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Working as an emergency nurse I deal with many children that present with a high fever, and if not treated can cause febrile convulsions. For first time mothers, this can be quite scarey. Some say that febrile convulsions help to bring down the temperature, and this is true, but
a child can not convulse for too long, as it stops the supply of oxygen to the brain due to vasoconstriction occuring. For a short term fix at home, tepid sponging and oral panadol/ nurofen is the first line of treatment. But dont forget that the fever is usually a side affect to something else. So if a fever is relieved after administering panadol, then this is by no means a cure. By administering these medications, it is only lowering the temperature slighty, thus relieving the symptoms for a small while. Fevers are usually an underlying sign of an infection, and in infants, the most common infections are respiratory ones and urinary tract infections. Another common cause is due to teething - and just plain panadol can help with this.
Alot of people these days have thermometers at home, and I know from speaking to parents, they wonder what a normal body temperature is, and what would be a temperature that they should be concerned about. Where I work, we consider a sustained temperature of 37.5 and higher, to be a sign of infection. If the temperature is managed at home, and kept below 38, then I would suggest presenting to a GP. But a prolonged temperature above 38 and higher, I would suggest seeking medical advice as soon as possible. Infants are given higher priorities in an emergnecy setting and should be seen to fairly quickly if the triage nurse is concerned.
A couple of pointers to think of - when children have a temperature, they are loosing alot of body fluid through sweating. And therefore their urine output is less. So we always encourage oral intake if the infant can manage, and if given regular panadol/nurofen, this should make them feel better and well enough to swallow some fluids. If you are presenting to an emergency department, they are going to want a urine sample at some stage. In infants under 2 years of age, this is an extremely difficult task ( believe me - I've had parents trying to catch samples from their kids in the department, and it can take a long time - especially if they are not taking any fluids). So I suggest trying to get any fluid into them prior to presenting, if you are able. If they are just not responding to the panadol/nurofen, then it will be difficult to get any fluids into them. Thus they will need early intervention as soon as they present to hospital. This will be done either intravenously or nasogastrically.
But always remember, fevers are only symptoms, The cause of the fever needs to be found and treated to fully alleviate symptoms. Dont worry about feeling silly if you present and you find out the temperature is only related to teething. It is always better to be safe than sorry!
(December 2006) (
