Giving Calpol AND Nurofen - when and how much - please help

[pigindisguise]

Been waiting for NHS direct to call back since 2pm. DD is 16mo and has had a temperature since last night. It now peaks at 40/40.4 but Calpol brings it down to the low 38s. However after about 3 hours it creeps up again so suffers until I can give her Calpol an hour later, and for another 45 mins until her temp comes down.
I got some kids nurofen this afternoon because I know you can alternate, but what I need to know is:

I gave her Calpol at 5.45pm, so next dose will be 9.45. Can I/do I give her nurofen at 7.45? (have been giving her 5ml doses of calpol btw (every 4 hours)

thanks.

My dd went into hospital at 14 months with a raging temperature and vomiting. They gave her calpol and baby nurofen at the same time. They gave her the normal dose of each. Brought her temperature right down. Have you tried googling a medical site? Would be scared to do this without talking to a doctor.

You can give the nurofen at the same time. But if she's fine for a few hours then alternate the calpol and ibuprofen. Remember that Ibuprofen is only a 2.5ml dose.

Hope she feels better soon

Thanks. Haven't had much luck googling although not been concentrating as panicking over DD.

You can give both. That's fine. They don't affect each other. You just need to give them in their recommended doses. So calpol no more than 4 hourly, nurofen I think 6 hourly. Check your boxes. If you alternate as you are suggesting then it's easier to keep them 'topped up' as it were. But when doing this it's easier to do 3 hourly as then you're spacing the calpol a wee bit more than you ordinarily would but not giving too much nurofen.

Nurofen is much better at lowering a temp, calpol at stabilising it so together they work quite well if your child is really uncomfortable.

Do pursue why the temp's continuing though. And make sure you're giving lots of fluids, lightly dressed, no duvets, maybe a fan in the room. Keep cool by natural means.

I'm not a medicine giver personally but if she's uncomfortable and the temp is bothering her, alternating the two will avoid the scenario you have atm.

any other symptoms beside the high temp?

Unpure I'm not a big medicine giver either but as it's so high am giving it. She's been drinking lots of water, is just wearing nappy atm (she's sleeping now).

So, just to clarify, when she wakes up I will giver her Nurofen, so e.g.

8pm - Nurofen
11pm - Calpol (so will have been 5+ hours since last dose)
2am - Nurofen
5am - Calpol
8am - Nurofen

Keep that written down - it is so confusing in the middle of the night - you have no idea what you have done.

any other symptoms beside the high temp?

Definitely write it down, it's impossible to keep track of it on top of everything else (especially, not for you I know, if you have more than one child down). Hope she gets better soon, my dd1 typically runs scarily high temps when she's ill and the alternating calpol/profen thing works a treat.

no other symptoms just sneezing and very runny nose

agree, write down what you are giving and when to avoid overdose.
a paed in germany reccomended us to give calpol and nurofen alternating every 3 hours. but only for pain relief. the little body has fever for a reason...
what helps getting fever down is cold compresses on the legs (cold wet socks work well) and stipping down to the vest.

Mouseymouse - cold anything isn't recommended anymore - the body thinks it's cold and so acts to conserve heat which is the opposite of what is desired.

okay- sounds flu-ey with such a high temp alongside cold symptoms.

if he gets to a point where temp isn't coming down with calpol/nurofen, arrange to get him seen tonight.

vest only plus sheet for comfort. window open enough to get air in and cool flannel on head/back of neck works well too.

The NICE (National Institute of Clinical Excellence) 'Guidelines on Management of feverish illness in children younger than 5 years' state:

1. do not routinely use antipyretic agents with the sole aim of reducing fever in children who are otherwise well

1. do not routinely administer paracetamol and ibuprofen either in combination or alternately

1. antipyretic agents do not prevent febrile convulsions and should not be used specifically for this purpose.

was advised not to use cold flannel..

mariaBN6 what does 'routinely' mean in this case?

the cold flannel thing is always debated and guidelines change constantly.

a cool, not cold flannel to the forehead/neck can relieve a temp but very cold water/sponging isn't advisable.

I think routinely means don't do it as habit ie if calpol alone is sufficient, don't need both. If the child is otherwise well but just has a temp, don't reduce it needlessly, no meds necessary.

But in the scenario you describe where the temp is making your dc uncomfortable and calpol alone isn't cutting it, a GP would advise alternating.

'Routinely' in my understanding means 'every time the fever occurs', 'consistently', 'habitually'. But of course I didn't write those guidelines so can't interpret them.

Hope your little one is better. It's so distressing when they are poorly! I always struggle with what to do but trying to keep the use of paracetamol to an absolute minimum. Vitamin C is something I try and give in large doses when things like that happen (cranberry compot mixed with sweet apple juice - freshly made, oranges, lemons, etc)

I was also sent this link:
www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61445-2/fulltext

Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6?7 years: analysis from Phase Three of the ISAAC programme
Original Text
Prof Richard Beasley DSc a Corresponding AuthorEmail Address, Tadd Clayton MSc b, Prof Julian Crane MBBS c, Prof Erika von Mutius MD d, Prof Christopher KW Lai DM e, Prof Stephen Montefort PhD f, Alistair Stewart BSc g, for the ISAAC Phase Three Study Group?
Summary
Background
Exposure to paracetamol during intrauterine life, childhood, and adult life may increase the risk of developing asthma. We studied 6?7-year-old children from Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) programme to investigate the association between paracetamol consumption and asthma.
Methods
As part of Phase Three of ISAAC, parents or guardians of children aged 6?7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis, and eczema, and several risk factors, including the use of paracetamol for fever in the child's first year of life and the frequency of paracetamol use in the past 12 months. The primary outcome variable was the odds ratio (OR) of asthma symptoms in these children associated with the use of paracetamol for fever in the first year of life, as calculated by logistic regression.
Findings
205 487 children aged 6?7 years from 73 centres in 31 countries were included in the analysis. In the multivariate analyses, use of paracetamol for fever in the first year of life was associated with an increased risk of asthma symptoms when aged 6?7 years (OR 1·46 [95% CI 1·36?1·56]). Current use of paracetamol was associated with a dose-dependent increased risk of asthma symptoms (1·61 [1·46?1·77] and 3·23 [2·91?3·60] for medium and high use vs no use, respectively). Use of paracetamol was similarly associated with the risk of severe asthma symptoms, with population-attributable risks between 22% and 38%. Paracetamol use, both in the first year of life and in children aged 6?7 years, was also associated with an increased risk of symptoms of rhinoconjunctivitis and eczema.
Interpretation
Use of paracetamol in the first year of life and in later childhood, is associated with risk of asthma, rhinoconjunctivitis, and eczema at age 6 to 7 years. We suggest that exposure to paracetamol might be a risk factor for the development of asthma in childhood.
Funding
The BUPA Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, Astra Zeneca New Zealand, and Glaxo Wellcome International Medical Affairs.

maybe not the best place for this info, maria... bit of a hijack.

I agree, not the place. The op's baby is suffering, she says so herself and states that she doesn't often use medicine.

I do think it's worth encouraging women to look at the child, not the temperature which is what the op is doing as far as we can tell.

DD has had calpol on about 4 occasions. She is 3 and a half. I'm not a big user but if a child is in pain, I think you have to take that into account.

'In pain' is different to 'feverish'.

Sorry, didn't mean to hijack. Thought the info was relevant. Can't delete unfortunately.

Apologies, pigindisguise.

I would not give Calpol (or any medicine) unless I really felt I had to. Whilst I prefer to 'suffer' myself, I can't do it to my baby. Thanks for the info though, it is worth bearing in mind

no need to apologise Maria, it's food for thought (although I would still have given her calpol in this instance had I received the post before giving it