Thursday, September 8, 2011

High Fever In Kids

All mothers go through it, tending to your child who is running a high fever. It's physically and emotionally tiring.. add to it the grandparents' concerns and you are just ready to break..

One of the things that I really try to avoid is to overdose my kid with medication. But really when people are  overly concerned just how much medication can you give your kid?

Can I give my child both Paracetamol and Nurofen? 

Alternating between Paracetamol and Nurofen/Ibuprofen is possible. But, you have to ensure that you do not exceed 4 times a day for Paracetamol and 3 times a day for Nurofen. The gap between the two dosage should also be about 2 hours (as advised by my family PD; Dr Sim from Pasir Ris Baby and Child)

For example; when my son has high fever, paracetamol's effect will be very slow, I will be sponging him for the next two hours and still the temperature will not recede. This is very tiring for me, which is why I prefer to use Nurofen unfortunately my son will begin to burn up 2 hours before his next dose for Nurofen, so I will give him paracetamol first and then Nurofen 2 hours after that to contain the temperature. Do note that there will be one time a day where the two dosages will coincide; this is still ok.

So, let's say I start with Paracetamol at 9 am, the timing for the day will be; 9am, 3pm, 9pm and 3am.

Then I start Nurofen at 11am, the timing for the day will be; 11am, 7pm and 3am.

How do I give my kid a sponge bath? 

Put your child in a tub and pour water in the tub; water should be warm or room temperature not icy cold, just gently pour it over your child's body over and over again for as long as he allows you to.

I have also heard that using the water mattress sold in pharmacies (if I am not mistaken) greatly reduce the need for sponging but my kid just refuses to lie on it. Both kids also refused to be sponged (ermm using wet towel) in bed, so I improvised with using the water spray and just lightly spray water on their head while they are sleeping).

My child refuse to drink any fluids, how do I get him to drink?

This is perfectly normal, as they are not feeling well but it is important to keep them hydrated as you don't want them to be hospitalized due to dehydration. I try to sneak in fluids by feeding them soupy food but if your child is also not eating then I find bottle feeding them honey water or diluted milk while they are asleep very helpful as they will at times gobble it up without much protest. If that is not possible, then I feed them fluid using the syringe. I try to aim at least 50-80ml per force feed.

I usually give them honey+ lemon +warm water if they suffer from sore throat or tamarind + sugar + warm water if they have high fever and phlegm. Mom swears by barley water but my son don't really like it plus it doesn't really help with phlegm.

I also find keeping notes of how much food and water my child take and the timing of the medication each day very helpful. Especially so if more than 1 child is sick. Taking care of more than 1 child is very taxing and you may get mixed up with the timing of their medications or the amount of their fluid intake. Also, as we don't really give medication like clockwork everyday, the timing will definitely vary. Keeping notes ensures that we don't deviate from the schedule too much.

How much fluids does my child need?

A 13kg child needs about 1.1 litres of combined fluids intake each day. This includes soups, water, ice creams and what not but does not include medication.

What are the signs of dehydration?

Dehydration signs are; little or no urine passed, red and cracked lips and no tears when crying.

My child refuses to take oral medication. How do I overcome that?

Wrestling with your kids and forcing their medication down their throat is very tiring for us and traumatizing for them. My first child is terrible in taking his medication and he will ether spit out the medication when we force upon him or cough so much until he vomits out everything. Cleaning up after him and washing the puke clothes are what I dread the most.

What I would do usually is to ask the doctor for a better tasting medicine or one that requires to be taken only once or twice a day to reduce the traumatic experience.

Recently, after my complaint with regards to my son's difficulty, the PD even prescribed Paracetamol suppository (commonly known as the butt medication for fever) which can be used for mild fever every 4 -6 hours which I can used in replacement for the oral Paracetamol. What a God send! Of course we still asked for Voren suppository too for high fever (to be used every 8-10 hours).

The kind doctor also suggested a tasteless powder called Singulair for my son's cough which can be sneaked into my son's favorite drink or milk (as long as it is not hot).

Therefor, I think it is advisable to discuss with your PD the various options for medications that are available to you.

When should I be worried?

You should be worried when the child is always sleepy / lethargic and fever has been ongoing for more than 5 days.