Managing a Fever for Infants and Toddlers
The times when your infant or toddler is sick are the worst times of parenting. Your child is extra cranky, extra clingy and you are extra worried and tired. More often than not, whatever sickness they have is accompanied by a fever. This post today is to provide a reference for how to manage this fever.
First of all, the baby’s temperature can only be taken under the tongue, under the armpits or in their ear. Forehead thermometers are not accurate enough to assess whether or not there is a fever, and no one’s hand touching any part of the baby’s body is able to tell the temperature of the child.
Once you have established that the baby’s temperature is above 37.5oC, you should administer Paracetamol (aka Panadol or Calpol). This is the safest medication for most babies above 2 months old and at least 4kg, unless they have a very rare allergy to it. The dosage should be according to the baby’s weight, which is 15mg of Paracetamol for every 1kg of body weight. For ease of reference, here’s a table displaying exactly how much Paracetamol to administer, depending on which type of syrup you are using:
|
Baby’s weight |
120mg/5ml strength |
250mg/5ml strength |
|
4kg |
2.5ml | 1.2ml |
|
5kg |
3ml | 1.5ml |
|
6kg |
3.5ml | 1.8ml |
| 7kg | 4ml |
2.1ml |
| 8kg | 4.5ml |
2.4ml |
|
9kg |
5ml | 2.7ml |
| 10kg | 5.5ml |
3ml |
|
11kg |
6ml | 3.3ml |
|
12kg |
6.5ml | 3.6ml |
| 13kg | 7ml |
3.9ml |
| 14kg | 7.5ml |
4.2ml |
| 15kg | 8ml |
4.5ml |
Paracetamol is usually “slow-acting”, which means it takes at least 30 minutes before taking effect, and usually takes up to an hour for the full effect. However, if after more than an hour since taking Paracetamol, your baby’s temperature is still higher than 38.5oC, you should administer Ibuprofen (aka Nurofen, Brufen or Bifen). Ibuprofen is “fast-acting”, which means it takes effect within 30 minutes, but pediatricians in Singapore recommend to use it as a second line of defence after Paracetamol.
The table below summarises what to do according to your baby’s temperature and the time since Paracetamol was last given to your baby.
|
Baby’s temperature |
Time since last dose of Paracetamol |
Which medicine to give to baby |
|
<37.5oC |
>1 hour but <4 hours |
Nil – Paracetamol is working! |
|
≥4 hours |
Nil – Paracetamol is working or baby has recovered! | |
|
37.5 – 38.5oC |
>1 hour but <4 hours |
Nil; wait till 4 hours have passed since last Paracetamol before giving Paracetamol again |
|
≥4 hours |
Paracetamol if you have given it ≤3 times in the past 24hours. If you have given Paracetamol 4 times already in the past 24hours, please wait till 24hours have passed since 4th last dose of paracetamol before giving the next dose. |
|
|
38.5 – 39.5oC |
>1 hour but <4 hours |
Ibuprofen if ≥8 hours since last Ibuprofen was given. If <8 hours since last Ibuprofen was given, please see a doctor. |
|
≥4 hours |
Paracetamol if you have given it ≤3 times in the past 24hours. If you have given Paracetamol 4 times already in the past 24hours, please wait till ≥8 hours since giving Ibuprofen and then give Ibuprofen again. Or, wait till 24hours have passed since last 4th last dose of Paracetamol and give Paracetamol again. |
|
|
>39.5oC |
>1 hour but <4 hours |
Ibuprofen if ≥8 hours since last Ibuprofen was given. Please consider seeing a doctor if you haven’t already seen one. If <8 hours since last Ibuprofen was given, please see a doctor. |
|
≥4 hours |
Paracetamol if you have given it ≤3 times in the past 24hours. If you have given Paracetamol 4 times already in the past 24hours, please see a doctor. |
Stay calm and keep up your personal hygiene and water intake when dealing with your sick baby as you do not want to fall sick yourself!