Fever in children

There are few problems more worrying to parents than a child
who is ill with a high fever they cannot bring down. However with 
some basic knowledge it can usually be dealt with easily. I have written 
this mainly for my own patients. Please do not rely solely on this if you
are concerned for the health of your child.

What is a high temperature ?

A feverish child will feel very hot to the touch but may himself
feel cold. You can take the temperature with a thermometer bought 
from a chemist or with one of the newer strips that you apply to the 
forehead. A normal temperature is about 37 degrees centigrade.
With a thermometer placed under the tongue or in the armpit a
reading of 38 and above will indicate a fever. The fever can go as 
high as 40 or 41 ( and rarely even higher than this ).
Having a fever makes anyone feel unwell. A child may feel clingy
or irritable. She won't want to eat. She will feel generally out of sorts.
Simply bringing the temperature down regardless of the cause will
make the child feel a lot better.

Firstly undress the child as much as she will let you. This will allow her
to cool down naturally. 
I recommend giving paracetamol ( acetaminophen )
syrup if the child feels unwell. Give the full dose recommended 
on the bottle for the age of the child. Give it as often as the bottle 
says you can. If the child spits it out then you can either mix it in with 
the child's drink or squirt it into his mouth with a syringe. (available from 
chemists ).

Although Calpol and Disprol are the well known brand names some 
large supermarket chains sell their own brands more cheaply
No response to paracetamol ?

If the temperature remains high then sponge him down with lukewarm
water or put him in a lukewarm bath every couple of hours.
Junifen ( ibuprofen syrup ) is another medicine you can buy without a 
prescription. It works very well on its own or alongside paracetamol 
to bring the temperature down. 

Usually the child simply has a cold, sore throat or chest infection.
The runny nose, red throat or cough makes the diagnosis clear. 
The commonest cause of a fever which can't be easily identified 
by the parents is an ear infection. This is often associated with 
vomiting and the child feels very miserable.
Another cause is a urine infection. The child may feel some pain
when peeing. She (girls are more vulnerable than boys) may go to
the toilet more often than normal and the urine may smell odd.
 

Sometimes.....
Antibiotics will not help a cold or sore throat. They help a small 
proportion of people with tonsillitis. They have been shown to help 
only one in seventeen children with ear infections. They are more 
clearly useful in chest and urine infections.

If the temperature stays high for more than a day or so
and you are worried  it may be the child needs to see a doctor. 
This can usually wait until morning. If you call at 09.00 you can 
usually book an appointment that day.

Call the doctor at night if 
- the child develops severe headache, light hurts the eyes, there is 
   severe vomiting or a reddish brown rash develops which doesn't go
   white when you press.
- the child has a convulsion or fit
- you feel the child is very unwell, you have tried all of the above 
   and you are worried.
- if you are worried.