There are many ‘recommended’ treatments for illnesses, some general and some specific, but there are three golden rules which apply to most common ailments, from feverish colds and coughs to infectious diseases. These are to give plenty of fluids to drink, keep your child comfortable, and to regularly check them.
Frequent small drinks encourage fluid intake which prevents dehydration and helps with fevers. Your child’s interest and ability to drink is also a good indicator of how well or sick they are. Keeping your child comfortable rather than trying energetically to cool or warm them reduces stress and lets them adopt a temperature they feel best with. Keeping them in the company of an older person who can regularly check on them will pick up those who may need to seek medical care.
Babies and young infants have fewer outward signs of illness and may deteriorate more rapidly than older children. It is best to seek medical care for any baby or infant under 6 months if they have a fever, seem ill or unwilling to feed normally, or more sleepy than usual. Breathing difficulties, rashes, and abnormal crying are also reasons to seek help without delay.
A lot of parents and health professionals focus on fever as something dangerous in itself and in need of treatment. Fever is merely an outward sign that the body is fighting an infection, and often doing so very well. The fever itself is not dangerous, does not cause convulsions on its own, and does not need specific treatment. What is important is to encourage fluid intake, keep them comfortable (which may include pain relief), check on them regularly, and consider medical help in case specific illnesses require treatment.
The best fluid is water. Sports drinks and other “fizzy drinks” have far too much sugar which can cause dehydration by sucking fluid into the bowel. If diarrhoea or vomiting from a “tummy bug” or gastroenteritis then specific Oral Rehydration Solutions are best with a balance of salt and sugar to maximise absorption. Young breast fed babies should be encouraged to continue breastfeeding.
Sometimes pain relief for sore throat is needed to help drinking. Iceblocks can also help.
Infants and children will shiver if their body is trying to heat up, and sweat if their body is trying to cool down. This heating and cooling is driven by the body responding to and fighting infection. Trying to uncover a child and cool them down if their body is trying to heat up, no matter what a thermometer records, will only cause them more stress. Similarly trying to cover them up when sweating will stress them.
Actively trying to cool with sponges, baths or fans will not prevent a convulsion. Treating fever with Paracetamol will not prevent a convulsion, even if the child has previously had a convulsion.
If a convulsion is going to occur with the fever it is due to underlying factors and not to the height of the fever nor the duration. Although taking a body temperature can help with decisions on seeking medical advice, the fever itself does not need treating.
Call a doctor if your baby seems ill, or has as temperature of 38.5 degrees or over, or has had a temperature over 38 degrees for more than a day.
Normal body temperature varies between 36.5 and 37.5 degrees when taken by rectal or core thermometer. Mercury thermometers are accurate when kept for three minutes in place, but mercury can be toxic if they break. Digital thermometers are quicker to use but their accuracy is not nearly as good as they imply with their readout. They can be used under the arm, or in the mouth in older children. Ear thermometers are no more accurate than other digital thermometers. Body temperature changes during the day, and fevers can change over minutes and hours. The absolute temperature is not as important as the trend.
If your baby or infant is feverish, consult your doctor. Describe any general concerns e.g. sleepiness, poor feeding) or specific symptoms (e.g. abnormal cry, cough, breathing problems, tummy upsets, rash).
Give plenty of fluids. Drinks are especially important if your infant has a high temperature, diarrhoea or vomiting. Lack of fluids can soon lead to dehydration.
Some medicines such as paracetamol for pain and fever can be bought over the counter at pharmacies. Others (e.g. antibiotics for infection) must be prescribed by a doctor or midwife and are prescription only medicines. It is unwise to give any medicine which is not essential, and some can have troublesome and unpleasant side effects.
Whenever possible it is best if a child can build up immunity by fighting infection naturally. Bacteria can become resistant to antibiotics if they are given for viral or for minor infections. Most infections in childhood are due to viruses, which are not killed or affected by antibiotics. When an antibiotic is prescribed for a bacterial infection, it is really important to finish the whole course, even if your child appears to be better halfway through the course.
Read the label carefully to check how often and how much medicine you should give. Only give the dose (amount) recommended by the doctor, midwife or pharmacist. Never give your child another child’s or adult’s medicine (even if they have a similar problem). Discuss any over the counter medicines bought from a pharmacy with the pharmacist to check that the medicine is all right for your child’s age and problem.
Do not give aspirin to children under 12 years old, unless prescribed by a doctor. There is a risk of a rare but serious liver condition called Reye’s syndrome if aspirin if given when influenza is causing childhood illness. Always check brand labels for a list of contents and to make sure aspirin is not included. Aspirin may be listed as salicylate or salicylic acid.
Give sugar free medicines if possible to help prevent dental caries.
Paracetamol is available in syrup and liquid form for children. It should not be given to babies under three months without a doctors recommendation. Whenever medicine is prescribed or bought over the counter, it is essential not to exceed the stated dose. Paracetamol overdose can cause liver problems, and rarely irreversible liver failure. Be careful not to duplicate dosage of a drug such as paracetamol by giving additional product containing it, such as a cough or cold cure.
If you think your child has taken an overdose of medicine or consumed any other poisonous substance, you need to phone the poisons information centre 0800 Poison (0800 764 766) and see a doctor urgently.