Reducing Fever in Children: How to Do It Safely and Correctly

What Is a Fever and When Should You Consider Reducing It?

Fever is an elevated body temperature that serves as the body’s natural defense response to an infection. In children, a temperature above 38 °C is considered a fever. Although it may look alarming, it is often a sign that the body is fighting an illness.

It is not always necessary to reduce a fever immediately. It is mainly recommended when the child looks exhausted, is lethargic, refuses to drink or feels uncomfortable. If a child is prone to febrile seizures or other complications, it is advisable to consult a pediatrician.

Symptoms of Fever in Children

• Facial flushing
• Headache
• Tired-looking eyes
• Mood changes: the child is tearful or, conversely, unusually quiet
• Loss of appetite
• Chills: often cold hands and feet
• Warm body: a hot forehead, neck or chest
• Weakness
• Rapid breathing

How to Measure a Child’s Temperature

• Rectal temperature measurement: Before measuring, apply a small amount of oil or cream to the tip of the thermometer. Lay the child on their back or side and carefully insert the thermometer approximately 1–2 cm into the rectum. Wait until the device signals that the measurement is complete. For infants, this is the most accurate method of measuring body temperature. It is then recommended to subtract 0.5 °C from the measured value.
• Underarm measurement (axillary): Place the thermometer in the middle of a dry armpit and gently press the child’s arm against their body. Read the result when the device beeps.
• Ear or forehead measurement (with an infrared thermometer): Use a contactless or ear infrared thermometer for this method. When measuring in the ear, gently pull the ear backward and upward to straighten the ear canal so the sensor can record the body temperature correctly.
• Body stickers:  These work as approximate indicators that continuously monitor the fever without requiring you to keep waking or disturbing the child with a traditional thermometer. They use liquid-crystal technology, which reacts to changes in body temperature by lighting up the relevant value field.
  

Ways to Reduce Fever in Children

There are several ways to help a child with a fever. The most important things are ensuring sufficient fluids, rest and monitoring the child’s condition.

• Physical cooling: This includes lukewarm compresses or showering, which may help with a very high temperature. Never use cold water or ice!
• Fever-reducing medicines: Paracetamol (e.g. Paralen) or ibuprofen (e.g. Nurofen) are most commonly used in children. Always follow the dosage instructions or your doctor’s advice.

For a fever above 38.5 °C or when the child is uncomfortable, start reducing it by giving a medicine containing paracetamol or ibuprofen, ensure a regular supply of lukewarm fluids and provide bed rest. Do not overheat the child or cover them with thick blankets; choose lightweight clothing. 

How to Apply Cooling Compresses Correctly

Cooling compresses are a traditional way to safely reduce an elevated temperature. Proceed as follows:

1. Prepare lukewarm (not cold!) water, ideally at 23–27 °C.
2. Soak a diaper or towel in the water, wring it out and wrap it around the child’s chest for 10 minutes.
3. Cover the child with a dry sheet. Keep the arms and legs uncovered.
4. Repeat 3 times.
5. Never apply cooling compresses if the child has cold hands – palms – or feet – soles!!!!!!!!!!!!!!!

Always remember to cool only the surface of the body, without causing shivering.

A lukewarm shower works in a similar way: cool the child while they are standing in the shower, moving from the feet upward.

Paracetamol and Nurofen Dosage for Children

The dosage of medicines intended to reduce fever should always be calculated according to the child’s weight, not their age.

• Paracetamol (e.g. Paralen, Panadol): The usual dose is 10–15 mg per kg of body weight every 4–6 hours. The daily dose must not exceed 60 mg/kg.
• Ibuprofen (e.g. Nurofen): The dose is 5–10 mg per kg every 6–8 hours. The daily dose should not exceed 30 mg/kg.

Consult your pediatrician or pharmacist about alternating these two medicines and about the exact dosage.

When Should You See a Doctor?

•  If the child is an infant younger than 3 months.
• If the fever does not decrease after medicine is given or lasts longer than 3 days.
• If vomiting, difficulty breathing, apathy, a stiff neck or a skin rash occurs.

Fever Complications and First Aid for Febrile Seizures

In some cases, a high fever can lead to complications such as febrile seizures, especially in children aged 6 months to 5 years.

If febrile seizures occur:

1. Place the child on their side on a soft surface to prevent them from inhaling saliva or stomach contents.
2. Do not put anything in their mouth or give them fluids during the seizure.
3. Stay calm and monitor how long the seizure lasts – if it continues for more than 5 minutes, call emergency services immediately.

Seek medical help if seizures recur or other serious symptoms appear.

Fever in children can be stressful, but with enough information, you can manage it calmly and safely. If you are unsure, contact your pediatrician.