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?

Yes I'm in the UK. All you're doing is prolonging the pain! Read about fevers. They are how a body kills infection. You keep bringing it down makes it last longer.

I'd be tempted to get her back to urgent care as 41 plus is just too high. Dehydration could also become an issue now.

@Daisydaisydaisyrosie she’s definitely not dehydrated. She’s had lots to drink over night. I’m quite willing to take her back but I’m not sure what they can do. She’s already on antibiotics

if she’s been seen by a doctor twice, is on antibiotics, is alert and not dehydrated then she is just unwell and is best cared for at home.

I would put a sheet on the sofa with a pillow, put her in cotton vest with no socks with a sheet/empty duvet cover or very light cotton blanket on her. Nothing fleecy. Then sit with her downstairs and let her doze or watch telly and lots of cuddles (you may find that makes her hotter but gives her most comfort).

Avoid draughts, baths etc.

She will do best with complete rest. You just have to let the virus or infection run its course.

Great advice

Please ignore this poster!

Definitely read about fevers and fever management but a temp of 40+ in a child can be dangerous and lead to cerebral convulsions which in extreme circumstances includes stopping breathing (happened to a friend of mine)

OP your doing all the right things. With fever management I found writing down the type given and time helped in the beginning so that I didn't lose track and then setting an alarm on my phone for next dose.

Ibuprofen is your friend overnight in most children it's more effective in temp management and lasts longer.

Dose before bed then around 6 hours later dose of paracetamol, 3 hours after that ibuprofen again and that should last til well into morning.

It’s not the height of the temperature that causes febrile convulsions, it’s the speed by which the temperature goes up. So it doesn’t have to be high to cause it.

@Scottishskifun i am ignoring that don’t worry. I have written all the timings down. The ibuprofen has worn off now so she’s just woken up wailing. Temp still 40 Given her Calpol and her antibiotics. She’s cuddled up in my chest at the moment and doesn’t really want to move but I’ll attempt to get downstairs like @PotKettel says when she’s a bit calmer. My mum’s coming round soon and she’s a nurse so I always feel a bit better when I have that back up. Ringing round local pharmacies as well to see if they have suppositories. So far no joy.

I find it's easier if you set yourself an actual schedule for the calpol/nurofen. I set reminders on my phone as easy to forget otherwise.

I also second the sofa sick bed - just let her do whatever she wants, offer plenty of fluids, ice pops, yogurt, let her nap as and when, her favourite tv shows and mummy near by. Hopefully she'll start to feel better soon.

Both of mine have had a few ear infections and they are miserable for them. My youngest is also very prone to vomiting when his temperature is high - it's tough!

Just to make things harder - I had to give suppositories to DS when he was that age and it was horrific. He absolutely hated it and was very upset. I guess I'm just giving a warning.

Maybe pop a window open to get some fresh air running through?

Interestingly she has just wandered into the kitchen and helped herself to a packet of pom bears and climbed on the sofa to eat them ( have offered breakfast but refused). I’m hoping this is a good sign!

Excellent sign! All nutritional concerns go out the window when mine are ill! Crisps, yogurt, jelly, ice pops! Whatever works!

Hope she is feeling better now OP.

Thought I'd comment. Currently camping downstairs with DS who's had a temp since Wednesday.

Went to the docs on Friday and said it may be an ear infection but couldn't be sure!

He's completely normal in himself just sat at 39! So fraudtrating

One thing to note is that ear infections can inflate temperatures on in ear thermometers due to the infection and inflammation generating heat, so if seem okay in themselves then fever might be lower than appears. If one sided then check the non affected ear if possible.

It's hard to say if true reading without correlating with say an under tongue or axillary thermometer though there will be some variation using those also.

But if keep getting readings 40+ obvs do get them checked out again!

Fingers crossed for less spikes tonight OP!
Set alarms on your phone to wake you up to give doses if she's been high again today

Hey all just thought I’d update. She had a much better night and managed to get a few hours myself. @Ihatewinding thsys a good point. Unfortunately though she was 40 as well on my digital forehead one as well We seem to be over the fever spikes thank goodness. She’s not eating really still but drinking plenty and playing happily so I’m hoping she’s over the worst now. Just need to deal with the laundry and housework that I’ve neglected for the past few days now!!

For future reference, ask your GP to work out the maximum dosage of Calpol for your child's weight. My son at 11 months had to have his dosage of Calpol (and Ibuprofen) upped quite significantly and only then it started bringing his temp down. I was told that the dosage on the box is so low to make sure parents don't overdose...

@BananaPalm I did that the other day because she’s big for her age. The dr said Calpol dosage was the same. Ibuprofen was 2.5 ml more

Sorry for typos

Interesting but a bit bizarre. For my DS our doctor recently calculated around 2ml more of Calpol but only 0.5ml more of Ibuprofen (as compared to the dosage on the box).

@BananaPalm god I hope he didn’t have it the wrong way around! He wrote it down for me. This was at the urgent care centre. I’ll have to check with someone else

I'd definitely double check it, particularly the Calpol dosage since your DC is prone to such high temps.

I've just found the note that my dr gave me and the absolute max of ibuprofen for my DS at his weight would be around 22ml in 24hr hours, divided into 4 doses (more than that and there could be liver and other issues). I guess if you were giving you DC 3x7.5ml that's just under that amount anyway.

She only had two at 7.5ml but I will definitely be checking. Thanks for the info