A5V4d

10 Advice for home care
Introduction
Feverish illness in children is a normal and common event although it can cause significant anxiety for
some parents and carers. Parents may seek support from healthcare services but in most cases the
parents can be reassured that the child is best cared for at home. They may need support and advice
to do this confidently. The overwhelming majority of children will recover quickly and without
problems. However, in a few cases the child’s condition may worsen or fail to improve. Parents need
information on when and how to seek further advice.
The guidelines development group (GDG) has found evidence to show that administering antipyretics
can make a child look better and feel better and therefore make it easier to differentiate those with
serious illness from those with non-serious illness. However, there is no evidence to show that it is
desirable to administer antipyretics to reduce fever. The desirability of reducing fever is controversial.
Where no evidence was found to answer the questions, the Delphi survey was used. Full details of
the survey are available in Appendix A.
10.1 Care at home
The GDG considered subjects that could usefully be included in written or verbal advice for parents
and carers following an encounter with the health services regarding a febrile child.
Review question
What advice should be given to parents for further management of a febrile child?
Need to consider:
hydration
feeding
frequency of temperature monitoring
methods of cooling
when to attend nursery or school
appearance of non-blanching rash.
Methods of cooling
Antipyretic interventions are discussed in Chapter 9, and they should be included in advice for parents
or carers.
Fluids
One systematic review (SR) 233 reporting that there were no randomised controlled trials (RCTs)
assessing the effect of increasing fluid intake in acute respiratory infections found. No further studies
were found meeting the inclusion criteria about giving oral fluids and thus the Delphi survey was used.
Delphi statement 1.1
Parents/carers looking after a feverish child at home should be advised to offer the child regular fluids
(where a baby or child is breastfed the most appropriate fluid is breast milk).
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