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A Pharmacists Guide to Managing a Fever By Sheena Mitchell, Pharmacist and mum of three school going children

A high temperature in babies and children is one of the most common ailments that parents will deal with during those early years. Fever in children usually indicates that they have picked up a bacterial or viral infection, but it can also be a result of a reaction to a vaccine or becoming overheated. Since viral infections are the most common cause of fever in children, the symptom rather than the cause is treated.

Measuring Temperature

A child’s normal temperature can range from about 36.1°C up to 37.4°C. Most doctors consider a temperature of 38°C or higher as fever when measured using an oral, ear or rectal thermometer. When your child's temperature rises, it is natural to worry. However, it is important to remember that fevers can be beneficial since they kick the immune system into high gear to help the body fight infection.

Very young babies will need to see a doctor when they develop a fever as their health can deteriorate very quickly. A baby younger than three months of age with a temperature over 38°C or a baby aged between 3-6 months with a fever of over 39°C should be brought straight to a doctor.

For children aged up to five years of age, it is recommended to take their temperature using an ear thermometer or an underarm thermometer. During the Coronavirus restrictions, we saw a lot of healthcare, schools and childcare settings use a non-contact forehead infrared thermometer to measure temperatures while preventing any cross-contamination of infection. While these thermometers are very effective and can even be used to check a baby’s bath temperature or bottle, an ear thermometer will give you the most accurate reading.

READ NEXT: A Pharmacist's Guide to Managing an Ear Infection

Reducing Temperature

There are several things you can do as a parent to help cool down your child if they have a temperature.
  • Remove excess clothing so that your child is wearing a light layer, don’t remove all clothing.
  • Give them plenty of fluids in the form of breast milk, formula, Dioralyte or water depending on their age.
  • Do not use a fan or a tepid sponge as this is likely to cause your child to start shivering which can increase their temperature.
  • Avoid putting your baby in a warm or cool bath as any quick change in body temperature can be difficult for their bodies to manage and can lead to further complications.

Fever Treatment

You can give liquid paracetamol or ibuprofen to children over three months of age when appropriate. Both over-the-counter medicines are good for reducing temperature and getting to work within 15 minutes.

These medications are only recommended for fever if your child seems distressed or unwell. I would advise starting with a dose of paracetamol and then reassessing your baby’s symptoms 30-60 minutes later.

Ibuprofen and Paracetamol can be given at the same time, if necessary, just make sure to follow the dosage instructions and manufacturer's guidelines for administration within 24 hours.

I would not advise that parents routinely give both medicines together, only in the case that one of the medicines alone is not working to reduce your child’s high fever. It can be useful to note the dosage and the time that you give the medication each time as the dosage amounts will be different for Paracetamol and Ibuprofen depending on your child’s age, while the frequency will also be different.

Parents also usually experience broken sleep when caring for a sick child so writing down the medicine will not only help your memory but also inform your partner if they are sharing the responsibility through the night. In the event you need to bring your child to a doctor or hospital, this information will also be useful to the medical team caring for your child.

If your baby is very sick or suffering from a sore throat it can be difficult for them to take oral medicine. When necessary, I would recommend using children’s Paracetamol or Ibuprofen suppositories. They are so easy to use and at least you will be sure that they got the full dose, especially if they are vomiting.

READ NEXT: A Pharmacist's Guide to Managing Nasal Congestion

Seeking Help

Trust your gut. A parent’s gut instinct will usually steer them right, remember nobody knows your child better than you. If you are in any doubt about your child’s health or you are seeing any of the following warning symptoms, please seek medical attention.
  • If your child is lethargic, not eating, has a rash, shows signs of dehydration, or has a seizure.
  • If your child has a swollen fontanelle.
  • If your child’s colouring is ashen, or blue. This is easiest to see around the lips, earlobes, and fingers.
  • If your child is crying constantly, particularly a weak or high-pitched cry.
  • If your child is not responding to you in their normal way.
  • If you have difficulty waking your child or keeping them awake.

Think Pharmacist First

Your local pharmacist is a free accessible healthcare professional in your community, who can help to guide you through various at-home treatments and advise you when it is time to visit your GP.

You can find more information and tips on how to identify and treat common illnesses and conditions that affect the family on the pharmacy advice website. Or tune into the Wonderbaba podcast for more expert advice and insights into how other families are facing their healthcare challenges head on. Find a WonderBaba Podcast on iTunes, Spotify or wherever you stream your podcasts.

Sheena Mitchell is a mum of three children who provides expert pharmacist advice through her community pharmacy - totalhealth in Milltown in Dublin and online platform