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9 common mistakes of parents when caring for children with fever

In fact, Fever is not a disease, it is the body's response to a particular pathogen. Fever is beneficial because it inhibits the growth and reproduction of certain bacteria and viruses.

9 common mistakes of parents when caring for children with fever

1. Fever has defaulted harmful and parents don't care about other symptoms

Fever is not a disease, it is the body's response to a particular pathogen. Fever is beneficial because it inhibits the growth and reproduction of certain bacteria and viruses.

But it makes children uncomfortable; affects daily activities; relates to increased metabolic rate, oxygen consumption, CO2 production, and the need for the cardiovascular system - respiratory. (In a normal child, these cause little or no consequences. For a child who is in shock or has a heart-lung abnormality, it can be harmful.)

2. Not measure the temperature when the child has a fever

Many parents who come to see the doctor often say that the baby has a fever, but don't know exactly the temperature.

Advice: Fever is extremely important to help doctors diagnose correctly the disease and limit unnecessary testing

WHEN IS IT A FEVER?

  • The temperature of anal and ear ≥ 38.0 C
  • The temperature of armpit and mouth ≥ 37.5 C

3. Wrong temperature measurement

Because the baby often cries, parents normally use infrared thermometers to measure the temperature which is often inaccurate due to the technological quality. Infrared measurement is used to diagnose whether the baby has a fever or not instead of accurately showing the temperature. While the temperature is very important to diagnose and accurately predict the disease, especially children under 3 months.

Advice: Instructions on how to accurately measure temperature: use a thermocouple

  • Infants up to 2-year-olds: anal temperature (option 1), armpit temperature (option 2).
  • Children over 2-year-olds and under 5-year-old: anal temperature (preferred), armpit temperature
  • Over 5 years old: oral temperature (preferred)

4. Inappropriate fever-reducing medicine: Using fever-reducing medicine when not indicated even when the baby has a low fever and still plays happily

When children have a high fever, parents are really worried and afraid they’ll have seizures. However, it has been shown that febrile convulsions are added by many factors but not only high fever. Other factors include hyperthermia, hereditary (nearly 20% of children whose parents or siblings have febrile convulsions or seizures), virus. Hence, not all cases will have seizures. As a result, taking fever-reducing medicines will not be able to prevent seizures.

It is important that if a child is diagnosed with a benign febrile seizure, there will be no sequelae causing brain damage or high seizures (the risk of epilepsy is 1%).

Advice: Reduce fever when the child has a fever above 39.0 C (some advice to wait for a fever over 40.0 C)

5. Have to reduce fever right away,  use a combination of fever-reducing medicines, and use the flexible-dose

  • The common antipyretic drug that is quite safe in young children is acetaminophen or paracetamol. The dose is 10-15mg / kg every 4-6 hours and no more than 5 doses in 24 hours.
  • Ibuprofen is an antipyretic drug that the effect is stronger and more prolonged antipyretic than paracetamol. Should follow the doctor’s guidance instead of freely using it for patients who have the risk of dengue fever, chickenpox.
  • Two antipyretic drugs should not be combined at once (risk of wrong dose).
  • It’s the same to drink or inject. So if the medicine is inserted through the anus, it is not allowed to drink more within 4-6 hours.

6. Cool the children to reduce fever 

It's just a temporary method to reduce fever but makes the baby uncomfortable and get more tired. It is also ineffective when parents use patches to reduce fever, alcohol, lemon rub to reduce fever.

Advice: For children who use fever-reducing medicines but cause allergies, vomiting; or children have a high fever while waiting for the medicine active; bathe them in warm water (30c, at room temperature 23-24c).

7. High fever will cause seizures that harm the brain

Febrile convulsions usually occur in babies 6 months to 6 years old which do not affect. Except for those with epilepsy, the febrile seizure may be one of the initial symptoms.

8. When a child has a fever seizure, parents don’t have appropriate first aid

Parents worry that their children should bite their tongue and put hard objects (a spoon, a stick, or even a finger) in their mouths. This leads to a risk of children swallowing foreign objects or putting lemon into their mouth which creates choking.

Advice: Keep a correct posture when the child has convulsions. 

9. Late check-up 

Many parents let their children have a fever for too long to see a doctor. It can increase the risk of serious illness (e.g. children under 2 months have a high risk of meningitis, sepsis).

Advice: When do children need to see a doctor?

  • Children under 3 months of age and anal temperature measured at 38 degrees C or more. No matter how healthy your baby looks, it needs to be evaluated by a doctor. Antipyretics should not be given until approved by doctors.
  • Children 3 months to 3 years of age who have an anal temperature of 38 degrees or for more than 3 days or whenever they don't look well like crying, irritability, clinging to their parents not leaving, refusing to feed.
  • Children from 3 months to 3 years old have a fever of 39 degrees or more.
  • Children of any age have a fever of 40 degrees or more
  • Children of any age have seizures.
  • Children of any age who have a fever for more than 7 days, or even only 1 fever per day lasts a few hours.
  • Children of any age have a fever and chronic medical conditions such as heart disease, cancer, lupus, and sickle cell anemia. There is a skin rash.

Reference:

1. https://www.rch.org.au/clini…/guideline_index/Febrile_child/

2. https://www.uptodate.com/…/febrile-seizures-beyond-the-basi…

3. https://www.healthychildren.org/…/…/fever/Pages/default.aspx

Author: Dr. First Degree Specialist Lai Thi Bich Thuy 

  • More than 12 years of experience
  • Specialized in pediatric general medicine, consultation, and treatment of kidney-endocrine diseases
  • Certificate of Pediatrics training in Sydney (Australia)

 

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