Sunday, 08 March 2015
How to treat temperatures in babies and toddlers
With winter on the horizon, parents need to prepare for the seasonal colds and flu it can bring to our babies and toddlers.
So to make sure we are fully prepared, we put some parent questions on how to treat a temperature in a little one to star of Channel 4's Embarrassing Bodies, doctor and mum Pixie McKenna so you know exactly what you need to do.
1. If you suspect your baby/toddler has a fever what is the first thing you should do?
It may seem like common sense but we often forget to do the most simple thing which is, take the temperature. If you haven't got a thermometer and your baby feels hot to the touch it is highly likely your instinct is right and they are in fact feverish.
2. Taking a baby's temperature can be tricky, what tips can you advise?
With a toddler explain exactly what you are going to do otherwise you will instil fear in them which may make the whole exercise impossible. If you are dealing with a baby try to get help from a third party, then one can cuddle while the other checks.
I'm a fan of the ear thermometer, whilst I appreciate they are expensive they are so easy to use. That said always ensure it is inserted into the ear fully and for the correct duration of time to get an accurate temperature reading. Digital thermometers may also be used but must be placed in the armpit not the mouth in any child under 5 years old. They should be placed against the skin ensuring it is not touching any clothing and the arm held against it leaving it in place for the appropriate time as per the manufacturer's instructions.
Current advice does not recommend taking rectal temperatures in children aged 4 weeks to 5 years or the use of old fashioned mercury thermometers. Forehead thermometers are unreliable and should not be used.
3. What temp is considered dangerous and requires immediate medical attention?
This is very much dependant on the age of the child.
Children under 3 months with a fever of 38 are deemed to be at risk of serious illness.
Children aged between 3 to 6 months with a fever of 39 or greater are also deemed at risk.
Irrespective of fever levels, any child who is pale or ashen, not responding to social cues, difficult to rouse, has difficulty breathing, is irritable and giving off a high pitched or continuous cry or displays a non blanching rash warrants urgent review.
Any child with a fever ongoing for longer than 5 days also needs to see a doctor. As a rule of thumb any child under 3 months with a temperature above 37.5 needs to be seen irrespective of how they seem.
4. What steps should you take to naturally bring the temperature down?
Whilst previous advice was to undress your child and consider tepid sponging them this is no longer the case. You should ensure they are comfortable and not underdressed or over-wrapped. Aim to keep the room temperature comfortable at around 18 degrees C. Offering the child regular fluids is important, in a breastfed baby breast milk is the most appropriate option. You should also continue to observe your child for signs of dehydration and deterioration of symptoms even as they sleep overnight.
5. What other symptoms linked to a temperature could your baby/toddler experience?
They can experience a whole host of symptoms ranging from general to specific. Irritability is not uncommon as is being off food. Rashes are not uncommon in viral illnesses so it is vital to know how to do the "glass test" to enable you to rule out meningitis.
aches and pains
sickness may all occur.
Fever due to specific issues like ear infections and tonsillitis will result in pain in these areas. Gastroenteritis resulting in diarrhoea and vomiting can occur with Gastic bugs. Respiratory conditions can result in associated cough and mucous production. With a whole host of systems involved when your little one has a fever on board it's no surprise that they often seriously play up.
6. What is your advice if your baby/toddler becomes very distressed from the temperature?
We do not recommend treating fever if your child seems content and is taking fluids. If they are distressed by fever my first port of call would be Ibuprofen as it is pain killing,anti-inflammatory and whilst also working against fever. As it only needs to be taken every 8 hours and is fast acting it is the ideal choice for overnight.
You should never double dose with paracetamol but can alternate between ibuprofen and paracetamol if the child seems irritable in between doses. It is important to keep them comfortable well hydrated and continually keep an eye on them. The key thing is to treat the child not the fever. Rushing in with medicine in a well-child is ill advised.
Many parents falsely believe that dosing a child up with drugs will prevent a fever fit, it doesn't. What it does do is put your child at risk of overdose, so to prevent this make a note of the dose and time drugs have been given either by yourself a child-minder or another care giver.
Sarah Sheere chatted to Dr Pixie McKenna while she was working with Nurofen for Children on their Confidence Collective initiative. Nurofen for Children Cold, Pain and Fever (RRP £3.99) relieves fever for up to 8 hours and is clinically proven to last longer than paracetamol. It starts to work in just 15 minutes to bring down a temperature and both orange and strawberry flavours are sugar and colour free.