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Childhood fevers
Childhood fevers can be scary for any parent. Most fevers, however, are a normal part of childhood and should pass without much trouble. Below I have tried to set out some information and guidelines to prepare you and get you through a fever as smoothly as possible.
What causes a fever?
A fever is normally a sign of a bacterial or viral infection. The infection may be seated in the ear, throat, chest or urinary tract, or indeed be of non-descript systemic nature, with no symptoms in particular except a high temperature.
In some rare cases, a fever accompanies a serious disease such as meningitis or septicaemia and in these cases immediate help from a medical professional must be found.
Please make yourself familiar with the most common signs and symptoms of such serious illnesses so that you can relax when they are not present.
Why do we have a fever?
A fever develops when the body has been invaded by germs of some sort. A high temperature is a tool the body uses to kill off invaders. Seen in this way it is our ally, not our enemy.
Biological mechanism of a fever
When the body detects a harmful invading organism such as a bacteria or a virus, certain chemicals are released. These cause the body’s thermostat to reset its temperature to higher than normal. In an otherwise healthy person this same thermostat has a cut off point so that overheating of the body and subsequent damage to brain cells and other tissues is prevented. For us this means that we can probably be about 95% certain that our child’s fever will not go beyond a temperature of 41C (105.8F) if left alone.
When the body has reached the new higher temperature determined by the thermostat it will make an enormous effort to stay there until such a high temperature is not deemed necessary anymore. Any fever reducing measure which goes against this principle may result in subsequent rise of the temperature back to the point determined by the thermostat. Medicines such as Calpol as well as physical methods of cooling down both may result in a return of the fever at even higher levels than before in an effort of the body to resolve the problem.
By contrast, homeopathy seems to work in tune with the body as it may increase the efficacy of the immune system in dealing with the cause of the fever. In effect, homeopathy may result in a reduction of the temperature to comfortable levels because under the influence of the homeopathic remedies the immune system does not need the extra help it would get from a higher temperature.
A fever is beneficial in three ways
Most bacteria and viruses cannot survive at high temperatures. They begin to die off from about 38C (100.4F) upwards. A fever is the body’s direct weapon against germs.
Our immune system becomes more efficient at detecting and destroying germs when our body temperature is raised. A fever therefore super-charges our immune cells and gives them an advantage over germs which die off at high temperatures.
Our body shuts down some less important functions during this time. In this way a fever causes us to feel lethargic and physically weak, forcing us to rest. In addition, our digestive system shuts down for a few days so that energy can be saved for a full-scale immune defence.
Eating (and formula feeding in infants) during a fever can cause vomiting, diarrhoea, a rise in temperature and a general prolonging of the illness, and therefore should be avoided. Drinking (and breastfeeding infants) is essential to supply vital fluids for prevention of dehydration.
When do we need to bring a fever down?
A fever beyond 41C (105.8F) is commonly understood to be dangerous for our body cells. It is thought that brain cells may begin to die off at such a temperature, although no exact figure has been established at which brain cells are thought to begin suffering.
Biochemists speak of temperatures of 43C (109.4F) and above as destructive to our body components, but it is better to err of the safe side. For this reason, I advise to think of 40C (104F)as the upper limit you should allow a fever to rise to.
How do we bring a fever down?
A fever of 40C (104F) or above needs to be brought down to avoid damage to body cells that may occur from 41C (105.8F) upwards.
A fever should not be brought down to lower than 38C (100.4F) because the body needs a raised temperature to kill off the invading germs.
Biochemists speak of temperatures of 43C (109.4F) and above as destructive to our body components, but it is better to err of the safe side. For this reason, I advise to think of 40C (104F) as the upper limit you should allow a fever to rise to.
There are several ways to achieve this:
Anti-pyretic medicines (Calpol, Ibuprofen, etc)
These pharmaceuticals are very efficient in most cases and should be at hand in all homes with children. They are our last resort and can be life-saving in extreme cases. Use should be restricted to temperatures above 40C (104F) that do not respond to natural ways of fever management.
The disadvantage of anti-pyretics is that they tend to stop the fever altogether and in some cases cause an abnormally low temperature. This means that the immune system has been robbed of its most powerful ally in destroying the invading germs.
Subsequently, the illness may linger on and may need to be treated with further medication to help the body get rid of the infection. Additionally, the immune system has been robbed of its chance to defend itself against this particular type of germ and so remains open to attack in the future. In this way, using medication can set up a cycle of recurring fevers, infections and dependency on medication.
Physical methods such as wet sponging, wet wraps etc
Sponging down and wet wraps are an option of natural fever management. Never use cold or ice-cold water because this may push the fever up even higher as the shock of the cold water on the skin may cause the body double its efforts to keep its desired temperature.
Use warm water only, at similar temperatures to your child's skin, to avoid shock. The cooling down effect is produced when the water dries on the hot skin. This should cool your child down slightly without causing the fever to go up.
Homeopathy
Homeopathic remedies may help bringing down a fever to manageable levels so that your child may sleep or rest. The remedies appear to support the immune system and increase its efficiency so that a very high fever may not be necessary. A temperature of 38 - 39.5C (100.4 - 103.1F) may remain for the duration of the illness, but under the influence of the remedies your child may feel more comfortable and may be able to rest or sleep while the immune system is working most efficiently. Additionally, the homeopathic remedies appear to address the underlying cause of the fever and may enable the body to overcome the infection naturally. In this way the immune system appears to learn from the experience and may deal with future attacks more efficiently.
Natural cycles of a fever
Our body operates within natural wake-sleep cycles. The interplay of hormones creating this rhythm also influences our body temperature, even during a fever. When we are well, our body temperature naturally begins rising from 4am onwards, remains high during the day and begins falling again towards 4pm. This wakes us up in the morning and lets us go to sleep in the evening.
When we have a fever, our body responds in the opposite way, because the hormone which wakes us in the morning at the same time suppresses our immune system making a fever less intense.
This means that most fevers go through a cycle of low intensity from early morning till early afternoon, but then begin their phase of high intensity in the afternoon through the night till about 2 am.
In an average fever lasting 1 – 3 days we can therefore expect several low intensity and several high intensity phases depending on the time of day. Do not think of an afternoon surge in temperature as a worsening of the condition! It is only the natural cycle a fever will go through.
Natural stages of a fever
A fever may go through several stages. As the body is heating up to achieve the temperature determined by the thermostat to be the best one for dealing with the invading organism, your child may feel cold within themselves, although they may feel hot to touch. They may shiver and ask to be covered. It is very important not to physically cool down a child who is in this stage as the body may react by trying even harder to heat up, resulting in an even higher temperature and greater exhaustion.
Once the desired temperature has been reached, your child may begin to feel hot while the immune system is working at its best. It is difficult to predict how long this highest point will be sustained, but commonly the next stage will set in during the night. This stage is called the crisis point and is marked by sweating and a desire to cool down. This is the time when your child may feel worst, but it indeed marks the turning point for the better. The immune system has done its good work and the thermostat determines a new lower temperature to be adequate for the following hours. At this point it would be wrong to keep your child especially warm as the body needs to cool down. Uncovering is usually all that is required at this stage.
As the morning approaches, your child may be back to an almost normal temperature. In some cases this marks the end of the illness, but in some cases another cycle will start in the afternoon and perhaps again the following day. Most fevers will last 1-3 days.
My step by step action plan for a childhood fever
If you are not sure, go to see a doctor immediately.