Traitement de la fièvre chez les enfants : les conseils d'un médecin

Comme vous vous en souvenez peut-être de mon scarlet fever article, I have a young child at home and can relate to the constant infections coming through the door. This also relates to the GP surgery where I work, where we are seeing lots of toddlers that are unwell.

De loin la cause la plus courante de fever in children en hiver, les infections virales. Il existe des milliers de virus, et nous ne pouvons pas toujours vous dire quel microbe cause le problème. Nous savons cependant qu'il y a des symptômes qui sont les mêmes pour la plupart des infections courantes.

In general, if children have snotty noses but are well then we don't really worry. You can usually manage these at home with good advice so that you know when to come to see us in the surgery.

Treating a fever with paracetamol and ibuprofen

Il est important de connaître la raison de fièvre élevée - tel qu'un températures froides ou maladie virale. Si vous avez déjà consulté un médecin et obtenu un diagnostic, vous pouvez alors gérer la fièvre et les symptômes à la maison.

If children aren't unwell or in pain you don't have to use paracetamol or ibuprofen - but often it will bring them comfort.

Paracétamol

Paracétamol is a good first-line medicine to help children feel better. It is usually fine to give to anyone and in the doses stated on the bottle. For those born prematurely, you should have already been given advice on the right doses for an infection. Always check if you are unsure.

The correct dose will be according to the age group. You can only give paracetamol four times a day (a 24-hour period) and each dose has to be at least four hours apart.

When can I not give paracetamol?

If the child is allergic to paracetamol or they have liver problems, do not give paracetamol. You also need to seek advice if they are on medications for epilepsy.

Ibuprofen

Ibuprofen is a great second-line medication for both pain and fever. I always advise to give it after some food as it can cause an upset tummy. Always read the instructions on the bottle and check the correct dosage for the age. Always ensure there is a 6 to 8 hour gap between each dose and give no more than 3 or 4 doses over a 24 hour period. For those children who are born prematurely - their doctor should have advised whether they can or cannot have ibuprofen and in what dose.

When can I not give ibuprofen?

This is an important question:

Other people who cannot have ibuprofen are those who:

• Sont allergiques aux ingrédients ou allergiques à non-steroidal anti-inflammatory medications (NSAIDs). Ibuprofen is an NSAID.

• Avoir asthme.

• Avoir heartburn or reflux symptômes.

• Avez des problèmes intestinaux - tels que maladie de Crohn ou la colite ulcéreuse.

• Have kidney problems.

• Are severely dehydrated as this can cause kidney damage.

Tips to keep you right:

One thing I’ve found as a parent - usually when sleep-deprived - is that I forget what I have given at what time. Recent studies have shown that parents are at risk of accidentally surdosage ou sous-dosent leurs enfants parce qu'ils oublient quand et combien ils ont donné.

• Je trouve que l'écrire aide, et j'envoie également un message à mon partenaire pour qu'il soit au courant de ce que je donne comme médicament et quand. Par exemple - j'ai donné à mon tout-petit malade Calpol - qui est un paracétamol - à 12 h et ibuprofène à 15h. À 18h, sa fièvre montait, donc je savais que je pouvais lui donner du Calpol en toute sécurité.

• Using a syringe to measure doses helps to give out the exact amounts needed without wastage.

• Loose clothing - I tend to let them run around in their underwear and a loose tee shirt. It keeps them cooler and more comfortable - avoid cold sponges and direct cooling from fans. Lowering a temperature too quickly can be problematic too.

When to seek help urgently - the same day

• If you are concerned - I always tell patients that they know their children the best so if they are concerned then call the doctor.

• If a fever is not coming down despite the full doses of paracetamol and/or ibuprofen and cooling measures.

• If you don't know what is causing the fever.

• If a fever lasts more than five days - or sooner if they are getting worse.

• If children have stopped eating and drinking.

• If there are less than three good wet nappies or children have not been for a wee or have a dry nappy for more than 12 hours.

I know it is hard to know when to seek help but If your instinct is saying that your child needs to be seen, then go with it, because you know best - all doctors will understand this.