Pain and fever are common symptoms in children. They are the body’s signals that something is wrong - pain usually indicates damage, e.g. to bone or tissues, and fever is a sign that the body is ‘fighting’ a bacterial or viral infection. The information on this card will assist you in caring for your child and knowing when to refer to the doctor. In addition, ask your Life pharmacist for advice.

Children can experience as much pain as adults and, like adults, they respond to pain in different ways. Assessing children’s pain can be difficult because of the many factors that influence how they show pain and respond to it - factors such as age, their levels of understanding, family/cultural background; etc Babies and very young children in pain will continue to cry after you have tried everything else such as food, nappy changes and cuddles. Older children can identify from where the pain is coming (head, throat, ears, stomach), and in their own words can describe what they feel. Ask your child to explain the pain, and monitor it to determine if it is improving or getting worse. Things to look for ­suggesting pain that needs attention - are children who are

• quiet and withdrawn,
• tugging on their ears,
• crying, agitated, anxious, angry or frightened.
• Avoiding their usual activities because that may make the pain worse.

Fever

The body’s normal temperature, when measured by thermometer, is around 37°C. Your child has a fever if his forehead, or the back of the neck, is very hot to touch, and a thermometer confirms his body temperature is higher than 37°C. Talk to your Life pharmacist about the different types of thermometers available to measure body temperature, and how to use them.

The fever could be a response to the common cold. This is confirmed if other symptoms, such as sore throat, runny or blocked nose, and cough, occur at the same time (see the Coughs & Colds fact card). For mild fever, and in most common cold cases, the fever is self-limiting and will clear-up without the need for medicines. You can help relieve the fever, and may prevent it from getting worse by

• keeping your child cool and rested.
• taking off some of your child’s clothes and keeping bedding light.
• regularly wiping your child’s head and body with a wet cloth (lukewarm not cold), or putting her in a cool bath.
• Giving plenty of fluids (water, ice cubes, ice blocks or jellies) to prevent dehydration that can result from fever and sweating.

Medicines

Medicines in liquid form, especially prepared for use in children, help relieve pain and reduce fever. The decision to treat your child without seeking the doctor’s advice first should be based on how unsettled and unwell your child seems, what other symptoms are present, and what the body temperature is.

Paracetamol liquid is the most widely-used medicine for relieving children’s pain and fever, especially pain and fever associated with headache, earache, immunisation,

Toothache and cold and flu symptoms. Ibuprofen liquid also is available. Always read and follow carefully the dose instructions on the medicine’s label, and provide the correct amount at the correct time.

When using paracetamol to reduce your child’s pain and fever, don’t give her non-prescription cough and cold medicines as well. Many of these also contain paracetamol and you would be doubling-up on the paracetamol dose - which is harmful. Discuss this with your Life pharmacist.

Safe use

Special medicine measures (spoons or syringes) are available from your Life pharmacy so you can measure your child’s dose accurately. Don’t use household teaspoons; they vary in sizes and you won’t get the correct liquid dose required. Special droppers are available for giving medicines to babies and young children - look out for infant-specific products as these usually contain free measuring dispensers.

Safe storage

When you have medicines in the home with children, there is the potential for poisoning. Here are two very important steps to keep your children safe and stop them getting hold of the medicines:

1. store out of reach and sight of children (e.g. in a locked kitchen cupboard or on a top shelf) all medicines not being used, and
2. use child-resistant closures (safety caps) on all medicines not already packaged in special packaging.

If these caps are not provided with your child’s medicines, or medicines used by other people in your household, ask your pharmacist to put them on. Sometimes you will need to pay a small cost per cap. People can have difficulty using the caps and so may not put them on properly - which means the caps will not provide child-resistance. Ask your Life pharmacist to show you the correct use.

Use-by dates

Medicines have “use by” dates beyond which they should not be kept, even on a “just in case” basis. Non-prescription products have these dates printed on the packaging; some dispensed items have them on the dispensing labels (if not, it is assumed the medicines will be used-up before the expiry dates are reached). Check your medicines regularly and discard all those that have ‘expired’. Also, dispose of all medicines that are no longer needed.

Disposal

Do not throw-out medicines in the rubbish, or flush them (especially large quantities) down the toilet. Instead, talk with your Life pharmacist about safe disposal, including the possibility of returning to the pharmacy for safe disposal all medicines no longer needed.

Important

• Pain relievers should not be used regularly or continuously in children, unless under doctors’ advice.
• Read medicine labels and always give the correct dose at the correct time.
• Medicines for pain and fever sometimes can hide more serious illness - such as ear infection or meningitis, especially in babies and younger children. Check your child regularly for warning signs that things might be getting worse (see the next section for further information).
• Do not give aspirin to children under the age of 12 years - especially to treat viral-related fever, unless the doctor says you can.
• Check with your pharmacist before giving your child any new medicine.

When to see the doctor

See a doctor if your child:

• still has pain or high fever (temperature 39′C or more) after 24 hours.
• is crying, grizzling and tugging the ears (possible ear infection).
• has an unusual cry for longer than one hour.
• is floppy, pale and hard to wake, or not responding to you.
• has a fit (febrile convulsion).
• Develops a rash or stiff neck (could be bacterial meningitis).