Fever in Babies: How to Manage and When to Worry
Fever in babies can be terrifying for parents. But fevers are natural and actually very important: They help your child’s immune system fight the infection. At the same time, babies are more easily overwhelmed by a high fever than older children or adults because their immune systems are underdeveloped, making home care a fraught line for parents to walk.
Based on our research — and with input from Mumbai-based pediatricians Dr. RK Anand and Dr. Paresh Desai — here is what parents should know about home remedies for baby fever.
Fast facts about fever in babies
- Babies of all ages can be given sponge baths – but only if the water is tap-temperature. DON’T sponge with ice water or alcohol.
- Babies under 3 months should be taken to a doctor immediately if the sponge bath fails to normalise their temperature.
- Babies older than 3 months can be given fever medicine for babies (like infant paracetamol or acetaminophen) at 10 to 15 mg for every 1 kg of body weight, every 4 to 6 hours – but no more than 4 doses in 24 hours.
- Babies older than 3 months should see a doctor immediately if the fever is accompanied by other symptoms like vomiting, diarrhoea, difficulty breathing, etc. Otherwise, wait to consult a doctor until a fever has persisted alone for three days.
Both doctors advise parents not to stress. Fever in infants under 3 months is very rare, says Dr. Desai. At this age, high fever in babies is usually due to something in the baby’s environment. Swaddling babies or keeping them in rooms with no A/C or fans can make a baby feel warm and fussy, just like an adult wrapped in a blanket on a hot day. A sponge bath of room-temperature water can quickly make the baby more comfortable and normalise his temperature.
However, if the baby still feels hot to the touch, consult a doctor immediately.
What’s wrong with an ice or alcohol bath?
At any age, an alcohol bath is useless, only serving to dry out a baby’s skin, Dr. Desai says. And an ice bath can actually be harmful; the difference in temperature between feverish skin and ice water is so great it is a shock to the system and causes blood vessels to spasm – which can lead the fever to shoot up even higher than before.
Tap water – which is still roughly 20 degrees colder than feverish skin – is less of a shock to the system and will cool a baby without causing a rebound in temperature.
For a fever in babies older than 3 months, Dr. Desai says a digital thermometer held under an armpit is the best way to take a temperature. For babies 6-month-old and older, an ear thermometer is also an option.
But, he says, don’t get too hung up on degree; in most cases, a fever is a fever, and addressing it right away is the best way to manage it. Both Dr. Desai and Dr. Anand recommend sponge baths and baby fever medicine combined as the best home remedies for baby fever.
Sponge baths should be given with tap-temperature water only. (See above.) Paracetamol or acetaminophen (common brands are Crocin, Metacin, Calpol, etc) can be given at 4 to 6 hour intervals – but not more than 4 doses in a 24-hour period. Dr. Anand recommends 15 mg of paracetamol per 1 kilogram of body weight. (So, a 9-kg baby – the average 8-month-old – would be able to take a dose of 135mg paracetamol). This is the same ratio most brands follow in their infant products, so you only need to follow the directions on the box.
Dr. Desai, however, takes a slightly more conservative stance and recommends 10 mg of paracetamol or acetaminophen per 1 kilogram of body weight. (So, a 9-kg baby would be given a dose containing 90mg of paracetamol.) Following this recommendation might require a little math, as doses are typically listed in millilitres, and 1 mL tends to contain 100 mg of medication.
Beyond this, it’s a waiting game. Dress your child in comfortable, light clothing and keep his room well-ventilated; using a fan or A/C is fine, says Dr. Anand. Also, pay attention to your child’s other functions — if he or she is continuing to poop and urinate normally, that’s a good sign. And while your baby may be a little less hungry than usual (again, a natural response that helps the body fight the fever), if she is feeding or eating in small amounts regularly, it’s not cause for concern. As long as your baby is alert and responsive, Dr. Anand says — whether grumpy or playful — you can continue treating the fever at home.
However, if the fever persists for more than three days, or if other symptoms like diarrhoea, vomiting or difficulty breathing develop before then, consult a doctor.