Sunday, March 6, 2011

Fevers...what every parent should know

By Dr Ellie Cannon
Last updated at 10:01 PM on 5th March 2011
As a mother of two children  -  mine are three and seven years old  -  I know how worrying it can be when they are unwell and I often reach for the Neurofen when they are running a temperature.
So I was interested to read a report published last week that criticised parents for giving children with fevers painkillers when all they need is sleep.
Mother taking child's temperature
If there has been a temperature for three days with no improvement in symptoms, talk it through with your GP
The report went on to say that most fevers, caused by viruses, resolve without any intervention and don't cause lasting damage.
While this is true, fevers can be serious, especially if a child is not drinking water. With this in mind, here is my guide for parents.

Q: What constitutes a fever?

A: Using a digital ear thermometer, a fever is a temperature above 37.5C. It is associated with other symptoms, including a fast heart rate and shivering. In most cases, fevers are secondary to viruses or bacterial infections.

Q: Are all raised temperatures a worry?

A: A fever with other minor symptoms, such as a slight cough or sore throat, is not a cause for concern. Temperatures are more of a worry when associated with red-flag symptoms: fast breathing, not drinking, not urinating, a rash or drowsiness.
Having a temperature with no obvious reason is also a cause for concern. Being lethargic and having a reduced appetite are not red flags.

Q: When should you see the doctor with a temperature?

A: If there has been a temperature for three days with no improvement in symptoms, talk it through with your GP. See the GP urgently with any red-flag signs of more serious infection or if the fever is not coming down with medication.

Q: How long should you leave it before giving medicine?

A: If a child is active and drinking well despite a temperature, it is not necessary to give medicine. If, as a result of the temperature, the child is distressed and not drinking, give medicine to make them more comfortable so they will drink.
It is also important to give antipyretic (fever-reducing) medicines such as paracetamol if the child is uncomfortable or if there are signs of dehydration.

Q: What is the best antipyretic to give a child with a fever?

A: Both ibuprofen and paracetamol are very effective. Ibuprofen lasts longer and in the majority of children is slightly more effective. It shouldn't be used in anyone vomiting, in many children with asthma or with stomach or kidney problems. It is safe to give ibuprofen and paracetamol together but not always necessary.

Q: Are natural methods effective for reducing raised temperatures?

A: Natural methods are useful either on their own or as an adjunct to medication. Removing a layer of clothing and drinking plenty are both important. Open a window to allow flow of air or place a fan at the other end of the room from the child. Do not aim a fan directly at the child as being too cold makes a fever worse. Cold sponging is not recommended for the same reason. Resting is important.

Q: Should I give doses according to my child's weight or age?

A: Always follow the instructions on the side of the box. If a doctor has weighed the child, they can give you an exact dose. Never guess the dose from your child's weight or mimic a dose specified for another child.

Q: What is the best thermometer to use for my child?

A: Mouth thermometers are no longer recommended for children. The most accurate are digital ear thermometers, which are widely available on the High Street. For babies younger than a month these are not accurate and we use thermometers in the armpit. Forehead thermometers are not accurate but may be used as a general guide.

For sensible heath advice, follow Dr Ellie Cannon on Twitter.

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