Care of a Child with a Fever

Fevers often occur unexpectedly. You might notice that a child often becomes ill after a period of stress, as stress increases vulnerability to infection. For example, insufficient clothing can result in hypothermia, which leads to a cold. Other stressors might be a birthday party, a long trip, or the painful emergence of a molar.

Fever is important
A fever in humans is an important defensive mechanism because it helps the body eliminate viruses and bacteria. A fever signifies that the immune system is working well; a fever activates the body's own immunity by increasing white blood cells. Fever hinders the multiplication of viruses and bacteria. We know that some viruses multiply easily at body temperature (98.6F) but cease multiplying at 102F.

In my experience, there is a great deal of anecdotal evidence indicating that fever not only assists in immunological defense by raising the body's temperature above the level that many viruses and bacteria can easily tolerate. Fever also seems to usher in milestones in the development of the child—some of them health-related.

Sometimes, for example, I see that, after a disease with a high fever, a condition such as eczema or asthma improves. I often see that, after a disease with a fever, the child has grown, as if she had experienced a psychological/emotional growth spurt. For example, her speaking has become clearer, her drawing has improved, or her shyness has disappeared.

In my opinion, this occurs because warmth also has a non-physical origin. We feel warm inside, for example, if we are enthused about something or have fallen in love. This contrasts with a feeling of anxiety, when we often feel cold and look pale. In one complementary medical tradition, anthroposophical (Waldorf) medicine, warmth is the carrier of the ego of a human being (i.e. that which is represented when we say "I").

Viewed from this perspective, when a child has a fever, the "I" of the child is more fully present in the body than ever before. One might speak of "incarnation"--the further grounding of the child's spirit in her or his body. Hence, the child has mastered a resistance by moving more from the spiritual world to that of the physical world. This is how anthroposophical medicine would explain how fever seems to lead to spurts in overall development.

Nevertheless, even for those who do not find such an explanation helpful, it remains the case that fever often precedes important steps forward in a child’s growth and development.

Tylenol (acetaminophen)
Many parents fear a fever in their child. The higher the temperature goes, the more they worry. Largely for this reason, parents use Tylenol (acetaminophen) to suppress fever. However, it is important to understand that a fever itself is not harmful. It is the infection that causes the fever that can be harmful and demand medical treatment.

For example, an appendicitis, which can be life-threatening, might only lead to a temperature of 101F. At the same time, a harmless inflammation of the throat might result in a temperature of 104F. It is important not to automatically associate the level of fever with the severity of the underlying infection.

Because fever can be a health-promoting response in the child, I recommend that parents exercise restraint before administering Tylenol (acetaminophen) to lower a child’s temperature. When a child develops a fever, you can consult your physician about appropriate steps. With your physician's permission, you may decide to let a fever run its course without Tylenol knowing that it may in fact help your child in multiple ways.

Normal development of a fever
Fever normally develops in two phases: In the first phase, when the temperature is increasing, the child feels cold and wants covers. When you touch him, his feet, legs and arms and sometimes his forehead also feel cold. Sometimes the child complains about a head-ache or stomach-ache.

Then, in the second phase, the child becomes and feels warm, with the forehead becoming warm first. During this phase, the child often sweats and his whole body is like a stove. He wants to get rid of the warmth and cool down.

The two phases can also alternate. In that case, the temperature increases and decreases a few times. Often the morning temperature is lower than the evening temperature. Most ill children have a viral infection, and their fever disappears within three days.

A fever is a cleansing process in which proteins break down, and the child loses weight. He eats more as the fever subsides so that he can re-attain his usual body weight.

Concrete steps with a child with a normal fever
Always look carefully at your child and observe her behavior. Look at her eyes and facial expressions; note her movements and breathing. Feel her body, forehead, chest, belly, legs and feet. Then attend to the following:

Rest: When you notice the first symptoms, such as the child being cold or pale or having a fast heartbeat, place your child in a quiet, safe place: for example, in bed or on the couch. Clean the room. If necessary, close windows and curtains. It is unnecessary to totally darken the room. Avoid too many stimuli, however: no television, computer, music or visitors.

Warmth: At the onset of a fever, when he feels cold, provide your child with a woolen blanket and a warm water bottle for his feet or belly to help retain body heat. When his body has become warm and the child wants to cool down, however, it is important to make sure that the child can kick away the warm water bottle and blankets. At all times, ensure that your child is able to get rid of the warmth when necessary.

With very small children, be even more careful as they cannot tell you when they want to cool down. To prevent overheating, do not put a bonnet on a small child's head at any time during the two fever cycles. Also, with very small children, I do not recommend use of the warm water bottle or multiple blankets.

Drinks: When fever occurs, drinking is very important! Encourage your child to drink often. When her temperature is increasing and she feels cold, give warm herbal tea, such as chamomile, lime-blossom or elderberry-blossom if wanted with a sweetener (for example, honey). In the second phase, when she feels hot, give room-temperature drinks; ensure that the drinks are not too cold. She might like diluted fresh-squeezed orange juice. Or maybe she likes diluted apple-, cherry- or lemon juice. Diluted rice milk is also an option.

Food: A child with a fever usually doesn't want to eat much. You can offer him a variation of fresh fruits at room temperature, such as berries. Make sure that the food is easily digestible and does not contain too much proteins or fat. Do not give your sick child meat, cheese, eggs or milk.

Medicine: Parents and sometimes doctors want to minimize symptoms. Antroposofical (Waldorf) medicines can help the healing process without suppressing the fever. Chamomile cramp relief suppositories from Urial Pharmacy* ( relax the child. Apis/belladonna flu relief pellets also distributed by Uriel Pharmacy help with local infections. Infludo dilute from Weleda Pharmacy* ( accompanies the fever in the right way.

(*Note: Neither I nor Flowering Child has any business or other relationship with Uriel or Weleda pharmacy. If there are other pharmacies of which you are aware that can deliver these products, I would recommend them equally.)

Supplements: The following are products which help eliminate viruses: Vitamin C, Vitamin A, Vitamin D, zinc and Blackthorn elixir or Elderberry elixir from Weleda.

In principle, a fever is helpful in the battle against infections. However, if the temperature rises above 103F degrees, the child might feel overwhelmed by the warmth. This can result in a headache or delerium in the child. In such cases the following things might help.
Lemon socks; In the second phase, when the child's entire body feels warm (including the feet) and the child has a temperature higher than 102F degrees and is complaining of the warmth, you can put "lemon socks" on him following these steps:

1. Put a thick towel on the mattress under his legs and feet to prevent the bed from getting wet.
2. Mix half a liter of lukewarm water and the juice of one-half of a lemon.
3. Take long cotton socks which reach over the calves.
4. Wet the socks with the water/lemon juice mixture and wring them well.
5. Put the socks on his feet and calves.
6. Swaddle his feet with a towel or put wool socks on top of the wet socks to prevent the feet from cooling too much.
7. Wait approximately 15 minutes. When you remove the socks, they normally will feel warm and dry. Repeat this step as often as necessary.
When your child falls asleep, leave the socks on. If his feet get cold, the socks are probably too wet.
Washing: If it feels good for your child--but only if it feels good, wet his forehead and parts of his body with lukewarm--not cold--water. Application of lukewarm water to the forehead does not lower the temperature, but it comforts him. Always tell the child what you are going to do and what you are doing!

Normally when a child becomes ill, the temperature increases slowly. However, if the temperature is rising rapidly, a convulsion could occur. Convulsions are unrelated to a high fever. It has nothing to do with how high the temperature is. In most convulsion cases, the temperature is lower than 102F degrees. Sometimes parents only realize that their child has a fever after the convulsions subside.

Convulsions sometimes occur after children have taken Tylenol to suppress a fever. The convulsions occur after the Tylenol has been eliminated from the child’s system and stops suppressing the fever. At that moment body temperature can increase rapidly, and it is the rapidity of this increase that can cause the convulsion. A convulsion occurs in 2-5% of all children with a fever. This frightens the parents because it resembles an epileptic attack, though it can be completely harmless. Nonetheless, to be sure, in case of convulsion and/or seizure, I recommend that you always consult your physician.

When to consult your physician
Though you should consult your physician anytime you feel uncertain or concerned, the following instances definitely necessitate a doctor's care:

- In general, the younger the child, the more careful you need to be with fevers. A baby under the age of three months with a temperature higher than 99.3F degrees always needs to be seen by a pediatrician. Between three and nine months, the child must see a doctor if the temperature is higher than 101.3F. Also, when you are unsure of the situation, take your child to the doctor.
- When your child does not want to or is unable to drink or has a fever in combination with vomiting and diarrhea, take her to the doctor. Any of these conditions might lead your child to become dehydrated. If the same vein, if you observe fewer wet diapers or tearless crying, you should be concerned about dehydration and consult your physician.
- A child with a fever that is combined with faster and/or more superficial breathing than normal might have pneumonia and needs to be seen by a pediatrician.
- A child with signs of meningitis needs to see a doctor immediately. In this case, the child often looks very ill and/or often has had a headache. He may vomit and/or be unable to touch his knees with his nose. Little bloodspots can appear on his skin which do not disappear under pressure. Other possible indicators of meningitis include difficulty in awakening, grogginess, absence, being unusually quiet, apathy, and a weak or constant cry. If he is inconsolable along with any of these signs, get him to a doctor immediately.
- A child who has had a fever for more than three days or whose condition deteriorates on the third day must also see a doctor.
- A noted above, if your child displays convulsions and/or seizures, consult your physician.

A fever is often beneficial to a child with a medically unthreatening infection. The fever activates the immune system and may stimulate both personal and health-related development. Therefore, it is good to have trust in and take time for the healing process.

It is important to remain vigilant that the child gets enough rest and adequate fluids during a bout of fever. Above all, monitor your child closely throughout the fever and consult your pediatrician if you feel uncertain or concerned.

© 2012 Ester Delhoofen. All rights reserved.