Temperature control in children


What is a normal temperature in children?

  • 36.4°C to 37.5°C (97.9 to 99.5°F) is considered a normal body temperature.
  • It is recommended that you have a good thermometer. A thermometer that reads the child’s temperature in the ear or on the forehead seem to be the easiest to use for parents.

Why does my child have a high temperature/ fever?

  • A baby or child can develop a fever (high temperature) in response to infection (bacterial or viral). Trauma to the body (including surgery) may also cause a temperature.
  • It is important to control high temperatures since at levels higher than 39,0°C (102,2°F) a child can develop a fever fit.
  • At one stage, it was thought that fevers could contribute to a child’s immunity by killing the infection more efficiently. Trials have shown that controlling the fever helps the child to feel better and allows for quicker recovery from the infection.
  • If your baby is younger than 12 weeks please consult your health care professional if he/she has a temperature regardless of how the infant appears. Fevers in newborn babies need to be taken seriously and may require the baby to have blood tests.
  • Studies have shown that a temperature higher than 38.5°C are unlikely to be caused by teething. If the child is teething and has a fever it is most likely that the child has developed an infection.
  • Overdressing or swaddling a baby who is under the age of 3 months can also increase a baby’s temperature. A baby only requires one more layer of clothing than you yourself are comfortable with.
  • Immunizations can also cause fever. Be sure to ask your clinic sister about this as the time for fever will depend on the type of immunization administered. Some immunizations cause fever 24 hours after being given. Others like the MMR may only give a fever 7 to 10 days later. It is preferable not to use medication for the control of fever caused by immunizations. Such measures may slightly decrease the body’s response to the immunization. Contact your healthcare professional if your baby is struggling with severe symptoms following immunizations.
What steps must be taken when my child has a fever?
What steps must be taken when my child has a fever?

How do I treat the fever?

Administer medication to bring the fever down before instituting the other measures listed below.
The medicine dose is dependent on your child’s weight. Please contact your health professional if you are not able to calculate the correct dose of medication.

  • Medication:
    • For temperatures below 38.5°C (101.3°F) you need to give paracetamol syrups or suppositories.
    • Check the child’s temperature 30 minutes to one hour after you have given the medication. If the temperature continues rising please contact your health professional.
  • Increase fluid intake
    • Fever increases the loss of water through the skin.
    • It is important to give your baby extra fluids while there is a fever.
    • Children may not be hungry if they have a fever but should be taking fluids. If your baby is unable or not willing to take fluids for longer than 6 hours then you should consult your health professional.
  • Keeping the baby/toddler cool
    • Dress the baby or child in light clothing to allow body heat to escape.
    • Do not put a fan on your child. It is preferable to allow the medication to get the temperature under control.
    • It is not advisable to submerge the child in cold water or to wrap the child in wet towels. These measures may put the child’s body under stress since the body may try to maintain the fever while you are trying to cool the child down.

Medicine guideline:

Please use a syringe to measure the dosage for syrups accurately!

PARACETAMOL
**If your child has a temperature between 37.5°C and 39°C please make use of the table below to work out the correct dose of medicine.
**The medicine is administered 6 hourly.
**You must choose a medicine from one of the columns only. If you double up you will overdose your child. This will have serious consequences.

Weight

Calpol syrup or Panado syrup
     (120mg/5ml)

Empaped
suppository

Panado infant drops
     (60mg/0.6mls)

         3 - 3.9 kg

             2ml

      Do not use

          0.5 ml

         4 - 4.9 kg

             2.5ml

      Do not use

          0.6 ml

         5 - 5.9 kg

             3ml

      Do not use

          0.75 ml

         6 - 7.9 kg

             4ml

      125 mg

          0.9 ml

         8 - 9.9 kg

             5.5ml

      125 mg

          1.3 ml

        10 -12.9 kg

             7 ml

      125 mg

          1.7 ml

        13 - 15.9 kg

             8.5 ml

       250 mg

          2.0 ml

        16- 20 kg

             10 ml

       250 mg

          2.5 ml

        21 – 25 kg

             15 ml

       250mg + 125mg

               -

If the fever is not controlled on the above medicines or if the fever is above 39°C then you may need to add in an anti-inflammatory medication listed below.

Anti-Inflammatory medicines

**Anti-inflammatory drugs should not be used in the following circumstances:

  • children who are highly allergic individuals
  • children specifically allergic to anti-inflammatory drugs.
  • dehydrated children.
  • children who have bleeding problems.
  • children on anti-coagulants.
ATTENTION!
**You must choose a medicine from one of the columns only. If you double up you will overdose your child. This will have serious consequences.

**The medicine you choose from one of the columns below can be given every eight hours over and above the paracetamol table shown above.


Weight

Nurofen syrup or
Ibumol syrup
(100mg/5ml)

Voltaren suppository or
Panamor suppository

Ponstan syrup

Ponstan
Suppository
(125mg)

0 – 4.9 kg

Do not use

Do Not use

Do not use

Do not use

5 – 6.9 kg

2.5 ml

Do Not use

2.5 ml

Do Not use

7 – 9.9 kg

3.5 ml

Do Not use

3.5 ml

Do Not use

10 – 12.4 kg

5 ml

Do Not use

5 ml

Do Not use

12.5 – 15 kg

6 ml

12.5 mg

6 ml

125 mg

15.1- 20 kg

7.5 ml

12.5 mg

7.5 ml

125 mg

20.1-24.9 kg

10 ml

12.5 mg

10 ml

125 mg

25- 30 kg

12.5 ml

25 mg

12.5 ml

-


Conclusion

Every child is likely to experience a fever at some stage of their life. Children attending school for the first time are susceptible to infection and this in turn causes fever. Parents are often alarmed by high fevers and rightly so. In many instances, I have parents bringing children into my practice with very high fevers. They are reluctant to give medication to control the fever as they want the doctor to see how ill the child really is. Controlling the fever will make your child feel more comfortable while you await medical attention. The doctor will be able to assess what the root cause of the fever is despite the fever being controlled.


At all times, if the parent is concerned about the child’s general wellbeing or is unsure of how to handle the fever, medical advice should be urgently sought.

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