Understanding and Managing Fevers in Infants
Having a newborn is a very exciting time for parents. However, conditions such as coughs, colds, and diarrhea can create worry. As a parent or caregiver, you want to feel confident in how you are handling these situations, ultimately making sure your child is comfortable and safe. Here are some strategies for appropriately navigating common infant illness and tools to help your child feel better sooner!
One of the most common symptoms of infant illnesses is fever. While understandingly worrisome for parents, fevers are an important way your child’s body protects itself against viruses and bacteria. A fever is integral to the body’s system of activating an offensive attack against sickness. Fevers create an environment that is toxic to infectious organisms. They are associated with a boost in white blood cell count (the “soldiers” of the immune system), increased heart rate (helpful to circulate those soldiers), and the fatigue and lethargy that prompt your child to rest and recover. A fever is a sign that the body is doing exactly what it needs to do. Fevers due to an infection do not go high enough to cause neurological damage. Some children will be susceptible to febrile seizures (a seizure caused by a rapid increase in body heat) however incidence is low and even these have not been shown to cause damage.
While the fever itself should not cause worry, a higher fever may be an indicator of a more serious cause of illness. Most common childhood illnesses are viral. They cause low fevers and are generally benign and self-limiting, although they certainly can cause distress (think ear infections and croup). A bacterial infection may be more dangerous. A higher fever may indicate the need for medical care, particularly if there are other concerning symptoms (see below).
There is no need to suppress a fever (although an infant under three months of age with a fever should seek immediate medical care). When acetaminophen and ibuprofen are used to reduce fever and alleviate discomfort, the entire immune response is suppressed, potentially prolonging the illness. By allowing the body to do its work—marked by the fever running its course—you may be actually helping to promote recovery. There are many ways to help an ill child feel more comfortable without using a fever suppressing medication. Read on!
When to worry about a fever
So if fever alone shouldn’t cause worry, what should? Assessing your child overall is more important than the number on the thermometer.
Low risk - keep a watchful eye
- Skin, lips, and tongue are pink and plump
- Responds and cries normally
- Stays awake or is woken easily
- Mouth and eyes are moist
- Less active than usual
- Low grade fever
- Runny nose
- Decrease in appetite
- Loose stools
Medium risk - seek prompt medical attention
- Pale complexion
- Doesn’t respond or wake normally; lethargic/drowsy
- Increased breath or heart rate
- Mouth is dry
- Not nursing/eating/drinking well
- Persistent vomiting
- Signs of swelling or pain
- Skin rash
- Yellow or green nasal discharge
- Coughing up sputum
- Nostril flaring
- Symptoms or fever for > 3-5 days with no improvement
High risk - needs urgent care
- Less than 3 months of age
- Pale, blue, or grey complexion
- Not responding; does not wake or stay awake
- Weak, high-pitched, or continuous cry
- Grunting or sounds of distress
- Neck stiffness, seizures, or neurological changes
- Difficulty breathing or swallowing
- Coughing up blood
- Blood in stool or vomit
- Decrease in urination
- Dry eyes, sunken or bulging fontanelle
- Severe pain
Helping a fever at home
Barring signs of serious infection requiring medical attention, the goal is to help your child be as comfortable as possible while allowing her body to take care of the illness on its own. Here are some tools to help you appropriately treat common low-risk concerns:
Little ones who are ill are uncomfortable, cranky and need a lot of extra love. Cuddling, story-reading, and back-tickling occupy them during the time their body’s need to rest. Make sure their clothes and bedding allow them to regulate their temperature well.
How to use
You already know! Baby should be dressed comfortably in lightweight clothing
Infants typically have a decrease in appetite when not feeling well, and lose more fluids when they have a fever or diarrhea, so it is important they are getting the appropriate nutrition and hydration.
How to use
Continue to offer fluids in the form of water, breast milk, homemade vegetable or bone broth, smoothies or soups. Herbal teas contribute therapeutic benefits too!
Helps promote circulation, allowing the white blood cells to target the cause of infection.
How to use
Put cold, wet socks on child’s feet, and cover with dry thermal (wool or fleece) socks or booties. Tuck them into bed. The socks will warm up quickly and be dry by morning.
Nasal irrigation and bulb syringe
Helps to clear a stuffy nose.
How to use
Salt water helps dilute mucus to make it easier to clear. Breast milk does the same, and is rich in antibodies that help target the infection. Irrigation products designed for infants can be purchased in the pharmacy or a few drops of liquid gold can be simply dripped into the child’s nose. Diluted or not, mucus can be removed using a simple bulb syringe found in any pharmacy.
Helps to clear the nose and sinuses; may alleviate a cough.
How to use
Turn on shower to hottest setting; close door to create a steam filled room; bring infant into the room for approximately 10 minutes
Teas made from plants such as elderberry, yarrow, or peppermint are anti-microbial, support the immune system safely, and allow a fever to run its course in a healthy way
How to use
Pour 1 liter boiling water over 3 heaping tablespoons of dry herb. Steep until cool enough to drink or touch. Add to bath water, soups, or give to child directly as a tea. Even infants can safely take these teas from a cup or using a dropper.
Castor oil belly rubs
The digestive tract is richly supplied with lymphatic tissue—a key part of the immune system. Castor oil is absorbed through an infant’s skin and promotes immune activity.
How to use
Warm a small amount of cold-pressed castor oil in your hands; gently massage baby’s tummy, moving your hands in a clockwise direction; leave the oil on when you dress him. Rub it into the chest as well if there is also a cough.
If there are no concerning symptoms, but the fever is higher than your comfort level, this can help bring the temperature down without suppressing the rest of the immune response.
How to use
Using lukewarm water use washcloth to slowly bathe child; adding strong herbal teas to the bath water add therapeutic benefit!
Note: Essential oils such as eucalyptus should not be used in infants as they can be toxic. Honey also is not recommended to be ingested by infants until approximately one year of age.
It is natural to feel concerned about your child getting sick. Knowing when to worry, and having some tricks up your sleeve will enable you and your infant to sail through the most common childhood illnesses.