coping than to worry about the actual temperature. In most healthy individuals (other than babies and very young children), a temperature of 40°C (104°F) can still be regarded as a ‘healthy’ reaction, provided that the patient is conscious, reasonably alert and not in distress.
Listlessness, excessive drowsiness, hallucinatory states, convulsions, obvious and distressing pain and respiratory difficulties are some of the key factors to indicate that the patient is not coping and needs treatment. This can be with a temperature of less than 39°C (102°F) or as high as 40.5°C (105°F)!
Until then, common sense practical measures provide much more support to the fighting immune system than medication:
- plenty of fluids (preferably water or watered down fruit juice)
- light clothing (for babies: remove disposable nappy for at least some of the time)
- reducing room temperature (18°C/65°F is fine)
- sponging down the patient (with tepid water, one limb at a time)
- light food, if desired – avoid sugar and artificial or junk food because it doesn’t provide nutrition to the body yet puts more stresses onto the system
- bed rest – maybe not as obvious any more in our modern, hectic lives!
It is common for a feverish patient to lose their appetite. Part of the immune system’s response is to shut down the digestive system in order to allow all energy to be directed towards fighting the ‘attackers’. Hence the saying:
Feed a cold and starve a fever. Light food (fresh fruit, steamed vegetables etc.) is therefore all that is needed and, probably, wanted. Older babies who are still breastfed will probably only want breast for the duration of the illness – it gives them liquid, nutrition and great snuggle time!
Many cases of childhood fevers start with the child vomiting. This is not necessarily a sign of a stomach bug, but the body’s attempt to clear out the stomach so it doesn’t have to ‘waste’ any energy dealing with digestion. Vomiting can also occur later during the illness, when a feverish child has eaten a meal that was too rich or too much for the system.
A word about febrile convulsions – feared by all parents of young children: According to the NHS website (1), it is estimated that 1 in 20 children (5%) will have at least one febrile convulsion at some point, with most cases occurring between the ages of 6 months and 3 years. However, other websites state the risk as far lower, e.g. 3 in 100 children (3%) (2).
Most commonly, febrile convulsions occur as single incidents during any one illness or even the whole of childhood. Almost all children recover quickly from a febrile convulsion, though it is likely that the illness causing the fever in the first place might still need treatment. Febrile convulsions are extremely rare after the age of 5 or 6.
Febrile convulsions can look very similar to epilepsy, but they are not the same. There is no clear evidence that febrile convulsions lead to the development of epilepsy in later life (3) and there is no clear understanding why febrile convulsions develop in the first place. It appears not so much related to how high the body temperature goes but maybe how quickly the temperature rises, because many children have high temperatures without ever getting febrile convulsions.
So, unless the patient is not coping or the fever is prolonged, no medication (not even homeopathic remedies!) might be needed at all! However, common sense and parents natural instincts should always be followed.
There are a number of homeopathic remedies that should be considered in cases of fever and can be used before or, if necessary, in conjunction with paracetamol or ibuprofen. Miranda Castro, author of The Handbook of Homeopathy and Homeopathy for Mother and Children, describes them on her website http://www.mirandacastro.com/articles/fever_in_children.html. You can compare the information with this website too: http://health.hpathy.com/fever-symptoms-treatment-cure.asp.
- NHS Choices: Febrile seizures http://www.nhs.uk/conditions/Febrile-convulsions/Pages/Introduction.aspx
- Patient.co.uk: Febrile Seizures (Febrile Convulsions) http://www.patient.co.uk/health/Febrile-Seizure-(Febrile-Convulsion).htm