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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To not follow the doctor's advice?

54 replies

bubbleymummy · 27/05/2010 22:30

Ds2 has had a temp going up and down since Sunday. It was at its highest on monday and I thought he was back to normal on Wednesday but it went up a bit again that evening and it was around 38 still this morning so I took him to the doctor just to check for ear/chest infection. All is clear so the doctor just said to keep an eye on him and if he's still not back to normal bring him back next week.

That was all fine, I was relieved that there didn't seem to be anything more sinister lurking Then as we were leaving she asked did I have plenty of paracetemol in the house and to make sure I just kept him dosed up. I should probably mention that despite the temp DS has been in good spirits, even when it was at his highest. He's been a bit more clingy but he's been playing with his toys and torturing ds1 as usual. I mentioned this to the doctor and said I wasn't too keen on giving him paracetemol unless he really seemed to need it (and with a temp of 38 and playing away he really didn't seem to need it) but she said it was better to be safe than sorry and it would stop him having a convulsion!

AIBU to think that it's a bit unnecessary to dose a happy child with a low grade fever and no underlying infection up on paracetemol several times a day and therefore not take her advice on this occasion?

OP posts:
Vallhala · 27/05/2010 22:33

If you are unreasonable, then I would be too under the circumstances.

I hope all's well now with your son.

IwishIwasmoreorganised · 27/05/2010 22:37

YANBU.

IMO a mildly elevated temperature shows that the body is fighting any infection. If it gets too high for my liking (usually >39) then I give paracetamol, or sooner if they are really grouchy and miserable.

Hope your lo is better soon.

Original poster
bubbleymummy · 27/05/2010 22:40

Thanks Valhalla. He's sound asleep on my chest atm. (I love iPhones) His temp is down again. Wondering if we've just had an overlap of some bug earlier in the week with teething now.

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blinks · 27/05/2010 22:43

it's one of those things- it's up to you. if he seems well then it's not essential obviously.

keep an eye for a brewing infection though- ear and chest aren't the only infections to be wary about. chances are it's viral but be aware of any urinary problems/pain/rashes anywhere etc.

no doubt i'm stating the bleeding obvious.

Sassybeast · 27/05/2010 22:44

How old is your little boy ? 38' is not a 'low grade' fever in a small child and to be honest, a few doses of paracetemol are going to cause a lot less damage than a febrile convulsion potentially could. The fact that he's more clingy than normal suggests that he IS symptomatic so I'd say perhaps a little BU ? Hope he's better soon

Original poster
bubbleymummy · 27/05/2010 22:47

Thanks iwish. I'm very much in the 'treat the child not the temp' camp and I have met doctors in the past who have been v much in favour of letting the fever run as long as the child isn't uncomfortable because it's part of he body's defense. She just took me off guard. I mean 38 is barely a temperature and she could see he was in good form otherwise... It just seemed like such a strange thing to recommend.

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Piffle · 27/05/2010 22:48

I've got 3 kids ( eye bags to prove it)
ds1 convulsed at temp over 37.9 with calpol
dd never convulsed even with measles temp 43. Fed smiled slept... Calpol obviously brought it down to 41.5
ds2 no convulsions would still be deconstructing at temps of 40 ( chicken pox last week) barely appeared ill
motto being
mother knows best, demeanour means a lot with temps

MrsGravy · 27/05/2010 22:49

I probably shouldn't answer as I can't do so objectively but I will anyway...my DD has febrile convulsion and they are just horrible - for me to witness and for her to go through. So in the circs you describe I would give paracetemol. 38 would be a high temp for her too, she had her first febrile convulsion at around that temp.

BUT if he's past the age when febrile convulsions are a concern and is otherwise well I can understand why you wouldn't want to follow the advice.

Original poster
bubbleymummy · 27/05/2010 22:53

Sassy he's 14 months. Sorry- should have said that! Don't want you to think I'm belittling a fever in a v young baby! I've got a little kit to drop in a urine sample but the doc said they usually seem a lot more sick when there's something like that going on. He's obviously not feeling 100% - hence the clinginess but he's certainly not feeling awful considering that he's been chasing his brother around laughing and trying to steal his toys!

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Joolyjoolyjoo · 27/05/2010 22:53

I tend to go by the child. If they seem unhappy, whiny, hot and miserable, i give them calpol/ neurofen/ both, as i know how it feels to feel horrible with a temp, and also how much better you can feel after NSAIDs. But if they are a bit hot, but seem fine in themselves, I hang fire. There is a small possibilty that dosing them up could mask symptoms too, IMO, so I prefer to wait and see how it pans out. But then, none of mine have ever had a febrile convulsion, and I'm sure that would affect my judgement

LittleLebowskiUrbanAchiever · 27/05/2010 22:55

www.tripanswers.org/Answer.aspx?qid=5055

No evidence for calpol etc preventing febrile convulsions. In fact growing body of thought that fever is bodies natural response to pathogens and helps to kill them off faster.

If your little one is ok no need for meds. If he gets hot and miserable then give it.

MrsGravy · 27/05/2010 22:57

Ultimately it's up to you but I don't think it was a strange suggestion from the Dr. DD's first convulsion was at the age of 2 and 3/4 so not a very young baby. She seemed well too - in fact the first indication that she had a temp was when she had the convulsion!

Maybe try and keep it down by more natural means - as I'm sure you are already - cool bath, stripped down a bit etc etc

Sassybeast · 27/05/2010 22:57

Don't want you to think I'm being a cow I'm a bit like the other poster who probably isn't completely objective as we've had a couple of convulsions here as well, but I work in healthcare and a temp of 38' in an adult would always be a 'watcher' so I suppose I believe more in prevention.

Original poster
bubbleymummy · 27/05/2010 22:58

Mrs gravy, I can imagine that must be v scary. I think convulsions are the result of the speed at which the temp rises rather than the temp itself.

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Original poster
bubbleymummy · 27/05/2010 23:05

I've heard that before mrs gravy, that they've had the convulsion by the time you realise they're hot - be ause it's the quick rise in temp that causes it.

Sassybeast, I thought children tend to have higher temps than adults anyway? So a temp of 38 in an adult would be considered higher than a temp of 38 in a child iykwim. Also, I thought a fever was defined as a temp of 38 or above so 38 would be a low fever?

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MrsGravy · 27/05/2010 23:05

Yes, you're right I'm sure. We've actually never got to the point of noticing a temp first before the convulsion iyswim. The fact that he's had a temperature for a short while without any ill effects is probably a really good sign that he's ok.

And I HAVE ignored Dr's advice myself in the past...they give antibiotics out like sweeties round here and mine have been prescribed them twice 'just in case'. I never got the prescription. So I do see your point of view. Gah, I'm too much of a woolly liberal, sit on the fence person for Mumsnet AIBU!!

Original poster
bubbleymummy · 27/05/2010 23:06

Thank you for the link littlelebowski. I thought I'd read that somewhere before and I have met a few doctors now who think like that.

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LittleLebowskiUrbanAchiever · 27/05/2010 23:11

no worries. Am a dr myself and that was the line of thought at a recent uodate course. I give my children calpol at the drop of a hat when they are miserable or seem bothered by fever, but there is no point giving it if they are happy enough without. You go to your dr for an opinion, they give it based on a snapshot of how your Ds is when they see them. Its really totally fine to just play it by ear. Sick infants are usually pretty easy to spot as they just withdraw from everything around them.

Original poster
bubbleymummy · 27/05/2010 23:11

Lol mrs gravy. I think it's ok to sit on the fence. As a few people have said, it really is based on the child. If ds was feeling really miserable I wouldn't hesitate to give him something, I just don't think there should be a set temp to give paracetemol which was what the doc seemed to be suggesting.

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LittleLebowskiUrbanAchiever · 27/05/2010 23:11

update course, sorry

ThatVikRinA22 · 27/05/2010 23:13

follow your instincts. they are usually right where your kids are concerned.

Original poster
bubbleymummy · 27/05/2010 23:14

That's really interesting littlelebowski. I wonder will more doctors be taking that approach now.

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Sassybeast · 27/05/2010 23:15

I've always worked/been taught on the assumption that a 'normal' core body temp is 36.8, with 0.7' variataion on either side (and the measurement will vary depending on part of the body it's taken from) I'm not sure that there is any significant variation between adults and children, although am not paeds trained - I just have too many kids of my own . In a clinical setting, a 'low grade' pyrexia would be about 37'4 - 5, anything higher than that would be more of a watcher. But then of course, people in hospital are iller and more vulnerable anyway.

Interesting info from littlebowski which prompted me to actually look for some more info and the BMJ guidelines acknowledge that there is no evidence to say anti pyretics prevent seizures but still include their use in their guidelines.

bestpractice.bmj.com/best-practice/pdf/patient-summaries/febrile-seizures-standard.pdf

LittleLebowskiUrbanAchiever · 27/05/2010 23:21

I guess it depends on whether they bother going for updates!

Guidance changes constantly to be honest: as fast as the research is being done the guidance is being altered. Always feel a step behind! You sound very sensible to me - hopefully your dr has ruled out any obvious nasty illness, save the urine infection, just go with your instincts.

off to bed now before i am totally incapable of anything tomorrow!

Original poster
bubbleymummy · 27/05/2010 23:23

Thanks sassy. I got the fever definition from the nhs website. It does specify 38 for children so maybe it is slightly different for adults?

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