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(04.01.2025) Children often suffer from infections, especially in the first few years of life. But when should parents seek medical support? An expert explains.

Fever is one of the most common symptoms of infections. It occurs when the body adjusts its thermostat settings in order to better fight viruses and bacteria. "The increase in temperature improves metabolic and immune processes and makes the body an unfavorable place for pathogens," explains Prof. Dr. Stephan Ehl, paediatrician and Medical Director of the Centre for Chronic Immunodeficiency (CCI) at the Freiburg University Medical Centre.

Fever: an important alarm signal

The normal body temperature in children fluctuates between 35.6 and 38.2 degrees Celsius. "Fever itself is not dangerous: it does not cause brain damage, coma or death," clarifies Ehl. Parents should therefore keep an eye on the cause of the fever. Nevertheless, there are clear warning signs as to when medical advice is essential in the event of a fever:

• If the fever lasts longer than three days.
• In babies under three months of age.
• If the child's general condition is severely impaired (e.g. listlessness, unwillingness to drink or pain).
• In children with known pre-existing illnesses or an immune deficiency.

Febrile convulsions can frighten parents, but are usually harmless and subside on their own. The fever should be brought down at the latest when it leads to severe discomfort, pain or a lack of fluid intake. The following applies: fever-reducing medication does not reduce the body's immune system. They therefore do not prolong the illness.

Why it is okay for small children to have frequent infections

Frequent infections are not always a cause for concern - "on the contrary", says Ehl. In the first few years of life, the immune system is trained through repeated infections. Up to eleven respiratory infections per year are normal, especially at the start of nursery and kindergarten. "The immune system closes existing gaps during this phase and builds up a stronger defense in the long term," says the expert.

Warning signs for parents of sick children?

While frequent upper respiratory tract infections or diarrhea are normal during childhood, there are warning signs that may indicate an underlying immune disorder. Parents should take note if:

• Infections are unusually long or severe.
• Chronic infections occur or are followed by repeated relapses.
• Infections are triggered by pathogens that are normally harmless.

Clarification by specialists, such as in the CCI immunodeficiency outpatient clinic at the Freiburg University Medical Center's Department of Pediatrics and Adolescent Medicine, is important here. "We can identify whether there is an immune deficiency or another underlying disease and initiate targeted therapies," says Ehl.

Preventing susceptibility to infections

Parents can actively help to strengthen their children's immune system. The most important measures are

• Regular exercise in the fresh air.
• Eating a balanced, age-appropriate diet and drinking enough.
• Sufficient sleep and avoiding overstimulation.
• Consistent hygiene, especially during the cold season.
• Avoid passive smoking, as this weakens the immune system.
• Vaccinations, both for children and for adults in the vicinity.

Ehl advises against over-the-counter medicines that can stimulate the immune system. "They have not been sufficiently researched scientifically."

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