Help. 5yo with 39.1C temp. I've just given her paracetamol AND ibuprofen but the NHS site said NOT to give both at the same time.

[EweHaveGoatToBeKiddin]

She woke up 30 mins ago (been ill since Fri night) crying because she was 'sweaty'. So i checked her temp and it was 38.8. I gave her paracetamol 12.5ml (she's a big 5yo) and checked her temp again ten minutes later. It was 39.2. So i then went and got some ibuprofen and gave her 7.5ml of that.

When she was in the hospital earlier this year following her tonsillectomy, the doctors there said she was allowed to have both at the same time. And it was them who said to give her 12.5ml instead of the bottle instructed 10 ml due to her being a big 5yo.

I was just checking the NHS site to read up on fevers when i came across the instruction 'can't give both at the same time.'

Her temp is now 39.1. Both windows are open in her room. She's in shorts and t-shirt. She's complaining that her arms are cold but her legs and face are very hot, so won't part with her blanket. I've but one of those Kool n Soothe strips on her head and swapped her blanket for an empty duvet-cover.

Oh, small update, because i forgot to press the submit button, her temp is now 38.4 but I'm still worried I've overdosed her!

Don't worry, I've been advised that you can do that loads of time by HCPs.

Gp has told me to do it. Ideally you stagger them say 2 hours apart but perfectly ok to give calpol and nurofen for a temp

This is ok for emergencies, but i think the nhs website is trying to make sure people don't start doing this as a matter of course.

I remember reading somewhere the advice had changed.

I've got dcs in their 20's & teens- parents were advised to give paracetamol & nurofen together so I did, if & when it was necessary.

Im sure there was good reason to change the advice but a one of dose is hardly likely to do any harm.

Hope your dd gets well soon.

You can give both.

Remember that a fever is a symptom of illness rather than an illness in itself though - it's not a problem as such and you give Calpol/Nurofen to make them more comfortable and reduce pain rather then to reduce a temperature alone.

Keep her as cool as you can, make sure she's drinking plenty. Hope she's better soon.

It's not that you can't, it's that you shouldn't, which is what I think the NHS website says. The recommended course is that you give either Calpol or Ibuprofen and see if it works. If it doesn't, you switch to the other and see if that works. If it doesn't you contact a HCP and take advice, at which point they will advise you that it's safe to alternate between the two if they feel it warranted.

There are good reasons why you don't go immediately to giving both unless you have been told to do this specifically by a hcp. Quite apart from it being a lot of medication to go straight in with when usually one or the other is sufficient, it's sometimes hard to keep track of what you've given and when (you must always space them out according to their own dosage instructions and you can give more calpol in 24hrs than you can ibuprofen so you have people giving 2 hourly doses, alternating the two because calpol can be given 4 hourly but Ibuprofen can't so it should be at least 3 hourly if alternating for example). The other thing is, if one or the other isn't managing to control symptoms, then it's worth speaking to a hcp to rule out potential other reasons for the illness which might need more specific treatment (bacterial infection for example).

It is definitely safe to give both but you should be doing it on medical advice, not as an immediate go to solution for an unwell child.

Don't panic. I hope she's on the mend soon.

What sidge said is also worth remembering. You shouldn't give Calpol or Ibuprofen solely to lower a temperature, unless on advice of a medical professional. You give it to a child who is in pain or discomfort.

The reason it says not to give both together is that's its really easy to overdose a child. Ibuprofen should only be given 3 times a day and paracetamol 4 times a day.

And don't expect paracetamol to work within ten minutes! She probably didn't need the ibuprofen, her temp would probably have come down with the paracetamol alone.

Thanks for the replies. I've always been told to give paracetamol to bring a fever down, such as after jags etc. She has a tummy ache, so was technically in discomfort.

She's back down to about 37.8C now and having some dry toast. Hopefully it stays down.

Try not to worry if it does go back up. Our body's natural response to an infection is to raise our temperature to create a hostile environment for the virus/bacteria. That's why current advice is, as Sidge said, to just give paracetemol/neurofen for pain relief - not just with the sole aim of reducing a temperature. The fever is actually a good thing. Hope she feels better soon.

You shouldn't give paracetamol after immunisations either as it's been shown to decrease their effectiveness. Of course if they have a bad reaction and are in discomfort you would give paracetamol but otherwise, it can interfere with the natural reaction to the immunisation.

I think most people feel very wobbly about a child being ill and your natural reaction is to want to help. It is a difficult thing to get your head round at first, because people do worry at the presence of a temperature as obviously it's a sign of illness but really it is a good thing and shows the body is working to get over the illness.

It does sound like she's improving. I hope that continues.

You need to allow about 20 mins for a dose of anything to work, longer if they are immobile.

Hope she feels better soon.

Last time dd ran one of her epic temperatures (41 degrees once at the GP who accused me of withholding calpol so she would have a high temp ) a HCP advised frozen watered down fruit juice lollies and lots of iced water to cool her from inside.

thanks everyone for the advice. I'm just worried about her having a convulsion due to having such a high temp. Isn't it dangerous for a temp to be over 39C? that's why i was so eager to bring it down to at least 37.8C.

So, for future reference, (likely tonight) if her temp goes up like that again, i should leave it because it's helping to fight her tummy bug?

Or should i try and cool her down (with, for e.g. watered down juice lollies) but not with medicine?

She's didn't eat anything at all yesterday. So far today, she's had a slice of dry toast and a spoonful of pasta. Lots of water though. My mum will be minding her tomorrow while I'm at work. Was hoping it'd be a 24 hour bug and she'd be fine by Mon. But it's not looking likely.

Convulsions are not caused by a high temperature but are caused by a temperature rising very quickly. So if a child has 37. 5 degrees at 8 o'clock and five minutes later has 39 degrees then there is a much greater risk the child may have a febrile convulsion. However, this applies to children susceptible to febrile convulsions, which is a minority.

Febrile convulsions are scary to watch, but generally not dangerous.

In my experience it can take up to 45 minutes for a temperature to respond to paracetamol and 30 minutes in the case of ibuprofen. Certainly not ten minutes.

I tend not to give medicine unless they are feeling very poorly. My DSs both run quite high fevers while still bouncing around the room and eating as well as ever I would just make sure they were dressed comfortably - no bundling. Just light jammies and a cotton blanket. I make sure they drink plenty and give lots of snuggles but once I know they've got a fever I try not to check the thermometer and look at them instead. Easier said than done I know :) but the numbers don't mean much. A child can be very ill with a low fever and completely fine with a high one. As SewingBee said, convulsions are caused by the rapid rise in temperature and studies have shown that giving paracetemol etc doesn't prevent them anyway. Much more important to watch how they are in themselves and base your response on that.

Giving ibuprofen and paracetamol at the same time is fine as they are from different types of pain relief groups. The recommendation to stagger is them is so you are giving something regularly, it doesn't mean you can't give them together.

The recommendation now is to leave a temperature to do its job and not treat it (unless its sky high, 39-40), unless your children are irritable or in pain or uncomfortable.

It won't prevent a febrile seizure, if its going to happen it will happen regardless of giving medicine as its to do with the speed of the temperature going up, not how high it goes.

If you're giving paracetamol give it time to kick in, it won't have worked after 10 mins. Keep them stripped off and give plenty of fluids, more important than food, don't put in the bath or tepid sponge. If they seem lethargic, floppy and listless and you can't wake them up, take to a&e.

It's so hard to step away from the thermometer I think. The thing to try and do is to look at your child and not at a number on a thermometer. Are they in pain? Upset? Struggling? Do they need anti-pyretics (paracetamol or ibuprofen) in order to feel better? You then give one, see if it works and then switch to the other if it doesn't. Still no change, take advice. They may then advise alternating.

You don't need to lower a temperature when it reaches a certain figure unless you have a small baby. Under 3 months and a temp of 38 requires a once over from a doc. Between 3 and 6 months and a temp of 39 or over ditto. DS had a temp at 5 months. It wasn't over 38.4 at any point, usually 37.8 ish. He had double pneumonia and was very poorly. His body wasn't fighting the bug but a thermometer would have been quite reassuring most of the time he was ill if you operated on the principle of lower temperatures being 'better'. Try and remember that a fever is a good and natural reaction.

As others have said, convulsions are nothing to do with high temperatures. My nieces have convulsions when they go from 36 to 37.8. It's the speed of the temperature spiking. This is why you try and keep them comfortable in gentle ways. No shock tactics like cold baths or cold fans on them. They then shiver as their body tries to shoot the temperature back up again and it's this rapid change which is a convulsion trigger. Neither paracetamol nor ibuprofen prevent convulsions and they should not be given with this aim. If your child has never had a febrile convulsion before, it's unlikely that they would develop at this age. At 5, a lot of children are growing out of them. It's also important to remember that a febrile convulsion while horrid to watch, isn't dangerous.

Things like lots of fluid, keeping them in loose cotton clothing, no massive duvets, ice lollies, air circulating etc is to do with comfort and keeping their temperatures stable. You are avoiding making them shiver by rapid cooling or causing a temperature spike by over wrapping them. They generally feel better with gentle measures to keep their bodies stable and doing the job of getting better.

pebble, while 39-40 is a high fever - it's not sky-high and is no indication of the seriousness of the illness. Giving two at once is unnecessary - the advice is to use one and if it doesn't work then try the other one and use whichever one works best for the child.

I never said give two at once, I said you can give two at once as they are different medications so you will not be overdosing which is what the OP was worried about. I know what the recommendations are thanks, I'm a children's nurse. If the temp is higher than 39 and the child is distressed then calpol or brufen is suggested.

Sorry, pebble, I took it like you were saying that it was ok to give them together in response to other people saying not to.

they are 2 different drugs so are safe together, but it just means you can't give anything for another 4-6 hours, so you've thrown all your snowballs, so to speak! be aware that cooling a child too rapidly can cause them to shiver, though, and this extra muscle activity can actually begin to warm them up again. nice, loose layers and plenty of fluids.