Dietary management of fever

Introduction

According to Leggett (2011), fever is the temporary increase in the temperature of the body in the response to a disease or illness. A child has a fever when the temperature is at or above on of these levels.

• 4°F (38°C) measured in the bottom (rectally)
• 5°F (37.5°C) measured in the mouth (orally)
• 99°F (37.2°C) measured under the arm (axillary)

An adult probably has a fever when the temperature is above 99 – 99.5°F (37.2 – 37.5°C), depending on the time of day.

Considerations

Normal body temperature may change during any given day. It is usually highest in the evening. Other factors that may affect body temperature as stated by Axelrod and Diringer (2008) are:

• A woman’s menstrual cycle. In the second part of this cycle, her temperature may go up by 1 degree or more.
• Physical activity, strong emotion, eating, heavy clothing, medications, high room temperature, and high humidity can all increase body temperature.

Fever is an important part of the body’s defence against infection. Most bacteria and viruses that cause infections in people thrive best at 98.6°F. Many infants and children develop high fevers with mild viral illnesses. Although a fever signals that a battle might be going on in the body, the fever is fighting for, not against the person (Laupland, 2009).

Causes of fever

Fever occurs when an area in your brain called the hypothalamus— also known as your body’s “thermostat” — shifts the set point of the normal body temperature upward. When this happens, the person may feel chilled and add layers of clothing or wrap up in a blanket, or you may shiver to generate more body heat, eventually resulting in an elevated body temperature (Mahadevan & Gus, 2012).

Normal body temperature varies throughout the day — it’s lower in the morning and higher in the late afternoon and evening. Although most people consider 98.6 F (37 C) normal, your body temperature can vary by a degree or more — from about 97 F (36.1 C) to 99 F (37.2 C) — and still be considered normal. Factors such as your menstrual cycle or heavy exercise can affect your temperature.

Fever or elevated body temperature according to Leggett (2011) might be caused by:

• A virus
• A bacterial infection
• Heat exhaustion
• Extreme sunburn
• Certain inflammatory conditions such as rheumatoid arthritis — inflammation of the lining of your joints (synovium)
• A malignant tumor
• Some medications, such as antibiotics and drugs used to treat high blood pressure or seizures
• Some immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP) or pneumococcal vaccine.

Signs and symptoms of fever

Sullivan and Farrer (2008) stated that depending on what is causing your fever, fever signs and symptoms may include:

• Sweating
• Shivering
• Headache
• Muscle aches
• Loss of appetite
• Dehydration
• General weakness

High fevers between 103 F (39.4 C) and 106 F (41.1 C) may cause:

• Hallucinations
• Confusion
• Irritability
• Convulsions
• Dehydration

Dietary management of fever

Fever by itself is not an illness, it is body’s own way of fighting infection or sickness. Fevers are usually caused due to various infections such as bacteria, viral, fungal or immune mediated

Common symptoms during fever are as stated by Axelrod and Diringer (2008):

• Loss of appetite
• Lack of interest.
• Weakness
• Cold sweats
• In some cases there can even be vomiting, diarrhoea, cough and cold depending on the infection

It is most important to manage all these conditions with good nutrition to alleviate the symptoms and make one feel comfortable.

• The diet usually prescribed is a high calories, high protein, low fat and light fluid diet.
• The first two or three days can be more of a fluid diet consisting of soups, glucose water, juice, milk (only if there is no diarrhoea). Give small frequent meal at regular interval, every two hours which can be gradually increased to every four hours.
• Include foods which are soft, bland, easily digested and absorbed like gruels, cereal, milk, soft fruits like banana, papaya, orange, musambi, melons, etc. Soft or mashed curd rice or softly boiled veggies can also be included.
• Fatty foods, spicy and high fibre foods are difficult to digest and should be avoided.
• It is also very important to remember that during fever, there is an increased need of certain nutrients like vitamin A, vitamin C, vitamin B, calcium, iron and sodium.

Foods that should be eaten in times of fever include:

• Fruit juices
• Glucose water
• Milk
• Coconut water
• Barley water
• Custards
• Egg
• Vegetable juices
• Soups
• Cereal preparation
• Tender meat
• Baked fish
• Butter milk with a pinch of salt
• Boiled leafy veggies
• Boiled veggies (carrots, beans, pumpkins, sweat potatoes)
• Orange and yellow fruits (citrus fruits).

Foods that should be avoided during the time of fever include:

• Butter
• Ghee
• Vegetable oil
• Irritating fibrous foods
• Fried foods
• Rich pastries
• Highly spiced preparations
• Strongly flavoured beverages.
• Cream soups.

Conclusion

Some things to keep in mind when managing fever condition include:

• Don not force your child to eat if he/she does not like it. Just stop and feed after a short interval.
• Make sure you get plenty of rest
• Take a sponge bath with room temperature – cool water to bring the fever down and make then feel comfortable.
• Dress them with light weight clothes and just cover with a light sheet.
• Stay in a room airy, well ventilated and maintain the right temperature, not too cold or too hot.
• If fever consistently spike above 102 to 103^oF for 2 – 3 days you must call the doctor immediately.
• If you are a healthy eater and consumes a balanced diet that meets the daily requirements, you will be better able to fight off virus and bacteria infections.

References

Axelrod, Y.K. & Diringer, M.N. (2008). “Temperature management in acute neurologic disorders”. Neurol Clin 26 (2), 585–603,

Laupland, K.B. (2009). “Fever in the critically ill medical patient”. Crit. Care Med. 37 (7), 273–8

Leggett, D. (2011). Approach to fever or suspected infection in the normal host. In Goldman, L. & Schater, A. (eds.). Goldman Cecil Medicine (24^th ed.). Philadelphia Pa: Elsevier Saunder.

Mahadevan, S. & Gus, M. (2012). An introduction to clinical emergency medicine (2nd ed.). Cambridge: Cambridge University Press.

Sullivan, J.E.  & Farrer, H. (2008). The American Academy of Paediatrics. Section on clinical pharmacology and therapeutic and committee on drugs clinical report on fever and antigretic use. Paediatrics 23(6), 671-86.