Tackling fevers

If you take a reading in your child's mouth or from the ear, the normal temperature is 36-36.8°C (97.7-99.1°F).

If your child has a temperature: Make sure your child drinks plenty of fluids - a teaspoonful every few minutes if necessary

Let them rest - they don't have to be in bed all day but should be able to lie down when they want.

Keep them cool. If your child shivers while their temperature is rising, it's ok to cover them up, but as soon as the temperature has stabilised and they start sweating, cool them down. Take off some clothes so heat can escape.

Ask your doctor or pharmacist about medicines that can help. Dosage will depend on age and size of child. Calpol is the usual choice but Nurofen for children is an alternative.

Children under 16 should not have aspirin

Give them lots of tender loving care. Sick children are often tired and bad tempered, but it's ok to give in and spoil them on this occasion.

When is a fever critical ?

Use common sense when deciding whether to call the doctor. Call for help if your child looks ill and exhausted, is behaving differently, is less than three months old and running a high fever, cries and cries without you being able to comfort them, doesn't wake up easily, has a temperature more than 38C (101.3F) for more than two days, has just had an operation or doesn't seem to be getting better.

If your sick child experiences any of the following at any time, you should also call a doctor: stiff neck, trouble breathing, hallucinations, cramps, continued vomiting or diarrhoea, continued tonsillitis, pain when urinating, or urinating more than before, red rash or blue/purple dots or patches, is affected by bright light or other illnesses.

Vomiting and diarrhoea

Vomiting and diarrhoea can be caused by viruses, bacteria, parasites, foods that are hard to digest (such as too many sweets) and other things. Both can be harmful to children because they can cause too much fluid loss from the body (dehydration). Young babies can become dehydrated quickly but dehydration can occur in a child of any age.

Signs of dehydration

Signs include irritability, not eating well, weight loss, weeing less often, urine darker than normal, fast heartbeat, dry mouth, thirst (babies show thirst by crying and being eager to drink when offered), sunken eyes, no tears when crying, sunken soft spot in babies under 18 months and skin less springy than usual.

Preventing dehydration

Encourage children over two to drink water and other clear fluids. Ask your doctor about giving a baby or toddler an oral rehydration solution (ORS, eg dioralyte), which contains the right mix of salt, sugar, potassium and other elements to help replace lost body fluids.

In babies and children on heart medication, for example beta blockers (eg atenolol, propanolol, carvedilol,), ace inhibitors (eg lisinopril, captopril) and diuretics (eg frusemide), dehydration can cause complications.

If you think your child is dehydrated seek advice from your GP or cardiology team as medication may need to be changed while your child is unwell.

What can I give my older child to drink ?

Children older than two can have drinks such as apple juice, chicken broth, sports drinks (Gatorade) or tea.

Drinks containing a lot of caffeine shouldn't be given because it increases the amount of water and salt the body loses.

Should I give my child ORS?

If your child is under two and/or you're worried that he or she is dehydrated, ask your doctor about using ORS.

ORS comes as a powder that you mix with water, a liquid that is already mixed and as frozen popsicles. Ask your doctor about which to use.

How should I give ORS if my child is vomiting?

If your child is vomiting, try giving him or her small amounts of ORS often, perhaps one teaspoonful every minute. When your child is able to keep the drink down, slowly increase how much you give. If your child keeps vomiting, wait 30 to 60 minutes after the last bout, and then give a few sips of ORS. Small amounts every few minutes may stay down better than a large amount all at once. When your child stops vomiting, increase how much ORS you give each time and lengthen the time between giving it to three to four hours. Keep giving ORS until your child stops vomiting.

How should I give ORS if my child has diarrhoea ?

If your child has diarrhoea and isn't vomiting, give him or her ORS freely. Your doctor may ask you to keep track of how much your child drinks.

Should I feed my child when he or she has diarrhoea?

Yes.

Even though eating may cause the amount of diarrhoea to increase, your child will be able to get some nutrients from the food. This may prevent your child from losing too much weight and aid recovery.

For babies, keep breastfeeding while you're giving ORS. Some doctors suggest switching from formula milk to ORS for up to 24 hours and then switching back. Talk to your doctor.

Children should begin eating within 12 to 24 hours after starting to take ORS. Avoid foods with a lot of sugar and fat, such as ice cream, gelatin, pudding and fried foods. It's best to avoid dairy products for three to seven days. Bland foods, such as bananas, rice, apple sauce, toast and unsweetened cereals, are recommended for the first 24 hours.

You can add other foods over the next 48 hours. Most children return to normal eating about three days after vomiting and diarrhoea stop.