1. Fever in Children: Understanding and Managing a Common Worry
Madhavi: Namaste and welcome back to the Ananya Child Development Center podcast. I'm Madhavi, and today we're discussing a common parental worry: fever in children. We're fortunate to have Dr. Srinivas Jakka, a respected pediatric pulmonologist, with us. Dr. Jakka, welcome.
Dr. Jakka: Thank you. Glad to be back at Ananya.
2. What is Fever?
Madhavi: Parents often ask, "Should I skip therapy if my child has a fever?" or "How high is too high?" Could you explain what fever is?
Dr. Jakka: Fever is a symptom, not an illness itself. Normal body temperature is between 98-99°F. Fever is a sign the immune system is fighting infection. Generally, an oral temperature above 100°F, or an axillary temperature above 99°F, is considered a fever. It’s important to identify the cause rather than fixating on the number.
3. Accurate Temperature Measurement
Madhavi: Many parents touch a child's forehead. Is that reliable?
Dr. Jakka: Touch can be subjective. Your hand's temperature can affect your perception. Use a thermometer for accuracy, as it's crucial for appropriate medical decisions. Mild fevers (under 100°F) are typically less concerning. For concerns, consult a pediatrician.
4. Common Fever Causes
Madhavi: What causes fevers in children?
Dr. Jakka: Fevers are either acute (less than a week) or chronic. Acute fevers are usually infections, primarily viral. These can impact various body systems. Identifying specific symptoms helps pinpoint the affected system. See our page on Conditions for more information.
5. Recognizing Symptoms and Warning Signs
Madhavi: What should parents look for?
Dr. Jakka: Look for both general and specific symptoms. General symptoms like headaches, vomiting, and chills can accompany any infection. Specific symptoms depend on the affected system. Respiratory infections may present with cold, cough, sore throat, earache, or breathlessness. Digestive issues might involve stomach pain, vomiting, or loose stools. Ear infections cause ear pain and discharge. Brain infections can cause headaches, light sensitivity, irritability, lethargy, or seizures. Kidney or urinary tract infections can cause vomiting, painful urination, or discolored, smelly urine. Consult a pediatrician for any concerns.
6. Can Fever Cause Brain Damage?
Madhavi: Can fever cause brain damage?
Dr. Jakka: Fever rarely causes damage. Exceptions are extremely high fevers (107°F or above) or prolonged seizures. Understand fever severity: Low-grade: 99-100°F; Moderate: 100-102°F; High-grade: above 102°F. Even high-grade fevers are usually not damaging. Febrile seizures, brief seizures associated with fever, are also usually harmless. Prolonged seizures, however, can be a concern.
7. Febrile Seizures: Understanding and Managing
Madhavi: Parents are often scared of febrile seizures. Can you explain them?
Dr. Jakka: Children with existing neurological conditions, especially epilepsy, are more prone to seizures during fever. However, brief seizures rarely cause damage. Rescue medication can help stop prolonged seizures. Parents should learn how to administer such medication if prescribed and create a safe environment for the child during a seizure. Consult a neurologist if you have concerns about seizures.
8. Why Do Seizures Occur During Fever?
Madhavi: Why do seizures happen with fever?
Dr. Jakka: Seizures are caused by excessive electrical activity in the brain. Fever lowers the seizure threshold, making some children more susceptible. A family history of febrile seizures can also increase the risk. It's important to remember that brief seizures typically don't cause lasting harm. Learning basic first aid for seizures can empower parents. Check our FAQs for more information.
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9. Practical Fever Management at Home
Madhavi: What can parents do at home when their child has a fever?
Dr. Jakka: First, confirm the fever with a thermometer. Don't panic. Give an antipyretic like paracetamol (syrup, tablet, or suppository). For high fevers, ibuprofen can be used (consult a doctor before giving any new medications.) Supportive measures include loose clothing, a well-ventilated room, and plenty of fluids. Sponging with lukewarm water can help if medication isn't enough. Never use cold water. These steps can often manage fevers at home.
10. Feeding During Fever
Madhavi: What about feeding a child with a fever?
Dr. Jakka: Loss of appetite during fever is normal. Chemicals released during the immune response can cause nausea. Don't force-feed. Prioritize fluids like ORS, coconut water, milk, buttermilk, and juices. Aim for 40-50 ml of fluid per hour. Monitor urine output for hydration. If your child isn't eating solids for a few days but is taking fluids and urinating regularly, there's usually no need to worry. Watch for dehydration signs like drowsiness, lethargy, and reduced urination. Nutritional therapy can provide guidance for managing dietary needs during illness.
11. When to Use Antibiotics
Madhavi: When are antibiotics necessary?
Dr. Jakka: Antibiotics are often overused. They fight bacteria, not viruses, which cause most fevers. Use antibiotics only when a doctor diagnoses a bacterial infection, like tonsillitis, pneumonia, or a urinary tract infection. Never self-medicate with antibiotics. Antibiotic resistance is a serious concern. Always follow a doctor's prescription. Consult a doctor for appropriate diagnosis and treatment.
12. Warning Signs for Fever
Madhavi: When should a parent seek medical help for a fever?
Dr. Jakka: You don’t necessarily need to see a doctor for a low-grade fever in the first three days if the child is otherwise well. See a doctor if: the fever is high (103-104°F) and not responding to home management; the child stops taking fluids and urinates less; the child becomes lethargic, drowsy, or irritable; the child has breathing difficulties or seizures; the child is constantly in bed and not playing even when the fever subsides. When you see a doctor, provide a detailed, chronological history of symptoms. This is crucial for diagnosis and deciding on the right investigations. Avoid unnecessary "fever panels." Let your doctor guide the process. Book a consultation.
13. Top Tips for Managing Fever
Madhavi: Your top tips for managing fever?
Dr. Jakka: 1. Fever is common, especially in young children. 2. Fever is a symptom, not a disease; address the underlying cause. 3. Manage fever at home with the methods we discussed, but seek medical advice if warning signs appear. If you have concerns about your child’s development, consider our developmental assessments.
14. Coughs and Colds: How Many is Normal?
Madhavi: How many colds per year is normal for a child under six?
Dr. Jakka: Studies suggest six to eight colds a year is common, especially when children begin childcare or school.
15. Mucus Color: Does it Matter?
Madhavi: Parents often ask about mucus color. Is green or yellow mucus serious?
Dr. Jakka: Initially, mucus is clear. It can thicken and turn green, sometimes indicating a bacterial infection on top of a viral one. If coughed-up mucus (in older children) is green, a bacterial infection might be present. Understanding different infections is helpful. Consult a doctor if concerned.
16. Managing Nighttime Coughs
Madhavi: Any tips for nighttime coughs?
Dr. Jakka: Three main causes: 1. Postnasal drip: Mucus dripping down the throat when lying down. Steam and clearing the nose can help. 2. Asthma: Cough starts after falling asleep, often worse at night and early morning. Requires asthma medication. 3. Reflux: Food regurgitation. Avoid overfeeding before bed. If the cough lasts more than a few days, see a pediatrician.
17. Home Remedies: Honey, Tulsi, Ginger
Madhavi: What about home remedies like honey, tulsi, or ginger?
Dr. Jakka: Try what works for your child, ensuring it's safe and not too harsh. Honey in warm water can soothe the throat and is often as effective as cough syrup. Consult a pediatrician if home remedies aren't sufficient.
Madhavi: I remember my grandmother's concoctions!
Dr. Jakka: Home remedies can be comforting. Cough often disturbs the family more than the child. However, avoid over-medicating just for sleep. A pediatrician's advice is crucial for balancing symptom management with medication use.
18. Lingering Coughs: When to Worry
Madhavi: When should parents worry about a cough that lingers?
Dr. Jakka: For a chronic cough (lasting weeks), observe the trend. If improving, there’s likely no need to worry. If worsening or staying the same, consider whether it's wet or dry. A wet cough could signal a lingering infection, possibly needing antibiotics. A dry cough might suggest asthma. A prolonged cough with fever necessitates investigation for infections like TB. Consider fever, breathlessness, and weight loss when assessing a long-term cough.
19. Rashes with Fever
Madhavi: Are rashes common with high fevers?
Dr. Jakka: Yes, especially with viral fevers like measles, chickenpox, or hand, foot, and mouth disease. Some rashes are diagnostic (e.g., chickenpox blisters, hand, foot, and mouth rash). Others are non-specific. The rash's appearance, location, and accompanying symptoms help determine the cause. Consult a doctor if concerned. If a rash causes concern, consult a medical professional for evaluation.
20. Documenting Rashes
Madhavi: Should parents document rashes?
Dr. Jakka: Yes, photographing rashes is very helpful as they can change over time. Videos of unusual behaviors can also assist in diagnosis. This visual record aids doctors greatly.
21. Cough as an Asthma Indicator
Madhavi: How can a cough indicate asthma?
Dr. Jakka: An asthma cough is often worse in the evenings, night, and early morning. It can be triggered by exercise, emotions, cold air, cold food/drinks, or dust. Asthma medications like salbutamol provide relief. Other signs include breathlessness, chest tightness, and wheezing. If you suspect asthma, consult a pediatrician.
22. Allergies vs. Colds
Madhavi: Allergies versus colds? How can parents tell?
Dr. Jakka: Colds from infections usually have a fever. A runny nose with fever points towards infection. Colds can cause a runny or blocked nose, mouth breathing, and snoring. Allergies can cause these too, but also sneezing, itchy nose/eyes, red eyes, and watering. If these symptoms appear without a fever, suspect allergies. Allergy tests can confirm. Contact us for adhd support if needed.
23. Allergy Testing
Madhavi: How are allergies diagnosed?
Dr. Jakka: If allergies are suspected, allergy testing (skin prick or blood test) can confirm. Consult with a pediatrician.
24. Steam Inhalation: Safe Practices
Madhavi: Is steam inhalation advisable?
Dr. Jakka: Steam inhalation can be beneficial, but practice caution, especially with kettles, to prevent burns. Electric steam generators are safer. Ensure the steam isn't too hot.
25. Nebulizers: Appropriate Use
Madhavi: When are nebulizers needed?
Dr. Jakka: Nebulizers deliver medication in aerosol form, useful for wheezing in asthma or other conditions. Inhalers are generally preferred due to lower dosage, fewer side effects, portability, and ease of use. Nebulizers should be used with a doctor’s prescription.
26. Conclusion and Parent Support
Madhavi: Thank you, Dr. Jakka. This has been incredibly helpful for parents. At Ananya, we understand parents' deep love and concern for their children. This conversation provides confidence in knowing when to worry, wait, act, and observe. You're not alone on this journey. Remember, informed care is powerful medicine.
Dr. Jakka: Thank you.
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Disclaimer: This blog post provides general information and is not medical advice. Consult a qualified healthcare professional for any concerns about your child's health.
For expert guidance and personalized support, book a consultation with Ananya Child Development Centre today.
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