Q: I’m worried about COVID-19. It is all over the news and has drastically altered our daily life. I have a toddler who is a year and a half and I am worried if a fever is a sign that she could be affected. Can you give me some tips on how to know when I should take her to the doctor and how to care for her at home?
A: While a fever could be a sign of COVID infection, it is also very common in many other illnesses. Fevers are essentially your body’s way of burning out invading organisms (germs). While this is an essential role in combating invaders, it can make your child terribly uncomfortable. Most of the time a fever is nothing to worry about and can be easily treated at home. Yet in a small number of cases it could be a sign of something more serious.
The average temperature for small children is between 36.4C (97.5 F) and 37 C (98.6 F), taken under the armpit. Small fluctuations are normal due to hot weather or play, but for the most part this is normal.
High temperature and its signs
Usually they are sleeping longer than normal, their cheeks may be pink, their forehead or tummy will be warm to the touch. The official number for a “high temperature” is 38 C (100.4 F) or more, but a high temperature does not always correlate with the severity of the illness.
Child’s overall behavior
It probably isn’t too serious if they are still relatively happy, eating, drinking, alert, and smiling when their temperature comes down.
Caring for them at home
It is very common for a fever to come and go in waves over a 3-4 day period. Generally the temperature will come down with paracetamol or ibuprofen (fever reducing medicines), but may return in a few hours. Please remember children younger than 2 months should NOT be given any medicine unless prescribed by a doctor. If your child is younger than 3 months do NOT give them any medicine unless prescribed by a doctor.
Most children will experience increased tiredness, loss of appetite, and be a little more irritable. The main thing to focus on is keeping the little one hydrated with plenty of fluids. If you can get them to eat, bland foods seem to sit better when they are ill. Check on them regularly through the night and avoid leaving the house.
Pajamas and a light sheet are usually sufficient cover in the house. It is important to ensure that your little one doesn’t become overheated. This is particularly important in small babies, who can not regulate their body temperature, and can easily end up over bundled.
It is equally important you do not try to forcibly lower their temperature through sponge bathing, removing all their clothing, or other methods. These can be dangerous and cause more harm than good.
Time to get help
Take your child to the doctor immediately if they:
- are under 1 month and have any fever at all
- are under 3 months and have a temp of 38° C (100.4° F)
- are 3 months to 3 years with a temp of 39° C (102.2° F)
- have a fever lasting more than 5 days, or that doesn’t reduce with medicine
- have a rash or bruising on the skin
- have a stiff neck, headache, or aversion to light
- appear to have severe belly pain
- refuse fluids, have severe diarrhea, vomiting or any signs of dehydration
- have a seizure, unusually cold hands and feet, or appears pale and blotchy
- are drowsy, hard to wake, or unresponsive to normal activity
- have problems breathing, blue lips, tongue, or nails
- continuously cry, particularly if high pitched or a barking sound
- have a sunken or bulging fontanelle (soft spot)
Ultimately no one knows your little one like you. If you feel something isn’t right, or your child is showing more distressing symptoms then please seek medical attention. It is also important for you to seek medical advice if you or someone you have been in contact with has COVID-19 symptoms. In most cases COVID-19 is mild in children, and your little one may not be showing symptoms at all. If your child has a fever, persistent cough, or trouble breathing, and could have been exposed to the virus, phone for medical advice immediately.