Toddler Fever - Paracetamol Not Working

[BoopityBoop]

Toddler (2) has had fever of 39+, yesterday evening to this morning we couldn't get it below 40. DC is clearly uncomfortable and mostly unlike their usual self (aside from 30 mins yesterday and a short period today playing before going back to wanting to be held and grizzly).

We're alternating paracetamol and ibuprofen. I've noticed the paracetamol doesn't seem to get it down, sometimes the temperature seemed back up to where it was before it began or higher than that, before the ibuprofen is due.

I've monitored it hourly on the paracetamol and it's because it's not doing anything at all for the fever.

We've tried:
Cooler room - rads turned off in that room
No blanket
Cool clothing (just a light vest or nappy)
Cool foods and drink although DC isn't eating or drinking much.

Any advice?

How are things this morning @BoopityBoop ?

@BoopityBoop Just catching up on your thread from last night OP.
I called 111 about our 3 year old a few months back with extremely similar symptoms. We had visited GP that morning after 2/3 days of symptoms because I suspected Strep, and GP had dismissed it as viral without even examining DS. He ended up poorlier that night so I called 111 for a second opinion and they wanted him straight in to the Out Of Hours service.
Turned out to be Strep A and he needed a 10 day course of antibiotics.

I would ignore 111 and get your DC seen this morning.

Just as a warning - DH and I both ended up with Strep about 5/6 days after DS 🫠 it was hellish!

If your gut instinct is that there's something wrong, see a GP today. Doesn't matter what 111 said. My DD was similar last December with stubborn high fevers and changed behaviour. It was Strep A. It made her really unwell. She didn't have the scarlet fever rash or the appearance of Strep throat. Insist on a throat swab.

Agreed. For a temp that high that's not responding well to paracetamol and ibuprofen it's better to be checked over

DC was extremely tired during the night and this morning so we decided I'd try and see the GP after letting DC get some extra sleep.

I'm just waiting for triage at the moment.

@BoopityBoop Let us know how you get on with the GP. Hope DC is on the mend soon.

Hope you manage to get to the gp too, this happened to my DC, a fever up and down for a week with no improvement and they had tonsillitis.

Thanks for the advice.

DC has been seen and prescribed antibiotics for Scarlet Fever. It seems to be doing the rounds locally.

I've been reminded not to worry about the high fever and medicating it unless DC needs it. Although at the moment, DC does need the alternating meds.

Hopefully it won't take too long for DC to start feeling better once we get the antibiotics started.

Also, I'm guessing there's no way of DC1, DH and I avoiding getting it at this point and since there's also a 6 day incubation period before symptoms where it's most contagious?

DH and I are still recovering from Covid a few weeks back, DC1 still has the persistent cough. I'd imagine our immune systems aren't the best at the moment!

Oh the poor love! Hope they are on the mend asap with the antibiotics. I think (not 100% sure) scarlet fever is usually under 10s. So glad you got checked out but also how worrying that 111 were so dismissive!!!

Really glad to hear you got seen, and diagnosed - sorry 111 were so unhelpful.

I'm just catching up on this now, and was going to say scarlet fever.
I work in a pharmacy and am surprised that they were going to send you to one. We would of had to send you to the doctors also, as we wouldn't of been able to do anything but.
I hope your LO recovers quickly.

@BoopityBoop Aww your poor DC. My DS started perking up after a couple of doses of antibiotics when he had it so hopefully yours perks up quickly too 🤞🏼

Have you managed to get a dose of the antibiotic in yet? We had a hell of a battle for the 10 days 🫠 it’s vile!!

No idea the likelihood of catching it but, like I said, when DS had it DH and I were both down with it within a few days. DH and I literally just phoned the GP surgery and said to the receptionist we had horrific sore throats and DS was on antibiotics for Strep A and she got the doctor to email prescriptions straight to the pharmacy for us 🤷🏻‍♀️ so I’m assuming it’s common for it to go round the house.

DS said he didn’t have a sore throat at all. Mine was the sorest I’ve ever had by a mile. I actually resorted to sucking on ice cubes because I couldn’t take a drink 😳 If you even start feeling a niggle I’d get straight on the phone for an antibiotic 🫠

When my DD had Strep A, I didn't catch it. Neither did her GM who was looking after her when she first came down with it.

Hope your DC feels much better soon.

When my son had scarlet fever, nobody in the family or in his class appeared to catch it (symptomatically at least). The antibiotics improved things very fast.

Me and DH have both started to feel really washed out this evening. It might be all the lack of sleep so hopefully that'll improve. We've put off visitors for now just in case.

@Pumpkinseason3 DC is so good with paracetamol and ibuprofen usually but somehow just knew I was coming with the antibiotics, refused then spat up half of the dose after being held still. Next time, DC wanted to push the syringe but did the same thing Before the whole dose was wasted, DH offered chocolate spread if DC drank it and it worked. I hate bribery but I think we're going to have to go with it with these antibiotics. I can't understand why they can't be nicer either! No idea how DC's childcare is going to do it.

I hope you don't come down with it.

Re the antibiotics, it's really important you complete the course with this. If bribery does the trick don't worry about it! Just do whatever's necessary but do keep going. It can feel like a long slog.

Keep the syringe in their mouth until they swallow it. It makes it harder for them to spit it out.
We had red antibiotics once and the first day looked like a massacre! By day 3 she took them without a fuss. She takes daily medication by syringe and has done since birth but the antibiotics for her tonsillitis were a completely different ball game!

I've had DC spit the majority of the dose out this morning by doing this, I have a feeling it's where DC can't breathe. Currently using a vapour plug in and nose blowing very frequently to help with this.

I tried putting it in a baby bottle lid before the bribery but that didn't work at the time. Bribery just doesn't seem to be worth it for DC today!

Any other suggestions?

It's really tricky at this age as no amount of explaining is likely to make a difference. You could try role play. Say let's play a game where teddy is unwell and feels sad. Teddy needs some medicine. Will you give him it? You can then act teddy to be unsure but after he has the medicine he acts happy.

If you can't find anything that works you need to speak to GP again. I've known kids have to have their AB by IV in hospital but you really really want to avoid this route if you possibly can for so many reasons.

Why in heavens name the pharmaceuticals companies can't make kids' antibiotics more appealing I do not know! Just make it taste like Calpol and for most kids we'd be winning.

Another thought is I wonder whether getting some proper quality sugary blackcurrant squash to combine it with might help but I'd want to check with a pharmacist that it's safe to do this.

You could definitely try asking the GP for something more palatable for children. We had this once - I mentioned what we'd been prescribed to a friend with older children, and she said 'Oh that one tastes disgusting, ask for a different one'.

Give it in undiluted squash, that hides the rank taste. And it is rank, taste it, its revolting.

As for the fever, I'd give both paracetamol and ibuprofen together. They don't interact so it is safe to do so. They tend to pack a harder punch when taken less than an hour apart. I always spike a high fever when ill and one of them alone doesn't do anything.

It's surprisingly difficult as most drugs taste foul. It's actually an issue with clinical trials as by taste you can often tell the difference between drug and no drug!

@BoopityBoop
Play around and see what you can manage. I had a friend who in desperate drizzled antibiotics over ice cream and got their little one to lick it off!

Any food or drink that can make it more palatable. Alternating meds and something tasty. Whilst figuring it out I'd try to just give 1ml at time so less is lost if it doesn't work

@Superscientist I tried the ice cream trick, thank you. It worked for 1ml then DC got suspicious with the next and refused it. I then added sprinkles and sauce at DC's request and it was refused.

I've got to give DC ibuprofen due to a high temp and not coping with it. DC spat up paracetamol late morning. Has since refused the ibuprofen, crying, screaming and really distressed to the point DC can't breathe to take it.

DC also generally won't drink. DC still breastfeeds but can't breathe properly so is on and off and I doubt is getting anything much. I've tried syringing, spooning, straws, push up ice lollies, water, milk, strong squash, weak squash, fruit juice. Going to try some chocolate milk when DC wakes from napping.

I now need to do a urine sample as DC is in pain urinating with a strange odor. DC is getting extremely distressed with that. There's no warning of needing to go until DS complaining at which point it's too late, DS will hold it until a moment where I'm not focused on it then going on the floor. I'm going to have to try the bag technique if the pharmacy do a sterile one.