ThermometerWhat to Do When Your Child Has a Fever

💊Regarding the use of antipyretics🧸

🚨Fever in the neonatal period (within 28 days after birth) is particularly important, and identifying the cause is the top priority.

Due to an immature immune system, there is a possibility of serious illnesses such as bacterial infections. Please avoid using fever reducers on your own and be sure to consult a medical institution.
🛌Objective: To improve the child's discomfort and activity level, not to lower body temperature.
Safety: Acetaminophen and ibuprofen are generally safe when used at the appropriate dosage and according to instructions.
• Recommended by age
Neonatal period to less than 6 months of age: Acetaminophen can be used (10-15 mg/kg/dose, maximum 60 mg/kg/day). Use with caution.
• After 6 months of age: In addition to acetaminophen, ibuprofen can also be used.
However, caution is advised in cases of dehydration or kidney damage.
Forbidden / Points to note
Aspirin is contraindicated in children due to the risk of Reye's syndrome.
Overdose carries a risk of liver damage.
• Using multiple medications together or over-the-counter drugs without medical advice
Avoid.
EvidenceThere is no evidence that antipyretics worsen a condition or delay recovery.
There is also no proven preventive effect against febrile seizures.

References

  1. Tan E, Braithwaite I, McKinlay CJD, Dalziel SR. JAMA Network Open. 2020;3(10):e2022398.
  2. Sullivan JE, Farrar HC. Pediatrics. 2011;127(3):580-7.
  3. Bianchi M, Costa M, Cardinale F, et al. Expert Opin Pharmacother. 2025.
  4. Corsello A, Alberti I, Farhanghi S, et al. Br J Clin Pharmacol. 2025.
  5. Paul IM, Walson PD. Curr Med Res Opin. 2021;37(8):1363-1375.
  6. Purssell E, While AE. J Pediatr. 2013;163(3):822-7.
  7. Russell FM, Shann F, Curtis N, Mulholland K. Bull WHO. 2003;81(5):367-72.
  8. Kramer MS, Naimark LE, Roberts-Bräuer R, McDougall A, Leduc DG. Lancet. 1991;337(8741):591-4.
  9. Meremikwu M, Oyo-Ita A. Cochrane Database Syst Rev. 2002;(2):CD003676.

💡Suppository vs. Oral Medication💊

Oral administration (pills) is the first choice. Absorption is stable, and the onset of action and blood concentration are easy to predict.
Easy dose adjustment with less risk of overdose or uneven absorption. • Easy for caregivers to administer at home, and an internationally standardized route of administration.
Fever. Suppositories (rectal administration) are useful for vomiting or difficulty with oral intake.
However, due to unstable absorption and variable onset of action, it is not recommended as a first-line long-term treatment and is positioned as an adjunct.
Guidelines and reviews clearly state that oral administration is the primary method, with suppositories being supplementary.It is being done.
The Japanese Society of Pediatrics' drug dosage guidelines also state that acetaminophen is primarily administered orally,Suppositories should only be used when oral administration is difficult.It is considered.

References

  1. Arana A, Morton NS, Hansen TG. Acta Anaesthesiol Scand. 2001;45(1):20-9.
  2. Cuzzolin L, Antonucci R, Fanos V. Curr Drug Metab. 2013;14(2):178-85.
  3. Paul IM, Walson PD. Curr Med Res Opin. 2021;37(8):1363-1375.
  4. Sullivan JE, Farrar HC. Pediatrics. 2011;127(3):580-7.
  5. The Japanese Society of Pediatrics "Pediatric Drug Dosage Guidelines" Latest Edition

🌸Treatments other than fever reducers🍀

• Physical cooling methods: Sponging with lukewarm water and short, lukewarm baths can temporarily lower body temperature. However, they may increase chills and discomfort and are not recommended as a routine measure.
Bathing/ShoweringIf the patient's general condition is stable, short periods of lukewarm bathing are permissible.When you have a high fever of 38°C or higherThere is no basis for an absolute prohibition.Refrain if you have exhaustion, chills, or dehydration.
Bathing is positioned not as therapy, but as "comfort adjustment."
• Environmental adjustments: Maintain a cool environment, reduce clothing, and ensure adequate hydration.
These have a limited fever-reducing effect but help improve comfort.
• Measures for respiratory symptoms: Steam, humidification, and warm drinks may improve subjective relief from nasal congestion and cough.

References

  1. Meremikwu M, Oyo-Ita A. Cochrane Database Syst Rev. 2003;(2):CD004264.
  2. Axelrod P. Clin Infect Dis. 2000;31 Suppl 5:S224-9.
  3. Purssell E. Arch Dis Child. 2000;82(3):238-9.
  4. Sharber J. Am J Emerg Med. 1997;15(2):188-92.
  5. Okayama M, Igarashi M, Ohno S, Hashimoto A, Kajii E. Fam Pract. 2000;17(4):334-6.