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Health: true or false?

Don’t assume that your baby’s persistent high fever is just down to teething

Hong Kong doctors warn that while red cheeks and cranky moods are common as first teeth emerge, a persistent high temperature should not be ignored and warrants a medical check-up

PUBLISHED : Thursday, 23 March, 2017, 5:00pm
UPDATED : Monday, 27 March, 2017, 5:21pm

Is high, persistent fever a symptom of teething in babies?

The short answer: No

Most parents know when their little one starts teething. Their baby usually drools excessively, a couple of days before a new tooth erupts (typically between seven and 10 months); he may seem fussier, crankier and more restless than normal; he may have trouble sleeping and refuse to feed because of a decreased appetite; and he may be more eager to put his fingers in his mouth and chew on his toys or other objects.

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Some babies may also present a slight redness on the cheeks, as a result of frequent rubbing to relieve pain in their gums. If they tug at the ear on the same side as the tooth that is erupting, the redness may extend to their ears as well. Generally, these symptoms are not chronic and shouldn’t last longer than three to five days.

But is high, persistent fever a common symptom of teething, too? In the 4th century BC, Hippocrates observed that “teething infants suffer from itching of the gums, fever, convulsions, diarrhoea, especially when they cut their eye teeth”. Over the centuries, especially when infant mortality rates were high, the idea that teething was a sickness that caused high fever was never questioned; and eventually it became one that was widely accepted.

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Fortunately, modern medical research has proven that there is no association between high, persistent fever and teething. “If your teething baby has a high fever, it’s very unlikely that the two are related, so don’t automatically assume that that’s the case,” says Dr James Lynch, a family practitioner at OT&P Healthcare’s Discovery Bay clinic. “You should look for an alternative explanation for the fever, especially if it comes with other symptoms. If your child has a high temperature and is constantly tugging on his ear, for instance, it’s possible that he has an ear infection.”

Dr Oliver Tang, a paediatrician at Children at 818 in Central, agrees, but adds that a low-grade fever is not unusual in teething babies. “In this case, your child may experience a temperature of between 38 and 38.5 degrees Celsius,” he says. “This would be due to local inflammation of the gums. About one-half to one-third of babies experience low-grade fever when teething.”

The myth that a high, persistent fever is due to teething is a dangerous one, because it causes parents to write off their teething child’s fevers instead of seeking medical help for what might be a serious illness. After all, it’s important to remember that teething usually takes place when a baby is between four and 24 months old. This time frame tends to coincide with the period when young children experience the majority of their infections, the most common of which are viral infections, which can cause fever.

If your baby’s high fever comes with a runny or blocked nose, a cough, hoarseness of voice, skin rashes, and vomiting or diarrhoea, and if he seems less energetic and difficult to soothe, Dr Tang suggests taking him to the doctor for a check-up. If he has a low-grade fever that doesn’t seem to be improving, you shouldn’t assume that it’s due to teething, either. In this case, Dr Tang advises a medical check-up, because even a low-grade temperature that persists for longer than three days without obvious symptoms should be investigated.