7 things you should know about fever

Your baby has a fever if his or her underarm temperature is above 37.3 deg C.
Your baby has a fever if his or her underarm temperature is above 37.3 deg C. PHOTO: ISTOCKPHOTO

Your little one's forehead feels warm and her cheeks are flushed. Before you start panicking, here's what you should know about fever in babies and toddlers. Eveline Gan reports

1. It's not a fever until the thermometer reads 38 deg C.

That is, if you are going by your baby's rectal temperature (taken in her bottom), according to the American Academy of Paediatrics (AAP).

A person is said to have a high fever when his body temperature is 38.5 deg C and above.

The normal body temperature can range from 36.1 deg C to 37.8 deg C, said Dr Leo Deng Jin, an associate consultant at the department of emergency medicine at KK Women's and Children's Hospital (KKH).

Not only do babies and younger children have a higher body temperature than adults, but it can also vary throughout the day for different reasons, from being over- dressed to the time of the day, experts say.

Even the device and method you use to measure your little one's temperature can make a difference. For example, a temperature reading taken in the bottom tends to be higher than that taken in the underarm.


• This article first appeared in Young Parents magazine. Young Parents, published by SPH Magazines, is available in both digital and print formats. Go to www.youngparents.com.sg to subscribe and for more parenting stories.

You may also get slightly higher readings from infrared thermometers, compared to electronic ones, Dr Leo said.

2. Rectal readings are the most spot-on.

No one likes sticking a thermometer into their little one's bottom.

But it gives the most accurate readings for babies, especially those under three months, and toddlers up to the age of three, said Dr Michael Wong, deputy medical director at Raffles Medical.

For accuracy, take your child's temperature twice each time.

Digital ear thermometers, which use infrared rays, are not recommended for newborns. They are for babies above six months, older kids and adults.

Armpit temperatures are the least accurate. And don't bother feeling your baby's skin to check if she is having a fever - it is not accurate as it depends a lot on your own body temperature, said Dr Wong.

He said that your child has a fever if her:

  • Rectal temperature is above 38 deg C.
  • Ear temperature is above 37.8 deg C.
  • Oral temperature is above 37.5 deg C.
  • Underarm temperature is above 37.3 deg C.
  • This article first appeared in Young Parents magazine. Young Parents, published by SPH Magazines, is available in both digital and print formats. Go to www.youngparents.com.sg to subscribe and for more parenting stories.

3. Don't just focus on the numbers, look at the symptoms.

It is hard to remain calm as your child's temperature climbs. But a high reading on the thermometer doesn't necessarily mean her illness is serious, said Dr Leo.

Likewise, don't dismiss a low-grade fever as a minor issue, Dr Wong warned. A fever is not an illness, but usually a symptom of an infection.

Instead of focusing solely on the numbers, look at other signs to determine how sick your baby is - is she still playing and eating well?

See a doctor if her fever rises above 40 deg C or goes on for more than 24 hours, the AAP advises.

Dr Wong said you should take your child to the doctor if she:

  • Feeds poorly.
  • Is vomiting.
  • Looks lethargic or drowsy.
  • Is very young, especially if she is under three months old.
  • Has breathing difficulties.
  • Looks sicker than before.
  • Has stomach pain and discomfort.
  • Has a rash.
  • Passes less urine than usual.

4. If your two-month-old is heating up, go straight to hospital.

A hospital stay is usually required for babies under three months old who are running a temperature.

That is because the younger the baby, the higher the chance of get- ting a serious bacterial infection, such as a bloodstream or urinary tract infection, or meningitis (brain infection), Dr Leo said.

It is important that the baby gets the right tests and treatment in time. Symptoms of a serious illness tend to be more subtle in very young babies, which is why doctors are generally more cautious and may recommend additional tests for this age group, Dr Wong said.

For babies older than three months, see the doctor first to check if the condition warrants a visit to the emergency department.

5. Sponge baby with room-temperature water.

Bringing a high fever down with ice or cold water sounds logical, but the AAP advises against it. Doing so may cause chills or shivering, further raising the baby's temperature.

KKH suggests using tap or lukewarm water instead. Apply a cool compress to the forehead, nape of neck, armpits, neck and groin area, for no more than 30 minutes at a stretch. Stop sponging when your child starts shivering. Keep the room cool and well-ventilated.

6. Bundling up your feverish baby does more harm than good.

"When parents see their babies shivering, their usual reaction is to cover them with blankets. This would only trap more body heat, causing the body temperature to stay high," Dr Leo said.

Like adults, babies and children often feel cold or shiver during a bout of fever.

He said this occurs when the body tries to produce more heat to raise its temperature during illness to fight an infection.

Even if your baby is not sick, overwrapping can cause her temperature to be slightly above normal, especially in Singapore's hot climate.

"A blanket might be suitable if your baby is in an air-conditioned shopping mall, but not outdoors on a sunny day," Dr Leo said.

Ditch the swaddle, long-sleeved pyjamas and thick blankets. Opt for light clothing and offer plenty of fluids. Bring your baby's fever down with medication prescribed by the doctor, and then sponge her, he added.

7. You may reuse fever medications, but check the dosage.

Syrup paracetamol or ibuprofen can be kept in the refrigerator for up to six months or three months at room temperature, said Dr Leo.

But take note of the expiry date and storage instructions on the medicine bottle.

You will also need to know exactly how much medication to give your baby, which is based on her weight and not age.

The dose prescribed when she was six months old may not be suitable several months later.

To be safe, Dr Leo said parents should call the clinic or pharmacist to check the correct dosage, especially if the baby's weight has changed significantly since the last visit to the doctor.

You should never give your child over-the-counter medication.

For example, aspirin is not safe for children under the age of 18, as it can cause a rare but serious illness known as Reye's syndrome, Dr Wong said.

A version of this article appeared in the print edition of The Straits Times on January 17, 2017, with the headline '7 things you should know about fever'. Print Edition | Subscribe