Paediatric Pain and Fever

• Pain is an unpleasant sensation signalling an injury to some part of the body.¹
• Pain may be sharp or dull, intermittent or constant, or throbbing or steady.
• Sometimes pain is very difficult to describe. The intensity of pain can vary from mild to intolerable.¹
• Pain in children is often under-treated.²

• Viral or bacterial infections can cause mild-to-moderate pain and fever in children, such as the common cold, a sore throat or common childhood illnesses such as chickenpox.⁴
• 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.⁵
• Headaches are common in children, occurring in up to 75 percent of school-aged children.⁶
• There are many causes of headaches in children, but some of the more common causes include an upper respiratory tract infection (an ear infection, a throat
  infection, a sinus infection or an allergy), a minor bump on the head, or a tension headache.⁶

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

• Medicines to relieve pain and fever are mostly given to relieve the discomfort of the child. This enables the child to eat better, to prevent dehydration and to
  reduce irritability.^3,4
• Paracetamol and ibuprofen may be given to children to relieve pain and fever. Aspirin should not be given to children or adolescents, as it increases the risk of a rare but serious condition called Reye syndrome.⁴
• Due to anxiety or fear of 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 under-treated.²
• 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.²
• For example, for effective control of pain, paracetamol should be given as a scheduled dose over time, and not “as needed”.²
• Giving too much medicine may result in unwanted side effects or toxicity, and giving too little will hamper the effect of the medicine.²

Paracetamol has a dual action, which means it relieves both mild-to-moderate pain and fever in children.⁷ It is the number one prescribed reliever of pain and fever in children by South African paediatricians8 and is endorsed by expert bodies around the world, including the World Health Organisation.² Paracetamol may be given to children younger than 3 months of age, and children with chickenpox.²

• Teething Pain
• Toothache
• Sore Throats
• Headaches