Temperatures

[jrh1991]

Could I please have anyone’s previous experiences with temps, advise on ‘when to worry’ and how to manage it? My now 8 month old had bronchilitus over Christmas and since then have just been extra worried when it comes to high temps.

Over 6 months, I look at the child and their symptoms, not a number on a thermometer (don't even own one).

A fever in isolation isn't something to panic over. It's just a sign that the body is working hard.

Agree with show. How child is not the number.

It’s not the number - it’s how the child acts and whether or not it comes down with calpol

I agree in principle that it's the child not the number that you should look at but I agree that it helps to have a guide, especially when it's your first.

I am in a similar situation, DS is now 8 months and has had persistent bronchiolitis as well as teething on and off since Xmas. I feel for you OP!

I was told that a persistent fever over 39 is when you should start to worry. However they won't really do anything about it unless it's been that high for at least 3 days from experience, or unless they get really unwell. If in doubt 111 can advise.

Stock up on calpol and ibuprofen - if they have a high temp, I was told calpol first then ibuprofen an hour later only if it hasn't gone down.

GP here who has spent most of today on 111 talking to parents of children with fevers.

Treat the child not the fever. I think digital thermometers cause a lot of worry. Not coming down with calpol is not dangerous either.

We’ve evolved over millions of years to develop a fever when we have an infection. Viruses (the vast majority of childhood fevers are caused by self-limiting viruses) live at body temperature. The rise in core temperature is the body’s attempt to kill the virus. Giving medication to bring it down interferes with this process.

Parents also worry about kids having fits with high fevers. If your child is going to fit due to a fever, bringing the fever down with medication does absolutely nothing to prevent it.

Treat with calpol/ibuprofen on the basis misery.

I should just add, the above applies to children over 6 months old.

Screenshot from NICE guidance on managing fever in children

Plonky - that’s all very well but fevers can cause high hr and high breathing rates in young children which can be difficult to separate out what is a symptom of the fever and what of the underlying illness. If you lower the child’s temp you can see what other symptoms get better with this

Agree apples, that seems sensible

I can only give general advice in a few paragraphs, there will always be exceptions to any rule.

I look at the symptoms on top of the temperature. That's partially because dd2 had a tendency for temperatures of over 40 (over 41 on occasions too) and would still be dancing round and bouncing, whereas the other two would be wiped out by the time it got to 38.

What I look for:
Firstly when you first notice it, how are they in themselves. Are they refusing food? Not to worrisome. Refusing drink, that's not good. If I offer them a treat drink with a straw and they refuse it (or an ice lolly as another treat) then I'm onto keeping very watchful.
Are they vomiting? Once, no worries again. Second time-is there a reason-just gulped a glass of water/bouncing on the trampoline (yes dd2 would do that with a temperature of 41 if allowed)/ate a bite of toast... Otherwise how frequently are they being sick?
If they're sick every half an hour, not drinking and temperature up, that's when I start worrying.

Next thing is a do get them to move their neck (chin to chest) and check for rashes. Don't panic, even with a non-fading rash as viruses can cause that as I have found out through a ds who gets viral rashes very easily and many blood tests in A&E with them.

Are they complaining of anything else? Too young to tell you, took at how they react to you. Do they want to be touched, held etc?

Then what do they want to do? If they're down on the floor pushing a car around then they're probably fine. A really ill child won't have the energy for that. only time we've nearly been blue lighted was when ds was at the doctors and he wanted to play with the cars but didn't have the energy to crawl across the floor, just lay there with his head down.

Then what happens when you give calpol/ibroprofen. Yes, I know people will say don't use it to bring down fever, but you know what, if I have a temperature I ache and would give myself pain relief. I think children are the same.
So give it, take temperature. Take temperature about half an hour later. Has it gone down? If not, try again in an hour.

If it hasn't gone down at all, then I would start worrying unless that is typical for the child . But combine that with how they are behaving, if they seem to be getting worse etc.

And do bear in mind that temperatures do seem to have a tendency to rise at about 2am. My doctor agreed when I said that. Coincidentally that's the time they shut the out of hours at our local hospital for a couple of hours....

That’s brill practical advice witchend.

I’d add to that - no matter what the temp says or what the symptoms are - listen to your gut - a mummy or primary care knows a child best and sometimes you’ll just know there’s something very wrong even if you can’t put your finger on it. Don’t ignore your instincts and always act on them.

Oh yayy plonky a doctor that follows nice guidelines wow you are a rare specimen! I think treating fever with calpol is nuts. What is wrong with everyone? It is the bodys way of dealing with illness...let it do it's thing. Bringing a fever down top quickly can cause convulsions too so keep child comfortable...cover if they are cold and shivery and watch for other symptoms. I understand meningitis cannot survive at 40 degrees ao i am the other way i am frightened to lower a temp with antipyretics.