Pain and Fever in Children

Pain is the body’s way of telling us that something somewhere needs some attention. When a child is ill or hurt, nerve fibres detect the tissue damage and send pain signals to their brain to let them know that something isn’t right. These pain signals work the same way in adults too, however unlike adults, children can’t always express the cause of their pain clearly, especially when they are very young, which is why it is important to be aware of the different signs that a child may be suffering from pain.

How to tell if a child is in pain

Every person has their own individual pain threshold; some will have a high tolerance whilst others won’t. The pain threshold of each child will vary according to the emotions they are feeling at the time and if they are a little older, experiences with pain that they have had in their past will also affect how they react to it. Since every child experiences and reacts to pain differently, being able to identify pain in a baby or toddler is not always straightforward.

Babies

For babies who haven’t started talking yet, crying is the only way to communicate that they need something but because there are many different reasons they could be crying it isn’t always easy to know what they need. That being said, there are some basic reasons why all babies cry and these should be checked first:

• Is it time for a feed? They could be hungry. • Have they been fed but are still crying? They could have trapped air in their stomach and need burping. • Is their nappy wet or dirty? They could need changing. • Are they irritated and disinterested in playing?

They could be tired and need to sleep. • Is their face flushed and are they sweaty?

They could be too hot and need some layers of clothing removed. If the cries seem unusual and the baby is inconsolable then they may be in pain or suffering from illness. Check for any visible sources of pain or discomfort and check their temperature to see if they have a fever.

Toddlers

With toddlers it is easier to tell if they are in pain because by this age they can talk and even if they can’t explain in detail the exact cause of the pain they will be able to tell if something is wrong. If a toddler is in pain, it is common for them to also clutch the part of the body that is causing them pain. E.g. if they are hitting or holding their head then they may have a headache.

High Temperature

A high temperature is one of the natural ways a child’s immune system defends against infections by making it difficult for bacteria and viruses that cause infections to survive. When a child has a high temperature, it is a sign that they are suffering from an underlying illness such as a cold, flu, ear infection, sore throat or urinary tract infection. Children’s temperatures can also rise during teething, after vaccination or if they overheat because of excess bedding or clothing. The normal temperature of the body is between 36 and 36.8 C (96.8 and 98.24°F). This can vary slightly by individual. In children, any temperature of 38°C (100.4°F) or above is considered high and is classed as a fever. The most accurate way to measure a child’s temperature is to use a digital thermometer and hold under the child’s armpit. Parents should be encouraged to continue monitoring their child’s temperature closely to keep track on how the fever is developing and to also know if the high temperature is a result of having too many layers of clothing.

Symptoms of Fever

Symptoms of fever can vary according to the underlying cause, but you can generally tell that a child has a fever if they: • Appear hot and flushed all over. • Look pale with cool hands and feet but have a hot forehead, tummy and back. • Are irritable, crying and lethargic. • Start to shiver uncontrollably. • Act restless, particularly during the night. • Lose their appetite.

Relieving a Fever

Most fevers in children resulting from minor ailments are not serious and tend to go away on their own once the illness or infection clears up. In the meantime, there are some things that parents can do to help make their child more comfortable while trying to bring the fever down:

• Offer fluids regularly: During a fever the child will lose fluids through sweating or a runny nose. Because fluids help the body tackle infection it’s important to replace as much fluid as possible. Parents should offer the child plenty of water to drink and if possible some clear soup to replace the lost fluids. • Ensure rest: Rest helps the child’s body focus its energy on getting better. • Ensure your child is dressed comfortably:

When a child has a high temperature, they will feel uncomfortable in layers of heavy clothing. • Parents can place a humidifier in the child’s room can keep the air moist and reduce any nasal and chest congestion. • Offer some medicine: If the child is distressed, giving a pain relief medicine will help reduce fever.

WWho? Children and Babies

WWhat are the symptoms? The child may appear hot and flushed all over,

or lethargic

HHow long have they had the symptoms? A child temperature should be

monitored closely

AAction already taken? Parents may have tried investigating the source

of the child’s discomfort and found no obvious cause, such as wet nappy etc.

MMedication – Aspirin is not suitable for children

Product Information: Please consult the summary of product characteristics for full product information. Panadol Extra 500mg/65mg Soluble Effervescent Tablets, paracetamol, caffeine. Indications: Relief of mild to moderate pain such as that associated with rheumatism, neuralgia, headache, musculoskeletal disorders, menstrual pain, toothache, fever, symptoms of colds and u. Dosage: Adults and children 12 years and over: 2 tablets up to 4 times a day. Max 8 tablets in 24 hours. Do not give to children under 12 years. Minimum dosing interval: 4 hours. The lowest dose necessary to achieve ef cacy should be used. Contraindications: Hypersensitivity to paracetamol, caffeine or any of the other ingredients. Precautions: Do not use with any other paracetamol-containing products. The concomitant use with other products containing paracetamol may lead to an overdose. Paracetamol overdose may cause liver failure which can lead to liver transplant or death. Patients with depleted glutathione levels / glutathione depleted states. Diagnosed liver or kidney impairment, hereditary sugar intolerance, pregnancy, excessive caffeine intake, low sodium diet. Do not exceed the stated dose. Prolonged use except under medical supervision may be harmful. Side effects: Very rare cases of serious skin reactions have been reported. All very rare: Hypersensitivity reactions including anaphylaxis and skin rash, thrombocytopenia, angiodema, Stevens-Johnson syndrome, bronchospasm, hepatic dysfunction. Frequency unknown: Nervousness. dizziness. Legal Category: Pharmacy Only. MA Number: PA 678/39/10. MA Holder: GlaxoSmithKline Consumer Healthcare (Ireland) Limited, 12 Riverwalk, CityWest Business Campus, Dublin 24. Text prepared: July 2017. Further information available on request. Panadol is a registered trade mark of the GSK group of companies. Contains Paracetamol. Always read the label/lea et. CHGBI/CHPAN/0090/17