Thailand’s Department of Medical Services is offering guidance to parents navigating childhood fevers, a common concern that often leads to anxiety. With a rise in seasonal illnesses, health officials are emphasizing appropriate fever management techniques, cautioning against potentially harmful practices like using cold water or alcohol for cooling. The department, through the National Institute of Child health, is releasing updated recommendations, detailed below, to help caregivers effectively and safely address fever in children.
Thursday, November 20, 2068, 8:35 PM
Thailand’s Department of Medical Services, through the National Institute of Child Health, is emphasizing that fever in children is a common occurrence and a significant source of anxiety for parents. Proper fever management, particularly effective cooling techniques, is crucial for a child’s comfort. Incorrect methods can lead to shivering and distress.
November 20, 2068, Dr. Thanin Wetchapinan, Deputy Director-General of the Department of Medical Services, explained that a child has a fever when their body temperature is higher than normal – exceeding 38°C (100.4°F) when measured by ear or forehead, 37.8°C (100°F) orally, or 37.2-37.5°C (99-99.5°F) under the arm. While managing a fever, it’s not always necessary to reduce it if the child is otherwise comfortable. Recommended methods include administering acetaminophen (paracetamol) based on the child’s weight and using cool compresses. Cool compresses can offer additional relief, potentially lowering fever faster than medication alone within the first one to two hours, though the overall effect is similar. However, improper cooling can cause discomfort, such as shivering or fear. Studies suggest that compresses should be applied gently with lukewarm water to areas with good blood flow, avoiding very cold water or alcohol.
Dr. Akom Chaiwirawatana, Director of the National Institute of Child Health, added that fever is a natural response to infection, such as viruses or bacteria. Using fever-reducing medication like acetaminophen, dosed according to the child’s weight, is generally the first approach. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided in children suspected of having dengue fever or with pre-existing conditions like kidney disease, liver disease, or stomach ulcers. Cool compresses have been used for a long time, but there’s limited medical evidence to support their routine use. While combining compresses with medication may speed up fever reduction in the first one to two hours, the long-term effect isn’t significantly different from medication alone. Proper compress application involves gently wiping the child with a cloth dampened with lukewarm water in areas with good blood circulation, such as the armpits, neck, and groin.
It’s also important to observe the child’s reaction to the compress. If the child starts shivering or cries due to discomfort, the compress should be stopped. Avoid rubbing the child vigorously or using cold water or alcohol, as these can cause shivering or harm. Healthcare professionals should educate parents about the nature of fever, basic home care guidelines, and the fact that a fever isn’t necessarily dangerous if the child remains comfortable, playful, and able to eat. This information is particularly important as parental anxiety surrounding childhood fevers is common.
Associate Professor Dr. Ratchada Kasemsap, a specialist in social pediatrics, further explained that guidelines for initial care – including fever-reducing medication, adequate hydration, breathable clothing, and well-ventilated rooms – vary. The Royal College of Pediatricians of Thailand and the Pediatric Society of Thailand have therefore developed guidelines for managing fever in children, based on evidence-based practices, to help healthcare professionals provide appropriate care. More details can be found at https://www.thaipediatrics.org/5844/. However, parents should seek immediate medical attention if the child is under three months old, appears lethargic, experiences seizures, has difficulty breathing, develops a rash or red spots, has cold and pale extremities, or if the fever persists for two to three days.
