The very first thing that you notice would be a slight rise in temperature on child’s forehead. Then the suspicion of a fever starts to grow in your mind. You will then try to confirm the fever by touching the neck, hands, and the torso of your child. Oh god! poor kid is having a fever. But how much? You’ll need a thermometer for measuring the temperature and once you confirm the severity of fever, you can do things at home which can help in reducing fever and preventing the risks associated with it. The simple measures which can be done at home to reduce fever is not just confined to giving the child fever reducing medications like Acetaminophen (Paracetamol), there are other important steps to follow when taking care of a child with fever. In this article we will be discussing about the most common ailment in the world, FEVER. And since it is difficult to manage fever in children when compared to adults, let us focus more on the home care management of fever in children.

Understanding Fever

• Fever is a symptom and not a disease. Fear the cause of fever and not fever as such.
• Commonest fevers are Viral fevers which do not require multiple medications or various tests.
• Most viral fevers take 3 to 5 days to recover.
• The normal body temperature is 37 C or 98.6 F
• Thermometers are used to determine the body temperature of the child. There are several types of thermometers available in the market which can be easily used by anyone at home.
• Thermometers can also be used to monitor the temperature by keeping charts if required. Ideally it is advised to keep the temperature below 102 degrees of Fahrenheit or 38.9 degree Celsius. I will be writing more on how to use thermometers and will add the link here. UPDATE : Rea this article to learn about Thermometers.
• Fever management mentioned in this article should be used only after the consulting with your doctor and commenciing the treatment for the cause of the fever. Trying to suppress fever by overdoing the steps mentioned in this article, without consulting a doctor is not advisable.
• There are three main approaches to fever management at home and they are temperature control, giving proper supportive care and monitoring for serious life threatening illness.

Steps to Reduce the Temperature

• Make the child comfortable by removing tight clothes, caps etc. It is usually better to dress the child in a single layer of soft cloth and a light blanket (if required)
• Keep the child in a well ventilated room
• Give medications like Acetaminophen, Ibuprofen, which are available in India for over the counter use. It would be wise to consult your doctor if you are not sure about the dosage of the medications. Do keep in mind to follow the doctor’s prescription strictly and not to stop the medications once the fever comes down. Decreasing the frequency of medications is also not advisable. This is one of the main mistakes made by mothers who are afraid of overdosage.
• Continue the medications for 24 hours after the complete disappearance of fever
• Tepid Sponging : Using a sponge or wash-cloth to wet the skin of the child with warm water all over the body is very helpful in reducing the temperature. It works by promoting heat loss through evaporation from the skin surface and not by localised cooling. There is no use in placing wet clothes over the forehead as the cloth prevents evaporation.

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Cold Water Sponging to Manage Fever

Is cold water sponging effective in controlling fever of your baby? should you give paracetamol along with cold water sponging? This is what I’m going to tell you.

Cold sponging, it’s also called as tepid sponging. Using a sponge which is dipped in water which can be cold or warm and using that sponge wet the surface of your child so that a thin layer of water is always there on the body surface.It works by promoting heat evaporation from the body surface rather than by localized cooling. I have seen many parents who keep this same piece of wet cloth or sponge on the body surface in order to maximize the cooling effect.But it actually doesn’t help, What happens is that the process of evaporation doesn’t take place as there is a barrier which is the clothe or the sponge which prevents the evaporation and thereby the cooling process doesn’t actually take place.So it should not be done.According to NCBI, several studies have been conducted on the effectiveness of cold sponging alone then combining cold sponging with paracetamol and by giving paracetamol alone.

Most of these studies have shown that a combination of cold sponging and paracetamol seems to deliver the best results in lowering the temperature.It is concluded that cold water sponging although it has a rapid effect in lowering the body temperature. It only acts for a short period of time, that is for only the first 30 minutes after sponging. Paracetamol on the other hand produces a much gradual but sustained effect. The effect of Paracetamol starts only after 30 minutes of the intake of the medicine. But, once the effect of paracetamol starts, it has a sustained effect in lowering the body temperature which acts for approximately six to eight hours.

The reason why most kids and adults hate cold sponging is because of the discomfort it causes. This discomfort should not be a limiting factor when using cold water sponging to lower the body temperature when you have a fever. Coldwater sponging particularly helpful if your child has febrile seizures. Now body temperature rapidly reduces after sponging and by the time Paracetamol starts its effect on lowering the body temperature, cold water sponging can be used simultaneously to keep the body temperature at a reduced level in order to prevent further seizures and other complications.

If you have any doubts about cold water sponging just ask a doctor using chat, video call or audio call sitting in your home. So have you tried cold sponging to lower your babies or child body temperature? Did your child like it? Please remember that there are many doctors on Dofody who are willing to help you out. You can contact them by downloading the Dofody app.

Supportive Care

• Steady intake of warm oral fluids like salted rice soup, lime juice, tender coconut water. Avoid Coffee and Tea and even simple water as these fluids do not contain the essential electrolytes and glucose which are necessary to prevent dehydration.
• Continuos intake of small frequent portions of warm well cooked and soft nutritious food and locally available fruits.
• Rest till the symptoms disappears completely.

 When to report to a Hospital?

Do’s In Managing Fever

• Covering the nose and mouth while coughing or sneezing.
• Washing hands often with soap and water.
• Consult a doctor in case of high grade fever before starting self treatment.
• Give proper medications at appropriate frequency as prescribed by the doctor.
• Do tepid sponging of arms, legs and torso of the child with warm water.
• Encourage the child to drink more fluids.

Do NOT

• Restrict food or fluids
• Wrap up the child in multiple layers of clothing or use thick blankets, caps etc.
• Engage in activities which needs physical exertion
• Self medication as it is dangerous
• Compel doctors to give Injections or Intravenous drips for fever as they can lead to unwanted side effects like shivering, pain, dizziness or dangerous allergic reactions.
• Try to suppress fever without knowing it’s actual cause. Let the doctor decide the cause of the fever. Your doctor will prescribe medicines for treating the cause of fever. Steps mentioned in this article are to be implemented together with proper medications.