Fever always scares us, but think that it is a defense mechanism of the organism, since it stimulates the immune response and inhibits bacterial growth. It is not harmful in itself and we should not "bring down" a fever immediately.
We do not treat the fever, but the child's discomfort!
When should we "lower" the fever?
We say fever from 38°. Fever or tenths of 37 to 38°.
"When the general condition is affected, regardless of the temperature. That is to say, if your child is at 38.3 but is lively, playing...you can observe him and wait. If it is 37.5 but he is very complaining, you can treat him.
"-History of febrile seizures, due to family distress, although antipyretic treatment has not been shown to reduce seizure risk.
"-Chronic pathology that can be decompensated by fever.
How do we treat it?
"-Physical measures: Remove excess clothing, rubbing with warm water ... Cold cloths are not recommended, as they produce cutaneous vasoconstriction, hindering the elimination of heat, and is a sharp contrast in temperature.
"The most commonly used antipyretics are acetaminophen and ibuprofen.
"-Paracetamol (Apiretal, Dolocatil, Gelocatil, Febrectal): Antipyretic and analgesic, without anti-inflammatory effect. It can also be administered rectally. rectally (great advantage for children who do not tolerate oral drugs). The effect starts after 30 minutes and lasts from 4 to 6 hours. It has few side effects, being one of the safest antipyretics. Although paracetamol poisoning can be extremely serious, even lethal, that is why the containers are smaller and have a bitter taste, to make poisoning more difficult.
Mnemonic rule to calculate the dose (15mg/kg/dose): Weight x 0'15ml every 6h (for example, if he weighs 6kg: we will give him 0.9 ml every 6h).
"-Ibuprofen (Dalsy, Junifen, Dolorac, Neobrufen, Espidifen...) It is analgesic, antipyretic and anti-inflammatory. anti-inflammatory. Its effect starts after 45 minutes and lasts about 6-8 hours. It has few adverse effects as well. The main one is gastritis.
Not recommended for children under 4 months of age.
Mnemonic rule for calculating dose (20-40mg/kg/day): Weight/4 if Ibuprofen 20mg/ml: ml every 6-8h (for example, if he weighs 6kg: we will give him 1'5ml every 6h).
Weight/8 if it is Ibuprofen 40mg/ml
Do I alternate them?
Combination therapy has not been shown to be more effective than monotherapy, and may even lead to more dosing errors and overdosage. It is advisable to use only one antipyretic every 6 hours, and only alternate if necessary.
That is, only ibuprofen (I always advise ibuprofen, since there is always an associated inflammatory component, except in children under 4 months of age). Well, it would be ibuprofen every 6 hours, and only if the fever rises before 6 hours or the child is very complaining, alternate paracetamol between doses, that is, at 3-4 hours.
