Speaker 1 00:00:03 Hello and welcome to the WBA podcast. My name is Sheena Mitchell. I'm a pharmacist in mom of three. I combine healthcare and practical advice to help you on your parenting journey. If you enjoy listening to a WBA podcast, I'd be really grateful. If you could follow or subscribe and leave a review, it really helps to support the show. Thank you. I am delighted to partner with one of my all time favorite products sale. Plus this is the world's first 100% natural dry salt therapy device. It's clinically proven to relieve a wide variety of allergens and respiratory conditions. This salt therapy method has been trusted for generations and has become hugely popular worldwide. As more and more people recognize the superb results achieved from a natural and noninvasive method. This device will help you breathe easier and sleep better.
Speaker 1 00:00:57 This week. I'm talking all things fever in children. I'll be defining exactly what a fever is, what temperature is okay, and what isn't and talking about what can cause it I'll be explaining how best to check for a fever. And when you can treat it at home, I'll also be describing some warning signs, which mean that you shouldn't continue to treat it at home for information purposes. I thought it would be useful to highlight the main serious illnesses that can also cause a fever so that you can have a better idea on how to spot them.
Speaker 1 00:01:33 Fever is one of the most common problems that people come to me with for children. So just to start off, if your baby is under three months of age and they have a temperature of over 38 degrees Celsius, then you need to go and see a doctor. If your child is over three months of age and has a temperature of greater than 39 degrees, then you should also seek medical attention. Other than that, if your child has high fever and any other signs and symptoms of illness, it's a good idea to get them checked out. I'll talk more about the warning signs, which require urgent medical attention in a minute. If your child's fever lasts longer than five days, then you need to go back to the doctor. There is one exception, of course, and that is after vaccines. So we all know that when you're getting your child's men, B vaccine, there's a recommendation to give Cal poly. And that's because it's really quite common for children to suffer a high fever post vaccination. So if your child has just had a vaccine and seems to be doing well, other than the kind of fever and a bit of crankiness after the vaccine, then that's absolutely fine.
Speaker 1 00:02:48 So what causes fever fever is mostly caused by viral illness. And these are all usually self-limiting meaning that they go away by themselves, but they can also be bacterial. So I'd like today to talk about when it's okay to treat it at home. And when it's not, there's one thing that I just want to say before I start. And I can't say it enough times in this episode, if you're in any doubt, seek medical attention, no one will ever judge you for having your child's best interests at heart. You know, your child better than anybody else. And you know, when there's something wrong, the first thing we need to do is take your child's temperature. So what's the best way to do that. Well, first of all, don't do it when they're just after getting outta the bath or if they are wrapped up in really warm snugly clothes, because you might get a false reading.
Speaker 1 00:03:43 If your child's under four weeks of age, there's really only one type of thermometer you should be using. And that's an electronic thermometer. So just the little ones that you can pick up in the pharmacy and I'll pop a link to one online that we
[email protected]. This is placed in your child's armpit, or what's otherwise known as the Illa. A nice way to do this is if your child is little baby, um, and they're lying down on a changing table or something, you can just lift their arm up and pop the reading end of the thermometer, right in under the armpit and then gently pull their arm back down against their body so that it's snugly against their body so that you can get an accurate reading. Remember, we'll need to be held there for about 10 to 15 seconds, depending on the brand. And some will beep at you when the reading is complete for child aged four weeks to five years, you have a couple of options.
Speaker 1 00:04:38 So you can use an electronic thermometer under the arm, just like I discussed there, or you can use an infrared to panic thermometer. So that's basically an infrared ear thermometer like the bra Thermo scan. I like the bra Thermo scan seven because it's got cute little faces on it that light up in green, Amber red telling you when to act or just kind of alerting you to the fever, which can be very useful in the middle of the night when you can't think straight, because you've been woken for the 20th time in two hours. Again, I'll put a link to that in the show notes. Many of you may have infrared far head Tomers at home. These have been used widely throughout the last few years due to the pandemic and the need for regular temperature monitoring. The one problem with these type of thermometers is that there are a lot of variables.
Speaker 1 00:05:31 So the reading can vary depending on the position of the thermometer, pointing at the forehead and also on the environment. So safe, there's a little draft or a breeze, or if the room is particularly cold or particularly warm, that can all affect the reading. So what I would say is you can still use them. And actually I have one myself for used during the night sometimes because I don't want to wake the kids, um, when they're sick. So I would have taken an axilla. So an under arm reading before they went to bed and also an a forehead thermometer reading. So then because I have the two readings, I kind of know what's normal for my child on the forehead thermometer. So when I use it in the same room in the same way, at the same distance, from the same spot on their forehead, and I get my reading, I know that it's gone up 1.5 degrees.
Speaker 1 00:06:31 And, you know, I know to be alerted to the fact that their child's fever is rising. So they have their uses, but really I would always have an electronic thermometer to hand or an ear thermometer. An ear thermometer can be a bit easier like the bra Thermo scan, because it is noninvasive. So you're just literally popping into the ear. The problem with the ear thermometer is that there's some evidence to suggest they're not as reliable as an electronic thermometer. And that is because people don't always fit them into the ear correctly. So make sure you have a good read of the instructions, but they are an acceptable way to measure, um, according to the guidelines. So just bear that in mind, make sure you're using them properly. Make sure you're changing the probe covers regularly. Okay. So we'll fly straight into warning symptoms to start.
Speaker 1 00:07:28 And these are general ones. So if your child has a fever and any of the following symptoms, you need to seek urgent medical attention. So if your child's coloring is a little bit off, if their skin is pale modeled or a little bit blue, this can especially be seen around the lips or tongue. If your child isn't responding to you in the way they normally do, like when you call their name or tickle them or try and make them laugh, and they're not responding in the normal way, that's something to keep an eye at for if you can't wake your child or if you can wake them, but they don't stay awake for very long once you've ROS them. That's something else that needs medical attention. If your child is just crying continuously, particularly if they have a weak or high pitched cry, if your child has a bulging Fonte so that's the little soft spot on the top of their head.
Speaker 1 00:08:19 If your child is grunting or breathing faster than normal, when they're breathing, they can also start to draw their chest in a lot. So it just doesn't look like they normally breathe. It's also a good idea to check their skin elasticity. The way you do this is on their hand. Maybe take a little gentle pinch of skin and then let go and see does it return to normal position quickly? If it doesn't, it may be due to dehydration. Dehydration is one of the serious illnesses that I'm gonna flag for you today. I will highlight lots more now over the next few minutes. So for dehydration, obviously we've got that skin elasticity test. Another useful one is, sounds very technical, but actually it's not capillary refill time. So this is something that is very easily done at home. You take one of your child's hands and you take one of their fingers.
Speaker 1 00:09:14 And at the very top, you squeeze gently where the nail bed is and the opposite side with your finger and thumb, and then you press down on it. And when you release it's white and that's normal, but it should go back to a normal pink, healthy color within three seconds. So if that's not happening, it's an indicator that your child may be unwell. Another thing to keep an eye out for is an absence of tears when crying and also sunken eyes or dry mouth, there may also be a change in how frequent your child urinates. So that's something to, to watch for. And it's obviously easier to do if your child is still in nappies. So the next condition, which fever often accompanies, which is serious is meningitis. If you haven't had a chance to listen to the episode that was released, not the last one, but the one before it was called, please listen and act for meningitis.
Speaker 1 00:10:09 And that was with the lovely Chevon. And she was talking about the loss of her daughter, Ava, through meningitis. It just really hit home with me, how serious a condition it is and how important it is to act really, really quickly. A lot of people will associate the word meningitis with a rash that doesn't fade when you hunt, hold it under a glass, and that's called a non blanching rash. And absolutely that can be present in meningitis and is associated with sepsis. But it's important to know that it is not always present. So it is one of many potential symptoms Chevon described the rapid deterioration of Ava's health. That is probably the biggest warning sign. So if your child is unwell and quickly getting worse and nothing is helping, then you need to seek medical attention. Other common symptoms of meningitis include neck stiffness and a bulging fentanyl.
Speaker 1 00:11:05 So these are all things that you're just considering when your child has a fever. If your child has any seizures at all, then you need to seek medical attention. Another condition which can have an associated fever is pneumonia. Keep an eye out for symptoms like crackling sound in the chest. If your child is breathing particularly fast or drawing their chest in again, if their skin is kind of blue or per in color, especially around the lips, mouth, ear, lobes, and even fingernails. Any of these symptoms combined with a fever can sometimes indicate pneumonia. Now, obviously this isn't a diagnosis. This is just, this is just useful information so that you can get a better picture of what's going on with your child. It's also no harm to look out for septic arthritis or osteomylitis. So these would be indicated with the presence of a fever and also the swelling of any limb or joint.
Speaker 1 00:12:00 So if your child is not using one of their arms and legs, like they normally would, if they're not bearing weight, then it's just important to get them checked out. Only two more here. I promise, and then we'll move on to the treatment of fever. But next up is Kazaki disease. So this causes a rash and cracking of the lips and also a swollen or bumpy tongue. If you Google strawberry tongue, that's how it's described. You'll see what I mean. Also, if your child gets any rash or swelling of their hands or feet, that can also be an indication. And finally, sometimes you can get a bacterial urinary tract infection. So if your child has a fever and you notice they're going to the toilet more often than normal, so more frequent, wet nappies, or more trips to the Lou or so if they are toilet trained and all of a sudden they're wetting the bed and not feeling well, that could also be an indication of UTI, equally things like painful urination, which can be hard to tell in a baby or a young toddler who can't verbalize it.
Speaker 1 00:13:03 But I suppose, you know, distress or tears on the toilet, or when going to the toilet, if your baby slow on a nappy is a good indication of that. Also a decrease in fluid intake and dark or cloudy urine. Okay. You'll all be very glad to hear that is all of the main Gary diseases covered. You're at home and there's none of those warning signs. And you're happy that your child just has a little bit of a bug and they're not younger than three months old. And there's nothing that's making you overly concerned, your gut instinct to saying, okay, I think I can deal with this. So the treatment then at home would be not to overdress them. So don't overdress them and don't underdress them. We have a tendency to think that stripping the clothes off a hot child will cool them down, but it can actually cause a lot of dysregulation in their temperature and cause a bit more stress on the body.
Speaker 1 00:14:02 It's the same thing, really for a tempera sponge bath to decrease temperature. It's not recommended people often get engaged in a battle against fever with the use of medicines to try and ensure that the fever is constantly down. So the new guidance basically says that unless your child is distressed, as well as having a fever, you don't need to medicate them. So lots of mums are in the habit of, you know, detecting a fever and giving a bit of Cal poly or giving a bit of Han or whatever brand of ibuprofen or paracetamol that you have at home. And that's a very normal, natural response and something that I think we've all grown up thinking, but now really you're not medicating unless your child is distressed. If your, your child becomes distressed, you would give one or other of the paracetamol ibuprofen to start off.
Speaker 1 00:14:57 So paracetamol is what's in Kapal and ibuprofen is what's in Han. So I'm just gonna use the common brand names for now to make it a little bit less complicated. If you need to start off giving your child medication. I usually in my house start with Cal poly and the reason I choose Cal poly over nein as first line treatment is that Cal poly can be a little bit easier on their tummys, but really it doesn't make much difference, which you use first, your child has fever. They're distressed. You give the recommended dose of Cal poly. And if say an hour later, your child is still distressed and the Cal poly hasn't worked on its own, then yes, you can indeed give a dose of Neurophin. There's a lot of conversation about, can I give Cal poly a Neurophin together? And the simple answer is yes, you can, but don't do it routinely.
Speaker 1 00:15:50 Give one a chance to work first before deciding that your child needs more treatment and then add in the Neurophin. So you're basically alternating these medicines and overlapping them where ne necessary to ensure that your child is not distressed with their fever. Remember with Cal poly, it's a four time daily dosing schedule. So it's given every four to six hours. And for Neen, it is a three times daily dosing. So three doses in 24 hours, which is every six to eight hours apart. Always read the leaflet. I know it sounds silly, but even myself and my husband, both pharmacists, because we have three different age kids, we are always looking at the bottle for the dose before we give it just to confirm, confirm that we're giving the right dose to the right person. It's amazing what you'll do in the middle of the night.
Speaker 1 00:16:43 I've all been there. Plenty of times I've been woken up and you know, you're half awake. So it's always good to practice an extra check. If you're happy to keep your child at home and treat their fever there, then just remember to make sure to give, keep giving them regular fluids. So if you're breastfeeding, breast milk is the best thing for them. And if your bottle feeding or if your child is older, then just continue on their normal drinking pattern, but just offer little and often if they're inclined not to take it, this is probably the only time I will tell you to get out of your bed in the middle of a night for your child. But I would say when your child has a fever and is unwell, it is important to get up during the night to check on them. I would kind of set an alarm to kind of get up a couple of times, maybe every two or three hours, whatever take turns, bottle it out.
Speaker 1 00:17:36 If you're on your own, just yeah. Think of the coffee the next morning, just because you're awake. You don't have to wake your baby or your child. What you can check while they're sleeping is if they're breathing is normal, should be a nice, relaxed, slow breathing. When they're sleeping, you can also check their temperature, either using the underarm technique, if possible, or by using an ear thermometer or even the infrared fired one. If you know that it's giving you reliable results, another thing you can check without waking your baby is their Fonte. So you can have a little feel of their little head and see if there's any swelling. If everything's okay. You know, generally I wouldn't wake a perfectly fine sleeping child, cuz sleep is so important for everyone. If your child's fever lasts for longer than five days, then you need to see the doctor.
Speaker 1 00:18:26 Or if you have a fever with other symptoms, obviously you need to see a doctor. If you have a fever with any of the warning symptoms, you need to seek emergency medical attention. I really can't emphasize the importance of a mother or father's instincts here in this scenario. It's really important to trust your gut. And you may have brought your child to the GP at six o'clock or five o'clock on a Friday evening. And it might be 1:00 AM, you know, seven hours later, 1:00 AM on Saturday morning and you're like, but I brought them to the doctor. I can't go back. If you feel like your child is getting worse or you're still concerned, act go, no one is going to judge you for getting your child checked out. In fact, it's really, really important to do so in a reassuring tone, I just like to say that most fevers are self-limiting and caused by viral illness, but at least now you know how to recognize the serious signs and symptoms.
Speaker 1 00:19:26 I don't think I need to say this episode is not a substitute for individual medical advice. It's more just to empower and reassure parents with information. I also have a written article about how to manage a child's temperature. So I'll pop that up on the socials during the week as well. You know, if you want a little reference guide in the middle of the night and you don't wanna be listening to my voice, which is extremely understandable. <laugh> why do you think I'm talking to myself in my garage? The kids have kicked me out anyway. Thank you so much for listening today. I hope you found it helpful. If you enjoy listening to a Wonderbra podcast, I'd be really grateful. If you could follow or subscribe and leave a review, it really helps to support the show. Thank you.
