Conflicting advice - medicating a fever in a child?

[Embelline]

DS is three and gets frequent fevers whenever he is unwell - which is a lot as he goes to nursery! - sometimes as high as 40.
we’ve been advised in the past to treat the child not the fever so we only do back to back meds when it hits 40 or when he’s obviously unwell/shivering/clearly not feeling right.

we had a GP appointment this week as I have Strep and he’s started to show symptoms of it and she asked how high his fever had been and whether I’d given medication. It had got up to 38.8 but I hadn’t given calpol because he was happy, eating and drinking and watching tv. She said quite abruptly that that was a high fever and I should have been medicating and should do back to back medicine throughout the night.

ive Been feeling terrible ever since like I’ve been making him suffer unnecessarily but he was honestly fine apart from the number on the thermometer.

this afternoon he has a fever of 38.5 and is shivering and upset so I’ve given him some medicine, like I normally would.

I was just curious as to what everyone else does?

GP has said to us to leave a fever unless it’s making them feel terrible or it hits over 40.

the temp is fighting off infection so best to leave if possible for it to do it’s job.

I only give medicine if they are unhappy, which tbf they usually are when they have a temp.

Can you contact the surgery and suggest that the GP reviews current NHS guidance on fevers: https://www.nhs.uk/conditions/fever-in-children/

@nutbrownhare15 why didn’t I just look that up myself 🙈 brain like I don’t know what these days.

thanks for reassurance, he’s my only and I used to panic last year and calpol as soon as he was 38 and I genuinely think it helped it making him catch more things for longer! I got told off for that, and told to look at him whatever the number unless it’s around 40, and then got told this and was like WHATEVER I DO IS WRONG.

If you have a fever it is your immune system fighting FOR you not against you. Interrupting that process is ridiculous in most cases. I am a HCP and we are instructed to give anyone with a fever of 38 or higher paracetamol- a very out- dated process, that being said most doctors/ nurses worth their salt will say to leave a fever unless the child is in pain or really can't cope anymore. Fever is your friend!

Fevers work to combat bacterial infections but not really for viruses. So unless I have good reason to think my kids have a bacterial infection I medicate once it gets over 38.

That said, I don't think you should take what the doctor said to heart. You made a judgement call.

Thanks all.

Yeah, we keep getting told his fever with everything is a good sign actually, although it doesn't feel that way. Hoping we don't have another year of back to back illness like last year - that was rough!

100% this.

Thanks - if I medicated every single time he had a fever and did it back to back four hourly like the GP is suggesting 1) I wouldn't know how high it was going and 2) he would be having so much calpol/ibuprofen! (It was a bit like that last year when I was initially advised to always medicate, then told not to, and now recently told to again)
He's absolutely fine, no underlying conditions, just seems to be like I was as a child and get a fever for everything!

Generally I give pain relief if they are complaining of pain e.g headache. One of my dc has a history of seizures so I always give paracetamol to avoid a spike. Dr's have told me I should do that although I am sure someone will tell me it's the wrong thing to do.

I don’t get it, how does calpol ‘ interrupt’ the process? The increased white blood cells are fighting the infection, Calpol is just working on the part of the brain that’s regulating your body temp, you aren’t stopping the white blood cells from fighting infection?

@WhiteBloatus the raised temperature is the body's mechanism to physically kill the bacteria. Calpol lowers body temperature so interrupts that process. Not related to white blood cells.

I don’t understand… Can you explain how raised temperature fights infection?

White blood cells fight infection, high temperature does not fight infection…. Using Calpol doesn’t interrupt the white blood cells in fighting infection, it just acts on the part of the brain involved in temperature control…

You've got to weigh up what's going and use your judgement. It makes a difference if it's bacterial or viral
https://www.google.com/url?sa=t&source=web&rct=j&url=www.nci.nlm.nih.gov/pmc/articles/PMC7195085/&ved=2ahUKEwjT8_ma-4j-AhUCacAKHazNCTEQFnoECBoQAQ&usg=AOvVaw3S5Sc36Wgk3PduDeOFotPA

https://www.google.com/url?sa=t&source=web&rct=j&url=www.ncbi.nlm.nih.gov/pmc/articles/PMC7812885/&ved=2ahUKEwjT8_ma-4j-AhUCacAKHazNCTEQFnoECB0QAQ&usg=AOvVaw1vZYj2B-S-_vZWyfWfWvTz

You are right about somebody telling you this is incorrect. Paracetamol and ibuprofen will not prevent a seizure and should not be given to try and achieve this. It's in the NHS/NICE guidelines.

Did you not read what I said above? The raised temperature is one of the ways the body reacts to infection as it will physically kill or inactivate bacteria in the body. It may damage them or prevent them from reproducing. There are many mechanisms in the body to fight infection, not just white blood cells. By using calpol every time a temperature goes over 37.1 degree means that you are stopping one of these mechanisms from working.

I did read your message, I was requesting an explanation so I could understand how, as my understanding is clearly a bit rudimentary & incorrect on the topic. Thank you for explaining it further, wasn’t any need to be rude.

I thought paracetamol and ibuprofen while not or preventing a seizure, prevent the rapid spike in temperature which can cause a seizure. That’s what doctors have always said to us @ShowOfHands

Paracetamol will help to prevent a febrile (temperature related) fever, not an epileptic seizure.

https://www.nice.org.uk/guidance/ng143/chapter/recommendations#antipyretic-interventions

Paracetamol and nurofen will not prevent a febrile seizure.

Had an A&E dr and a paediatrician recently tell us to treat the child not the fever. The fever is your body’s natural defence and constantly lowering it can extend the period of illness. They also said that a fever is a fever until it’s over 40 - so it doesn’t matter really if it’s 38.1 or 39.5, doesn’t necessarily mean they are sicker.

i only treat now if they feel crappy with it.

As the parent of a child with complex febrile seizures who is under a neurologist I respectfully disagree. In a child who has previously had febrile seizures there are recent studies that show 6 hourly paracetamol to control the fever reduces the risk of a seizure by around 2/3. We've been advised to alternate ibuprofen and paracetamol because as well as reducing the risk of a seizure his are long and having it in his system to bring the fever back down makes it more likely it will stop quickly or be easier to stop if medication is needed. The nice guidelines on this are bollocks. It won't prevent all seizure but it makes a differwnce. The main driver for febrile seizures are the specific cytokines involved in the infection so different infections Carey different risk. Thankfully we now also have anti seizure meds but the 'pqracetamol doesn't help' nonsense pedalled by the nhs means nurses have a laissez olfaire attitude to it which has resulted twice in my son having likely preventable clusters of seizures.

Our neurologist and rheumatologist advised against it. Ditto, complex febrile seizures here.

I guess each of us can only go on the advice given by our respective consultants.

'and then got told this and was like WHATEVER I DO IS WRONG.'

That's motherhood! You're doing right though. Only medicate when necessary. Let fever do its job where possible.

This guideline is new since mine were little but I don't really egy only really take their temp if they are feeling out of sorts