Managing a Fever

Conventional & Homeopathic Advice for Managing a Fever

A raised temperature is usually an indication of increased activity by the body’s immune system. This is frequently in response to infection of some kind and is a good sign, showing the ability of the individual’s immune system to do its job and indicates that the self-healing mechanism is attempting to overcome the illness by itself.

A high temperature is therefore not a symptom to fear or to immediately be dealt with by giving antipyretic (fever-reducing) drugs such as paracetamol, Neurofen, etc. Often a watch and wait protocol is all that is required in the early stages, to see what the body will do and what further steps are required. Obviously if accompanied with other discomfort or pain, consult your healthcare professional, but use your remedies as well.

Fever is common in some of the childhood transitions, such as teething, and homeopathics can be equally efficient in this situation, as in the fevers associated with a cold or ear infection.

Research is now showing that early and too frequent use of antipyretics in small children can lead to more chronic conditions in the longer term, so some well-chosen homeopathic remedies can be a useful addition to your medicine cabinet.

You can use your homeopathics as the first step in your treatment plan, if you feel something needs to be done right away. This way if your remedies don’t work as expected, you can then go to step two, which may be to give Panadol, Neurofen, etc.

What you can expect if your remedy works is that, yes, the fever may come down, but sometimes what happens is the child just falls asleep and sleeps long and deeply. The fever may go up again, at which point you’d give another dose, but what I usually say to my parents is that sometimes you need to wait until the morning to see how things are and often this is when you see the big improvement.

It wouldn’t be the first time that a child who has been very sick with fever, keeping mum and dad up worrying all night, will bounce out of bed in the morning as if nothing has happened!

CAUTION: If the fever is high or prolonged and does not respond to homeopathic treatment after 3-5 doses of the indicated remedy and paracetamol/neurofen have also been administered, consider seeking medical assistance. Always seek medical advice for fever in a child under six months of age.

Common Homeopathic Remedies for Fever

Listed alphabetically below are some of the main homeopathic remedies for fever. The most common remedies used in small children are Aconite, Belladonna and Chamomilla, which come as single remedies or in the combination, ABC. However, it is important to look at the bigger picture of what is going on if your remedy is not working, or contact your homeopath for support.

Aconite: Sudden onset of fever or chill with restlessness and anxiety.  Often symptoms come on or are worse around midnight. In older children, the anxiety may be closer to fear, especially of death. The remedy is usually only considered at the beginning, during the active, inflammatory stage of illness. The patient may have a red, dry face and skin, but this may alternate with being pale, especially on sitting up. They may be chilly and intensely thirsty for cold drinks.  Everything tastes bitter except water, which tastes bland. There may be sweating on covered parts.

Cause: getting chilled in the cold night air, swimming, etc. Worse: evening, at night.

Arsenicum Album: The patient is very restless and agitated to the point of anguish often with fear of death and they won’t want to be alone. They may seem as if they rapidly decline into a state of collapse and the reaction is often out of proportion to the illness. There may be burning pains but the patient wants warmth (except for the head). They may alternate between being hot and cold, with thirst for small sips.

Worse: after midnight.

Baptisia: These patients rapidly become ill and this is actually a well-documented remedy for quite serious types of fever, such as typhoid and malaria. The temperature is very irregular and often highest at 11 a.m. There may be a bruised, battered, sore sensation and the bed feels too hard, with a dusky red face and mental confusion as if drunk! The patient may fall asleep while replying to a question. The tongue may be streaked down the centre with white or brown.

Worse: during sleep, on waking.

Better: for drinks, fresh air, motion.

Belladonna: Onset after suddenly becoming hot or cold, so heat stroke or getting chilled. There is sudden onset of high fever with bright red face, glassy eyes and dilated pupils. The patient may be delirious and sometimes hallucinates, sees ghosts and horrible faces, may be agitated, angry and jumping around. Small children may be very lethargic and floppy instead of agitated. The head is hot and hands and feet are cold. The skin radiates a dry heat and the pulse is usually strong and bounding. They are generally thirstless but some may crave lemonade (and you do see this).

Worse: light, noise, touch and jar.

Bryonia: This remedy has slow onset of symptoms. The patient is very irritable and wants to be left alone. Bryonia is known as the “grumpy bear” remedy. They feel worse for movement of any kind, even moving the eyes, and for talking. There is usually intense thirst for large quantities of cold water. The face is dusky red and tongue coated white. Any headache may be severe and worse for movement. They may present with a painful cough. There is sometimes delirium at night – and the old books say that they may dwell on business affairs  which could also be homework or similar. They often ask to go home, when already at home!  The mouth and lips tend to be dry.

Worse: 9pm, least movement aggravates any pains, moving head or coughing.

Chamomilla: Fever associated with teething with one red cheek and one pale or with onset of a middle ear infection. The patient is usually irritable, agitated, unsettled and often quite distressed. There can be sleeplessness and oversensitivity due to pain. The patient may be thirsty during fever and have a sweaty head.

Worse: 9pm, anger, teething, coffee.

Better: for being carried.

Eupatorium Perfoliatum: Useful in the true “influenza type” of fever, with sore, aching of the bones and frequently a sensation that the bones would break. The bone pains are a very marked and distressing part of these types of fevers. The chills may be worst between 7 and 9 a.m and may begin in the back. The chills may be preceded by unquenchable thirst and followed by vomiting. Sweating relieves all symptoms except the headache. Moaning during fever, the patient is sleepy and yawns and falls asleep all the time.

Worse: cold air, from 7am to 9am.

Better: vomiting bile, sweating.

Ferrum Phos: This is another important remedy for the first stages of a fever. Symptoms may come on gradually with a vague picture so it’s unclear what’s happening, or the fever may be on and off. This can be a useful remedy where a fever has been suppressed with Panadol and the temperature goes up and down with no improvement. These patients catch a cold easily and tend towards chest symptoms, so mucous, cough, colds, but also beginnings of ear infections, conjunctivitis, sore throat, etc. The patient is usually alert and the face may alternate between red and pale. Often moderate thirst with sweats which do not relieve. May be shivery with a red face, throbbing head and wants head cool.

Better: cold applications, lying down.

Worse: at night, 4am to 6am, cold air.

NB: This is a great first remedy for fever, particularly if you’re not sure what to give!

Gelsemium: Intermittent fever (on and off, up and down!) generally with no perspiration. The patient is mostly thirstless and can be sleepy, tired, weak and dizzy, with aching all over and will describe it as muscular, rather than in the bones (Eup Per). There may be chills running up and down the back and trembling on exertion. The head feels hot and full with headache and they want to lie in the dark and be quiet. Trembling and shaking is characteristic. There is often great heaviness of eyes and limbs and a feeling of droopiness is also key. They often look droopy which is often how you’ll pick this remedy!

Worse: least movement, light or noise.

Better: for sweating, for urinating.

Merc Sol: Is of special value at the onset of flu accompanied by swollen glands, progressing to ear infection, a cold or sinusitis. These patients are very sensitive to cold and the fever may be brought on by a change of weather. The patient may present with creeping chilliness alternating with burning heat, cold in patches and profuse sweats which do not relieve. The breath may be offensive and there can be a metallic or sweetish taste in the mouth with excessive saliva. The tongue may be flabby and pale, indented by the teeth and sometimes coated yellow and there may be mouth ulcers. There is often extreme thirst despite the moist mouth.

Worse: change of weather and temperature, for sweating, at night.

Phosphorus: Alternating fevers and chills, with thirst during the heat and hunger during the chills. Sweats may come on at night or in the early hours especially on head, hands and feet. The symptoms may be on one side of the body only. There is very often respiratory involvement with this remedy, so coughs are common. There may be delirium associated with exhaustion and lethargy. The patient often has unquenchable thirst for cold drinks and an increased appetite. Children with a high fever may play normally and appear quite well in themselves with rosy red cheeks and good appetite.

Worse: afternoon/evening/night, slightest exertion, walking.

Rhus Tox: These patients present with great weakness and prostration, but also great restlessness, constantly tossing and turning trying to get comfortable, sometimes with mental confusion. The tongue is thickly coated, but red at the tip and there may be great thirst. They tend to be very sweaty except for the head, and worse slight exertion. There may be frequent urination while sweating and they can describe feeling as if hot water is running through the blood vessels. Since this is a big musculoskeletal remedy as well, there may be sore muscles and joints, sore back, etc.

Cause: getting chilled after being hot and sweaty.

Worse: night, evening, mid-morning, for movement, for cold drinks, for being uncovered.

Better: for hot drinks.

Stramonium: This is a more intense remedy than Aconite or Belladonna and the symptoms can tend to be quite extreme and even violent. Symptoms may be brought on by a shock or fright or as a result of too much sun. Fevers will climb very high often with profuse sweating and sometimes with violent delirium, terrible hallucinations and a desire to escape. The patient may have a red face like Belladonna and staring, frightened eyes. Everything about a Stramonium state is frightening and usually violent in some way.

Worse: in the dark, fear shining objects, sight of water!

Better: bright light, company

Combination Remedies

Combination remedies can be easy to use and don’t take too much thinking about. This can be useful if you are woken in the middle of the night by a child with a high fever and you’re not sure what to do!

ABC (Aconite, Belladonna, Chamomilla) is a classic combination for fever in babies and small children

It can be useful for an unsettled or unhappy baby due to teething or just generally off color, or fevers related to other childhood ailments and can help with pain. All the remedies in ABC are known for fever, pain and other symptoms which come on suddenly (read the individual remedies above), so this is the fever that comes on in the middle of the night or similar, where one minute baby has been fine and the next is quite unwell. Usually there is a clear picture of fever, irritability, pain, etc, whereas the symptoms of Ferrum Phos (alone or in TS Acutes) has a vague, unclear picture of what is happening.

TS Acutes is my all-time favourite remedy for acute illness. If you’re not sure what to give, start with this remedy (read more above on Ferrum Phos). Ferrum Phos often has very vague symptoms in the beginning, but may morph into quite a high and intense fever. It’s useful for all ages, when you suspect something may be brewing – cold, sore ear, fever, etc – but you have no symptoms to pin a remedy on, or symptoms which you don’t feel necessitates a trip to the doctor in the early stages. Those times when under normal circumstances you might give Panadol or Neurofen, but where you would prefer to avoid these medications if possible.

TS Acutes contains those remedies traditionally indicated for the beginnings of colds and similar ailments with sneezing, runny nose, fever and general unwellness – but you may not see these symptoms in the beginning. Sometimes a mother’s intuition just tells you something is going on and this is a useful remedy where the fever is not full on.

Dose & Frequency

If a fever is intense, it is probably going to require reasonably frequent doses of your chosen remedy.

However, if the remedy is spot on, one single dose may be sufficient to bring the temperature down either permanently or for some period of time. A sign the remedy has acted is that the patient may fall asleep and sleep soundly for a while.

If a single dose is not sufficient and further doses are required then generally I recommend the following steps. This is a standard recommendation for most illnesses. You may find you need to change the remedy if the fever improves but is followed by cold symptoms, for example:

  1. Very acute situations where fever is high and has come on suddenly:

Every 10 minutes for up to 5 doses then, if there is improvement, continue hourly for the rest of that day if a remedy is still required. The following day give 2 hourly or as required, or change the remedy depending on the symptom picture.

If no improvement after the first 5 doses select another remedy, consult your homeopath or see your GP.

  1. Reasonably acute – you feel you need to do something but it’s not severe:

Give hourly on the first day, then reduce to 2 hourly on the second day and 3 or 4 times on the third day, as long as there is improvement.  Finally reduce to once a day for a further few days. In this situation you may find you need to change your remedy before you get to the end of these steps.

If there is no improvement through the first day, change your remedy, contact your homeopath or see your GP.

  1. Not very acute, slow onset – you know you need to give a remedy but it’s not intense:

Give 3 times a day for 3 days, as long as things are improving.

If there is no improvement at all after a day, change your remedy, contact your homeopath or see your GP.

Always seek medical advice for fever in a baby under six months old.

Medical Research & Advice on Treatment of Fever

The role of paracetamol in the increasing incidence of asthma in children has been shown in several studies and the links are below for your reference. Studies have shown that using paracetamol during pregnancy and early childhood increases the likelihood of a child with no family history of asthma, developing the condition. The practice of encouraging parents to use paracetamol at the first sign of a rise in temperature and through the immunization process is believed to exacerbate this increasing problem and studies have shown no discernable difference between paracetamol and placebo in the treatment of fever.

What is also becoming clear is that the use of paracetamol and/or neurofen in fever is also not without risk, partly due to the possibility and ease of overdose and liver damage, but also because continually suppressing fevers rather than allowing the body to deal with what is generally an infection, leads to recurrent acute illness and low grade chronic disease.

Below is the abstract and some of the content of a study published in the American Journal of Paediatrics. There have been several similar studies with the same conclusion and as you will see further on, some hospitals are now recommending a “watch and wait” protocol.

“Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child’s overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen (EofH paracetamol) and ibuprofen (EofH neurofen) in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

The desire to improve the overall comfort of the febrile child must be balanced against the desire to simply lower the body temperature. It is well documented that there are significant concerns on the part of parents, nurses, and physicians about potential adverse effects of fever that have led to a description in the literature of “fever phobia.” The most consistently identified serious concern of caregivers and health care providers is that high fevers, if left untreated, are associated with seizures, brain damage, and death. It is argued that by creating undue concern over these presumed risks of fever, for which there is no clearly established relationship, physicians are promoting an exaggerated desire in parents to achieve normothermia by aggressively treating fever in their children.”

Below is the Royal Children’s Hospital Melbourne’s advice on treating a fever. You will note that they advise not to give antipyretics (paracetamol, neurofen, etc) routinely and not if a temperature is below 38.5.

Fever is nature’s way of overcoming an infection (viral or bacterial). In a child with a strong immune system a high fever is not dangerous, can be managed and will burn up the infection, allowing the child to overcome the illness naturally.

There are many ways to treat fevers homeopathically before you need to use antipyretics. These drugs can be dangerous and should be used as a last resort.

The idea is not to lower the fever but to help the body work harder to overcome the fever. Again, it is better to take the “watch and wait” approach before jumping in with remedies and you will note that RCHM only recommends using antipyretics if a child is uncomfortable or in pain – not for the fever itself.

We are creating generations of children with compromised immune systems and poor health. A child who has never had a fever is definitely not presenting signs of good health, but rather a symptom of a weak immune system and this does not bode well for their future health.

The Royal Children’s Hospital Melbourne

Fever in children

  • Fever is when the temperature of the body rises to above 38°C. A normal temperature range for a child is usually up to 38°C.
  • Fever is usually a sign of infection in the body. Fever is often caused by a virus and sometimes by bacteria. Viral infections are far more common and do not need antibiotics. Antibiotics do not cure viruses. Bacterial infections are treated with antibiotics.
  • A high fever does not necessarily mean your child has a serious illness. The fever seen in common childhood infections is not harmful, and in fact it helps the body’s immune system fight off the infection.
  • There is no advantage to lowering your child’s fever except for comfort.
  • Treat your child by making them more comfortable; give clear fluids (eg water, diluted fruit juice) and paracetamol if the fever is making your child miserable.
  • Fever is a way the body fights infection, and your child’s temperature will return to normal when the infection has completely gone.
  • Fever is not known to cause damage to the brain or other organs.

Febrile convulsions

A few children can have convulsions (‘a fit’) when they have a fever. This may happen if your child’s temperature goes up suddenly. Sometimes a convulsion happens when parents don’t actually know their child has a fever. Febrile convulsions are not common and do not usually cause any long-term health effects.

You may want to take your child’s temperature if they are:

  • Unwell and feel hot
  • Irritable, crying
  • More sleepy than usual
  • Vomiting or refusing to drink
  • In pain

There are three ways to take a child’s temperature

  1. Under the arm – for all children.
  2. Under the tongue – only for older children.
  3. Ear (tympanic) – for children of all ages. It can be difficult to use and may not be accurate.

Different thermometers have different instructions to follow to make sure you get an accurate reading.  Ask your Maternal and Child Health Nurse, doctor or chemist to show you how to use your thermometer – before you need it.

Plastic tape thermometers used on the forehead are not reliable.

See your doctor if your child has the following symptoms with their fever.

  • Complaining of a stiff neck or light hurting their eyes.
  • Vomiting and refusing to drink much.
  • More sleepy than usual.
  • Problems with breathing.
  • If your child is in pain.

Also see your doctor if:

Your child is under three months and has a fever.

At home care

Treat your child at home by making them more comfortable.

  • Dress your child in enough clothing so that they are not shivering.
  • Tepid sponging (sponging with slightly warm water) and fanning children with fevers is not recommended.
  • Give your child frequent small drinks of clear fluid (eg. water, diluted fruit juice or cordial). If your child is less than six months old give extra cooled boiled water, breast feeds, or bottles.
  • Do not worry if your child refuses to eat at this time.
  • Watch your child for signs that their illness is getting worse.

About Paracetamol 

  • Paracetamol is also known as Panadol, Tempra, Dymadon and Tylenol.
  • If your child seems well and is happy, there is no need to treat a fever with paracetamol.
  • If the fever is above 38.5ºC and your child is miserable or has other symptoms such as a sore throat, they may be given paracetamol. Follow the correct dose on the medicine instructions.
  • Panadol may not make the fever go away but the aim is to make the child feel better.
  • Paracetamol is a common ingredient in a number of medicines for illnesses such as colds and flu. Make sure that when giving paracetamol for fever that your child has not had one of these cold and flu medicines in the last 4 hours.
  • Paracetamol can be given every four hours as directed on the bottle. No more than four doses should be given in each 24 hours. Do not give for more than 2 days without seeing your doctor.

When to go back to your GP

Bring your child back to see your own GP if they:

    • look more sick than before.
    • have not improved in 48 hours.
Key points to remember
    • The normal temperature range is up to 38ºC.
    • Fevers are common in children.
    • If your child seems well and is happy there is no need to treat a fever.
    • If your child is under 3 months and has a fever above 38º C, take them to the doctor to be checked.
    • If your child is miserable, treatment is needed to comfort your child. Give clear fluids and Paracetamol. The response of the fever to treatment does not matter.
    • Watch your child for signs of the illness getting worse.

For more information

    • Talk to your GP.
    • Talk to your Maternal and Child Health Nurse.
References

Prenatal and infant paracetamol exposure and development of asthma: the Norwegian Mother and Child Cohort Study https://academic.oup.com/ije/article/45/2/512/2572607/Prenatal-and-infant-paracetamol-exposure-and

http://www.ncbi.nlm.nih.gov/pubmed/18805332?dopt=Abstract (asthma)

http://pediatrics.aappublications.org/content/128/6/1181.full (asthma)

http://www.rch.org.au/kidsinfo/fact_sheets/Fever_in_children/ (fever)

http://pediatrics.aappublications.org/content/127/3/580.full (fever)


Melanie Creedy originally trained in the UK and now holds a Bachelor of Health Science in Homeopathy. She is registered with the Australian Register of Homoeopaths (AROH) and is a member of the Australian Homoeopathic Association.
She was Vice President and Professional Development Coordinator of the Australian Homoeopathic Association from 2011 to 2015 and is editor of the AHA National Newsletter.
 
Melanie has used homeopathy for 30 years and has been in practice since 1998. For many years she ran The Children’s Ear Clinic in Western Australia, but since her tree change to Tasmania, has a special interest in women’s and children’s health generally and helping individuals manage their journey on the spiritual path with homeopathy and her range of essences. Melanie has developed her own methods of dealing with complex cases over the years and offers distance consultations via phone and skype to allow people Australia-wide to access her services.
Homeopathy is a traditional medicine. It may be used in conjunction with other medicines. For any ongoing chronic condition, it is important to be assessed or examined by your healthcare professional or specialist. Always seek medical advice in emergencies. The information provided in this blog does not constitute medical advice but is for information only. If in doubt as to the appropriateness of a  suggestion or treatment seek advice from your homeopath.