What to do when a child has a high fever that is difficult to bring down?

All children with a fever lasting more than 24 hours should be examined by a pediatrician. (Image: health.mingpao)

According to Dr. Nguyen Thanh Sang from Ho Chi Minh City Children's Hospital, children with fever, especially viral fever, sometimes experience very high fevers, reaching 39-40 degrees Celsius, and even with medication, the fever doesn't subside. The child may only drop to 38 degrees Celsius before the fever returns to a high level.

"All children with a fever lasting more than 24 hours should be examined by a pediatrician. However, many children take fever reducers at home but their fever doesn't go down, so parents shouldn't worry too much," Dr. Sang said.

The essence of a fever is the body's fight against microorganisms. The high body temperature inactivates bacteria, viruses, etc., allowing the child's immune cells to easily expel harmful microorganisms from the body.

All children under 3 months old should be examined by a doctor if they have a fever.

This expert emphasized that even at night, parents should take their children to the doctor because 80% of the causes in this age group are infections. In particular, children may develop serious conditions such as meningitis or sepsis. Therefore, if parents notice that their baby under 3 months old has a temperature of 38 degrees Celsius under the armpit, is feeding less, is lethargic, and more tired than usual, they must take their child to the doctor immediately.

"I've examined many babies under 3 months old who only fed less, had no fever, and seemed lethargic more than usual, and the examination results showed they had meningitis. The earlier the antibiotic treatment, the lower the rate of complications in this group of children," said Dr. Thanh Sang.

The temperature doesn't necessarily have to drop from 40 degrees Celsius to 37 degrees Celsius.

According to Doctor Sang, the mindset of having to lower a child's temperature to 37 degrees Celsius is inappropriate. Many children have fevers that are difficult to bring down, especially in the first 3-5 days.

When a child has a fever of 38.5 degrees Celsius or higher, parents can give them a dose of paracetamol (acetaminophen) at 10-15 mg/kg, not exceeding 60 mg/kg/day.

A child's body temperature only needs to drop below the temperature before taking fever reducer to be considered acceptable. For example, a 10.5 kg child with a fever of 40°C can be given one 150 mg paracetamol sachet. 30 minutes later, the child's temperature drops to 38.5°C, they feel less tired and fussy, sleep better... parents don't need to wake the child up to cool them down or give them more medication to lower the temperature to 37°C as usual.

Many children have difficulty bringing their fever down. Photo: Vecteezy

Seizures are not related to whether a child has a high or low fever.

This depends on each child's individual constitution. For example, some children may not have seizures even with a fever of 40 degrees Celsius, while others may experience them at only 38 degrees Celsius.

Febrile seizures rarely affect the brain or cause developmental delays in children, contrary to some rumors. Children requiring neurological evaluation are those who experience seizures without fever or who have continuous seizures of unknown cause. In these cases, they should be taken to the hospital for examination to rule out epilepsy or other neurological problems.

According to the Ministry of Health's guidelines, ibuprofen should not be used at home or without ruling out dengue fever. Parents who wish to use it should consult a doctor or have ruled out dengue fever.

Don't worry too much if your child's fever hasn't gone down after taking the medicine.

Dr. Sang emphasized that if a child's fever persists after taking fever-reducing medication, parents should not worry or force them to take more. Doing so could harm the child's liver and kidneys.

Parents can use several physical methods to help their child cool down:

Dress your child in the thinnest possible clothing, even just a diaper. Do not use cool compresses unless the fever is significantly higher than 40°C. Below 40°C, you should let your child sleep. Studies show that cool compresses do not lower a child's temperature any faster than medication alone. Drink plenty of fluids, including electrolyte drinks (prepared according to the correct ratio). Ensure good ventilation or a room temperature of 24-25°C. Fever-reducing patches do not help lower a child's fever.

Families should take their children for a follow-up examination immediately if any of the following signs worsen or if the fever is accompanied by new symptoms (worse breathing, lethargy, higher fever, persistent diarrhea, etc.).

"Parents should stay by their child's side, listen to them, monitor for any new abnormalities, and refrain from giving further medication if less than 4-6 hours have passed, or use cool compresses," Dr. Sang said.