Contrary to what most people think, a cold-water bath is not the best thing to give to your child when he or she is running temperature. As a matter of fact, a cold water bath is highly uncomfortable for a hot child and also worsens the fever eventually.
Tepid sponging, otherwise known as a tepid sponge bath, is a cheap and effective way to reduce your child’s temperature before the medications begin to work or even before you get to the hospital. A tepid sponge or tepid-sponge bath will cool down your baby’s temperature and make your baby calmer.
Tepid-sponging involves using sponging/dabbing your baby’s body with a cloth soaked in tepid water. Tepid water is neither hot nor cold water. Here you will see how to make a tepid sponge bath for your febrile baby step by step.
How to tepid sponge your baby
To make a tepid sponge bath for your baby, follow the following steps:
- Make tepid water by heating tap water in a boiler until it boils or heats up well.
- Get a clean towel available.
- Turn the hot water into a deep bowl and gradually add cold water until the water becomes lukewarm: not too hot and not too cold.
- Ensure that the water does not burn your skin when even when you leave it for long.
- It should feel mildly warm on your skin over your body (back, arm, or neck) with a temperature of about 32 to 35 degrees Celsius.
- Soak your clean towel in the water and squeeze out excess water.
- Then, dab the soaked towel over the entire body of your hot child.
- Do this for up to 20-30 minutes.
- Stop when the temperature has normalized or if the child starts shivering. It means the water has gotten too cold.
How does the tepid sponge work in controlling a child’s temperature?
Several studies have reported the effectiveness of tepid sponging in controlling fever in children, especially those between the ages of 6 months to 6 years. Giving your baby a tepid sponge bath together with antipyretic medications has been shown to be more effective in controlling a child’s fever than the use of antipyretics alone.[1]Effect of Tepid Sponge on changes in body temperature in children under five who have fever in Dr. Achmad Mochtar Bukittinggi Hospital | Enfermería Clínica[2]Tepid sponging to reduce temperature in febrile children in a tropical climate – PubMed
Tepid sponging controls a child’s fever based on the principle of evaporation and conduction. Tepid water (which is moderately warm water) helps to increase the evaporation of water from the skin by causing vasodilation of the skin vessels. The skin pores also open allowing water to evaporate from the skin.
Evaporation causes a cooling of the body because, during the process of evaporation, the body loses what is called the “latent heat of vaporization”. Continuous tepid sponging of the child’s body can effectively reduce the temperature to normal levels.
Other important questions about tepid sponging
Where can tepid sponging be done?
Tepid sponging can be done anywhere. It can be done at home or in the hospital. The knowledge of tepid sponging and how it works can be used by caregivers (including mothers) or healthcare providers to rapidly control the temperature of a febrile child.
Can tepid sponging be done using cold water?
The name itself “tepid” means lukewarm water. Tepid water is not cold water, nor is it hot water. Cold water sponging has been advocated in the reduction of body temperature in a febrile patient but this is either not as effective or could even worsen the child’s condition.
Here is how:
Cold water can help absorb some of the heat from the body to reduce the temperature a little but it causes vasoconstriction of the skin vessels, reducing evaporation.
Also, during fever, because cold water is ‘very cold’, the body senses the rapid reduction in skin temperature through conduction and attempts to compensate for the decrease by triggering the hypothalamus to further reduce the temperature set point and further worsen the fever.
The concept of temperature setpoints and the hypothalamus will not be discussed in the scope of this article. This is focused on how to tepid sponge your baby to reduce fever.
When can you not do tepid sponging for a hot child?
Tepid sponging is not done for children who are seriously ill or unconscious. You should take them to the hospital immediately for specific and more aggressive treatments.
Tepid sponging is also not recommended for children who sustained burns injury, head injury, have septicemia, or have comorbidities. These require more aggressive management of the fever as well as treatment of the comorbid condition(s).
How long is tepid sponging done?
Tepid sponging is only effective within the first 30 minutes. If the temperature does not improve after thirty minutes, you should consider safely repeating the dose of antipyretics used prior or visiting the hospital as fast as you can.
Is tepid sponging better than paracetamol?
No, tepid sponging is not more effective than paracetamol in reducing fever. Tepid sponging is preferably used together with paracetamol in controlling fever. This combination has been shown to be more effective than paracetamol alone.
What parts of the body should be sponged?
The forehead, neck, armpit, and groin are common areas that can be sponged with tepid water. Other areas like the trunk, and chest, can also be used.
Is it recommended for adults?
No, tepid sponging is not recommended for adults. This is because adults have a smaller body surface area to volume ratio compared to children. That is, you need to sponge larger areas to achieve the same effect you would get when you sponge on a child’s body.
Tepid sponging is recommended for rapid lowering of the body’s temperature in children because children are not able to tolerate high temperatures as much as adults. They can easily develop seizures, heart failure, and dehydration from mild to moderate increases in body temperature.
Other interventions that can help during fever
Tepid sponging is particularly cheap and effective in reducing the temperature in children with fever. Other adjunct interventions to tepid sponging include the following:
- Removing the clothes to allow heat loss.
- Giving the child water to drink to reduce dehydration.
- Antipyretics like paracetamol. This is a mainstay and best combined with tepid sponging.
