Most fevers in children settle. A few are the first hours of malaria, pneumonia or meningitis. You do not need to know which. You need to know the handful of signs that mean this one is not settling, and those signs are the same whatever the cause.
Go now if the child has any one of these
These are the general danger signs health workers here are trained on. One is enough.
- Cannot drink or breastfeed.
- Vomits everything.
- A fit or convulsion.
- Unusually sleepy, floppy, or hard to wake.
- Fast or difficult breathing, or the chest pulling in under the ribs with each breath.
- Very pale palms or inner eyelids.
- Dark urine, or no urine for many hours.
- A rash that does not fade when you press a glass on it.
- Stiff neck, or a bulging soft spot in a baby.
- Any fever in a baby under two months.
What to do at home while a fever is mild
- Keep giving fluids, small amounts often. Breastfeed more frequently, not less.
- Undress the child to a single light layer. Do not wrap them up.
- Wipe with a cloth and lukewarm water if they are uncomfortable. Not cold water, not ice, not alcohol.
- Paracetamol at the dose for their weight, if they are uncomfortable. Fever itself is not the enemy.
- Keep them under the net, day sleep included.
Test before you treat
Fever is not the same as malaria. A rapid test takes fifteen minutes and is free or near-free at a health centre. Treating every fever as malaria means the child who has pneumonia gets the wrong medicine while the right one waits, and it is how resistance builds. If the test is negative but a danger sign is present, go anyway.
Counting the breaths
Fast breathing is the sign of pneumonia, and it is the easiest thing to measure at home. Watch the chest for a full minute while the child is calm. It is fast if it is over 60 breaths a minute under two months, over 50 from two to twelve months, or over 40 from one to five years. Fast breathing with fever means the child is seen today.
What not to do
- Do not give aspirin to a child.
- Do not give leftover antibiotics or somebody else’s malaria tablets.
- Do not bathe a feverish child in cold water. It causes shivering, which raises the temperature.
- Do not wait for morning if a danger sign is present.
