Tratamiento de la fiebre en niños: el consejo de un médico

Como quizás recuerdes de mi 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.

Con mucho, la causa más común de fever in children en el invierno son las infecciones virales. Hay miles de virus, y no siempre podemos decirte qué virus está causando el problema. Sabemos que hay síntomas que son los mismos para la mayoría de las infecciones comunes.

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

Es importante conocer la razón de temperatura alta - como un resfriado o enfermedad viral. Si ya has consultado a un médico y tienes un diagnóstico, entonces puedes manejar la fiebre y los síntomas en casa.

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

Paracetamol

Paracetamol 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.

Ibuprofeno

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:

• ¿Es alérgico a los ingredientes o alérgico a non-steroidal anti-inflammatory medications (NSAIDs). Ibuprofen is an NSAID.

• Tener asma.

• Tener heartburn or reflux síntomas.

• Tener problemas intestinales - como enfermedad de Crohn o colitis ulcerosa.

• 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 sobredosis o subdosificando a sus hijos porque olvidan cuándo y cuánto les han dado.

• Encuentro que escribirlo ayuda, y también envío un mensaje de texto a mi pareja, para que estén al tanto de qué y cuándo estoy administrando cada medicamento. Por ejemplo, le di a mi niño enfermo Calpol - que es un paracetamol - a las 12 pm y ibuprofeno a las 3 pm. A las 6 pm su fiebre estaba subiendo, así que supe que podía darle Calpol de manera segura.

• 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.

• Si los niños han dejado de comer y beber.

• 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.