Paediatric Pain and Fever

• Viral or bacterial infections that can cause mild to moderate pain and fever in children include the common cold, a sore throat or common childhood illnesses.¹
• Teething in young children is often a cause of discomfort as the tooth erupts through the gums. Cavities may also cause toothache in older children.²
• Headaches are common, occurring in up to 75 percent of school-aged children. There are many causes of childhood headaches, but some of the more common include as a symptom associated with upper respiratory tract infections (ear, throat or sinus infection, or an allergy); a minor bump on the head; or a tension headache.³

Fever:⁴

• is a normal response of the body to illness that facilitates and accelerates recovery^.
• is defined as a body temperature ≥38°C (degrees Celsius). Note that in children, it is more accurate to measure body temperature in the ear, or in the axilla (armpit).
• is frequently a cause for concern among parents and healthcare providers.
• causes discomfort, which is often associated with pain due to the underlying condition such as a sore throat or headache.
• is not harmful in itself. However, fever in a child younger than 3 months of age should be further investigated by your healthcare provider.

• Medicines to relieve pain and fever are mostly given to relieve the discomfort. This enables the child to eat better, may reduce the risk of dehydration and reduce irritability.⁴
• Over-the-counter medications such as paracetamol may be given to children to relieve pain and fever. Note that aspirin should not be given to children or adolescents, as it increases the risk of a rare but serious condition called Reye’s syndrome.¹
• Due to anxiety about fever, parents or caregivers may give more medicine than is needed to adequately treat a fever. On the flip side, pain, especially in young children, is often undertreated.⁵
• For pain and fever medicine to work most effectively, it is very important to give it to the child at the correct prescribed dose, at the correct scheduled time.⁵
• For example, for effective control of pain, paracetamol should be given as a scheduled dose over time, and not “as needed”.⁵
• Giving too much medicine may result in unwanted side effects or toxicity, while giving too little will hamper the effect of the medicine.⁵

• Doses should be measured carefully to avoid over- or under-dosing.
• If the child has a fever and their temperature does not come down after one dose, do not administer another dose immediately. Wait for the appropriate dosing interval to pass and only give another dose at the correct time.
• If the child vomits immediately after taking a dose of medicine, another dose may be given.
• Avoid combination products and “cough and cold medicines”, as these complicate dosing and may increase the risk of overdose and side-effects.
• Fever medication should not be administered for longer than two days without consulting a doctor.

• Do not overdress or under-dress the child, or wrap them in heavy blankets.
• Encourage the child to drink fluids regularly (breast milk is best for breastfeeding babies).
• To ensure that you are using the correct medication at the correct dose, speak to your doctor or pharmacist before administering medication for fever.
• Check the child during the night, but do not wake them just to administer medication for fever.
• Seek further medical advice if the fever does not get better within 48 hours, or if the child’s condition worsens.
• Sponging with tepid water is not recommended.