What is normal fever in toddlers?

Fever itself is not an illness; rather, it is a sign that the body is fighting an infection or illness. In toddlers (ages one to three years), fever can occur as a result of common illnesses such as the common cold, influenza, roseola, chickenpox, or ear infections. It is important to note that most cases of fever are not serious, but they do require close monitoring to determine if medical intervention is needed [1].

What are febrile seizures?

A febrile seizure is a convulsion caused by an increase in body temperature in otherwise healthy infants and young children. These seizures can occur with any type of fever and often happen within 24 hours of the onset of the child's illness. A febrile seizure does not mean the child has epilepsy, which is a condition characterized by recurrent seizures not caused by a trigger such as a fever [1].

Symptoms of febrile seizures include loss of consciousness, uncontrollable shaking of the body, stiffening of the arms or legs (which may involve the whole body or only a part of it), rolling of the eyes, and loss of bodily functions (such as drooling, vomiting, urination, or defecation). Simple febrile seizures are the most common; they last from a few seconds to 15 minutes and occur only once within a 24-hour period. Complex febrile seizures, however, last longer than 15 minutes, occur more than once within 24 hours, or affect only one part of the child's body. Although febrile seizures may be frightening for parents, simple seizures do not cause long-term health problems [1].

When are febrile seizures more common?

Children between the ages of 6 months and 5 years are most prone to febrile seizures, with the highest risk for children between 1 and 3 years old. Children with a family history of seizures, those who have experienced developmental delays, or those who spent more than 28 days in a neonatal intensive care unit are also at greater risk. The likelihood of recurrent febrile seizures increases if the child's first seizure occurred before 18 months of age, if there is a family history of febrile seizures, if the seizure occurred as the first sign of illness, or if the temperature was relatively low with the first seizure [1].

How to manage a febrile seizure and when to seek emergency help?

Most febrile seizures end within a few minutes. Parents or caregivers should remain calm and watch the child carefully. During the seizure, they should:

• Time the seizure. If it lasts for more than five minutes, call for an ambulance immediately [1].
• Call for an ambulance even if the seizure lasts less than five minutes but the child does not seem to be recovering quickly [1].
• Take steps to prevent injury during the seizure, such as placing the child on the floor to prevent them from falling off a bed or sofa. Do not restrain the child or hold them down during the seizure [1].
• Place the child on their side or stomach to prevent choking. If possible, gently remove any objects from the child's mouth. You should never put anything into the child's mouth during a seizure, as it could block the airway and make breathing difficult [1].
• Seek immediate medical attention if this is the child's first febrile seizure. Once it is over, take the child to a doctor to check the cause of the fever. This is especially urgent if the child shows symptoms of meningitis, such as a stiff neck, extreme drowsiness, breathing problems, or frequent vomiting [1].

Fever-reducing medications such as acetaminophen or ibuprofen can make the child more comfortable. However, many studies have shown that treating the fever does not reduce the risk of a febrile seizure [1].

Prevention and the importance of regular doctor visits

To prevent some febrile seizures, ensure children receive recommended vaccinations at the appropriate age. These vaccines protect children from diseases such as measles, mumps, rubella, chickenpox, influenza, pneumonia, and other conditions that can cause fever and febrile seizures [1]. It is also important to have regular well-child visits, where recommended vaccines are administered and routine check-ups are performed, which helps in preventing and treating health problems, in addition to tracking the child's growth and development [2]. For more information on toddler health and common problems, you can visit Toddler Health: Common Problems, Prevention, and When to See a Doctor (Arabic).

Medical references

• Febrile Seizures
• Toddler Health