Toddler 40 degree temp. What to do

[Eatentoomanyroses]

Dd 26 months has an ear infection and sore throat. She’s very prone to spiking 40 degree temps. She started with her current lurgy Tuesday night. Sat up with her most of the night and gave her paracetamol and ibuprofen. Paracetamol doesn’t bring it down. Ibuprofen does but takes a good 60- 90 mins to work. I took her to the walk in centre yesterday and they gave an antibiotic for her ear. Then last night sbout 4 am she woke and was so hot and sure enough temp was 40. Gave her ibuprofen and it came down. Then she was pointing to her mouth and saying ‘mouth ow’ so had a look and I thought I could see swelling. Took her down to a&e and they checked her over and sent us on our way. When we were seen she’d had ibuprofen a couple of hours before so her temp was down to 37. Literally as I left the building she went very pale and shivery and promptly vomited so I took her back in. Dr was probably a bit annoyed but acknowledged her temp was 39.8 and mentioned something about febrile convulsions and bring her back in if she got worse. Temp keeps going back to 40 when the ibuprofen wears off. Trouble is I’ve now given her 3 doses of ibuprofen since 4 am. So I can’t give her any more. What am I going to do in the night when this last lot wears off ( last gave at 5pm)? I can give her another dose of paracetamol but as I say it doesn’t seem to work. Obviously will do all the stripping off, fluids and will probably sleep on the floor next to her cot. Anyone else with a Dc that doesn’t seem to respond to paracetamol for temps?

Can you get paracetamol suppositories? My kids temps didnt really reapond to paracetamol either but for some reason in suppository form it worked. If you pop it in while changing nappy they dont be as upset by it as you would think.

@Cuppasoupmonster i went out tonight and got her ice lollies and ice cream but she didn’t want it. The trouble is when she gets a high temp she seems to want to be warm. Goes crazy if you try and take her duvet away or strip her off and gets all shivery. So hard to calm her down.

Never thought of those. I’ll get some in.

I promise I am not asking this in a snippy, snarky way - but what is it you want a+e/the hospital to do?

All they would do is exactly what you are doing now, except in a clinical, unfamiliar, and scary environment.

If there isn't anything that they would do that you can't do at home, home is always the best place.

If she is agitated and upset (assuming she isn't worryingly so) I would see that as a good thing. Lethargy is much more of a concern I think?

My DC used to run very high temps when sick - I think the highest we saw was just over 41 degrees. There was never anything untoward. The only my time one of them was seriously ill, it was the lethargy that was the red flag - iirc they didn't have a particularly high temperature at the time.

@BrimFullOfAsher nothing now. I’m not thinking of taking her back as things are. I took her today because I thought she had swelling in her throat and was worried she might need intravenous antibiotics. I’m just looking for people’s experiences of temps really because I don’t want her having a convulsion

You can’t prevent a convulsion though, if it’s going to happen it will happen. Some children have a lower tolerance for having a temperature and for some reason their brain goes ‘nope’ and they have a seizure, which of course is terrifying. It’s thought that giving calpol or nurofen won’t prevent a febrile seizure from occurring.

Have you never felt cold when you have a temperature? It's a mechanism of the fever. It doesn't mean you should let her wrap up and let the temperature continue to rise. It's not nice but she needs to be stripped off at that point. Down to underwear, very light blanket. Paracetamol and brufen.

Also with febrile convulsions it's the speed of the temperature rising not the end value of the temperature, so a high temperature that comes down and steadily goes back up again won't necessarily cause a convulsion but a temp that goes from say 36.5 to 38 in 30 mins might be more likely to cause a convulsion.

Go to the pharmacy tomorrow and get some children's suppositories for paracetamol, it'll work way better than calpol. Drs in Europe don't prescribe oral paracetamol for children, it's nearly always suppositories because as PP says they're better tolerated and they work on the body quicker, also you can't vomit them back up whilst crying.

Also try and get the full sugar versions of drugs if possible and no underlying issues with sugars like diabetes because they taste far far nicer than the sugar free ones.

www.nhs.uk/conditions/fever-in-children/

please just read this. You don’t need to strip her clothes or anything like that (that is specifically something you should not do). You don’t need to bring the fever down. The ibuprofen and paracetamol help her feel more comfortable. Just keep her as comfortable as possible, lots of fluids, alternate the painkillers and give the antibiotics.

Read the guidance and be aware of when you actually should be worried.

my kids have both had fevers of over 40 and have been ok. Didn’t need antibiotics in their cases. I didn’t consult a doctor - they just got better.

Hi OP it is very worrying especially at night time. I know you said she doesn't respond well to paracetamol but I'd still give it. Alternate calpol and Nurofen as often as is safe to do so and don't strip her down if she doesn't want you to. A fever can make you feel very cold and shivery.

Write down the times when she's had medicine and keep a log of her temperatures as it's easy to lose track especially overnight. Make yourself a little station of drinks for both of you and get yourself set up for the night. Make sure she gets the antibiotics on time. Reasses in the morning but if you're worried overnight have a bag ready in case you feel she needs to be seen at A&E.

Try to prepare and it will make you feel calmer.

Hopefully tomorrow after two days of antibiotics she will be starting to feel better.

If you turned up at a&e with a child wrapped up in snow suit, vest, baby grow etc and they had a temp of 40, you bet your ass I'd strip them off.

Sure, but that’s an entirely different case. The OPs child doesn’t need go be stripped to a nappy at home in mid winter. At least not according to nhs guidance which I would trust more than random people on the internet.

If you turned up at a&e with a child wrapped up in snow suit, vest, baby grow etc and they had a temp of 40, you bet your ass I'd strip them off.

This happens so much! You strip them off, take some obs, turn your back and they’ve got all their layers back on. 🙈

My little one is the same in that calpol has little Effect when he has a temp. And when he's ill he frequently hits 40

Just for future reference when ill your temp is usually higher at night this is because cortisol level in your body which helps control temp is lower at night.

I tend to try and give calpol in the day and save the ibuprofen for night time in the hope we will get much needed sleep. I don't strip him either and leave him in pjs but do try and take his duvet off.

Hope you get some sleep!!

All my sympathies - my dd spikes high fevers too and they never fail to scare me ☹️☹️She too goes very pale and very shivery and hot and I literally sit waiting for the time I can give more nurofen.
it sounds like you’ve done Everything right, getting her checked and going back in when she wasn’t right leaving a&e so well done. Could well be she’s picked up a virus too that won’t be touched by the antibiotics so that’s why she is still spiking fevers.
keep going- when mine is like this (all too often) I try to save my nurofen “allowance” for late afternoon / night wheb its highest. When she’s in hospital they keep her on a strict every 3 hours alternate calpol then nurofen which helps a bit. All our hugs xx

I know! The worst is when you ask if they've had any pain relief or antipyretics and you get the answer of 'no I wanted you to see how sick they are' I can see they're sick you wouldn't be here if they weren't please give them paracetamol!

I try to work the alternation of the calpol/nurofen to focus it at night as nights are always hideous when they are ill!

9am - calpol
12pm - nurofen
3pm - calpol
6pm - nurofen
9pm - calpol

That leaves you a calpol and nurofen dose to give overnight between 12am and 6am if needed. Obviously you need to always leave at least 4 hours between 2 doses of the same medicine.

Good luck! Fingers crossed she's on the mend soon.

DD is older now, but was also prone to ear infections and fever spikes.

I know it's really scary. But I always reassured myself that if she hadn't had a febrile convulsion the day she went from 36.6 to 42 degrees in an hour, she probably wasn't prone to convulsions - some kids are, some aren't - there's really no way to know.

The only thing to do is to alternate Para and Ibu, stay with her, check her temp at regular intervals, and really importantly... Don't try to cool her down by completely undressing her, using cool flannels or baths, fans or anything else - shivering is designed to increase body temperature, so don't do anything that makes her shiver.

Once you get through tonight the antibiotics should kick in. Hopefully tomorrow is better!

One of my first memories is men in uniform running through the house in the night & throwing my baby brother in a bloody cold bath. I was SO scared. Febrile Convulsion in the 1970's. He had a couple more then grew out of them.

these days they say to cool the child down (remove duvet etc) but not abruptly and no so they're cold. So keep pj's etc on so they're not shivering or their bodies just heat up more to warm them up!

it's scary I know, but they bounce back really quickly too, let's hope she's much better tomorrow (today!)

Thanks everyone. I have read everything everyone’s said and it does help. She woke up at ten and her temp was 41.2 on the inner ear. I gave her the paracetamol but she then threw up all over the cot so not sure how much if any went in. Eventually managed to calm her down, just gave a cool drink and changed her into a loose night dress. She vomited a few more times. Had her with me on the bed since then. She hasn’t slept but just been kicking about. Rechecked her ten now and she’s 38.8 so at least lower. I’ve made the decision to put her in the cot because I know she wants a sleep but she can’t seem to manage it in my bed. I’ll keep an eye from the chair 😴I really hope she’s better tomorrow

Dont strip her and dont have the open or fan on her… and dont wet her with cloths / flannels either

Light clothing and a lightish blanket will be fine !

Dont open the window

Hi OP
DS1 has suffered high fevers since a toddler has a over active immune response.

Don't strip her down too much rapid changes in temp are more likely to cause issues. If she's hot then light pjs and light blanket.

Did they explain fever management to you to try and avoid the very high spikes? So alternating paracetamol and ibuprofen so there is always a least an hour overlap beforeone starts wearing off (ibuprofen starts wearing off around the 6 hour mark paracetamol around the 3 hour mark)

Make a little floor bed up try and get fluids in her where you can. If she still isn't better by mid morning and having very high fevers I would call 111 and see if you can see out of hours.

Just to say OP - is she big for her age? Both mine were and when they were really unwell we needed a weight based dosage which the GP worked out for us. Needed it often for ds who was quite sickly and only for Dd when she had scarlet fever but it made the world of difference .

Also I know convulsions are scary but I had them at the drop of a hat as a kid, the slightest illness I had a fit and as I had two older siblings bringing every bug home it was A LOT. I can only remember one of them and there's no long term damage .I think they were definitely scarier for those around me. The one I remember is only because it happened at my sisters birthday party and she was really annoyed at me!

@thaegumathteth yes she is very tall ( we all are) more like a three year old. I asked the dr yesterday at the hospital about that because I suspected she wasn’t on the right dose. He worked out the ibuprofen needed to be 2.5 mls more but said that paracetamol was the same.
Poor thing didn’t go to sleep at all since waking at 10pm. Fever went down for a bit to 38.8 but back up to 40 at 3am. Gave her the ibuprofen as soon as I could at 4am and she eventually fell asleep at 5:30. She’s still asleep now.
@Scottishskifun I’m going to try and be a bit cleverer with the cycling of the meds today to see if we can avoid that dreadful bloody window we had last night. I’m going to see if someone can get me some of the paracetamol suppositories as well to see if they’re any better as well.