Collaborating With AWARE
Last night I gave a talk about parenting tips at the AWARE Center. This collaboration happened on the back of a jewellery campaign I did with Carrie K’s Pearls Of Society. In this campaign, part of proceeds from jewellery sold were set aside for AWARE to continue research and advocacy for single moms in Singapore. As I didn’t have enough time to organise shopping events, I suggested that delivering a lecture over dinner instead. Although the invitation sent by AWARE to their network of single moms, all caregivers were welcome.
For those of you who wanted to attend but weren’t able to, I’ll summarise what was discussed.
Being Aware About Fever
What Is A Fever?
The first big topic we discussed was fever. What is a fever? We know that fever is an abnormal rise in body temperature as a biological response. Normally your body’s thermostat keeps your temperature between 36.5 and 37.5 degrees or thereabouts.
In young infant who is 6 months old and below, we tend to check the axillary temperature, by putting the thermometer in the armpit. Sometimes, a doctor might verify this core body temperature with a rectal thermometer. For these cases, we consider a fever to be over 37.5 degrees Celsius.
In an older baby above 6 months old, we tend to check the tympanic temperature, by putting the thermometer in the ear. Here, we usually take 38 degrees to be the start of a fever.
How Do We Treat Fever?
For children, we give only 2 categories of medication for fever. The first is paracetamol, which can be given orally or as a suppository. I tend to recommend this as a first-line medication because of its safety profile. However if the fever rises after an hour or so, I might give another category of medication. This category includes oral ibuprofen or voltaren/diclofenac as a suppository. While this category of medication is favored by parents who find it “stronger” for high fever, it does come with side effects. Therefore I would prefer not to give it to a child with vomiting, poor feeding or has not passed urine. In specific cases like Dengue with low platelet counts, I would also prefer not to give ibuprofen because it can result in bleeding.
We do not give aspirin to children for fever.
When Must We Treat Fever?
For most children, we can view fever management as comfort management. Sometimes, I need to treat a fever if the child is unable to eat well, play well or sleep well. The assumption is that after reviewing the patient when the fever abates, he should be able to eat, play and sleep better. However if the child remains ill-looking, then the cause may be more sinister and I might have to admit that child for further investigation. Therefore, if your child is sleeping comfortably but you notice the child feels very feverish, you don’t have to wake him just to feed him medication. Let him rest; sleep is a great balm.
Why Don’t We Sponge Children Anymore?
Similarly, we no longer recommend showering your child to reduce a fever. We used to do this, thinking that by convection and radiation the heat would leave the body better. However latest research shows that the fever returns more quickly. Furthermore, children don’t like this and often cry. Following the principle that fever management is for comfort measures, we don’t sponge children routinely anymore.
We also discussed red flags for rushing to a children’s emergency room. Here is the video we watched:
Common Childhood Illnesses
Fever can present in so many illnesses. For my AWARE talk, I discovered that my audience was made up of caregivers of children under six years old. Consequently, I spent more time discussing conditions that are common in this age group, like Hand Foot & Mouth Disease: https://youtu.be/BmFfgfjzvY4. Because it is so highly infectious, it is a common problem in nurseries & kindergartens.
The other problem that is common in the age group between 6 months and 6 years old is fever fits. So we spent some time discussing first aid management, Facts And Figures About Fever Fits.
Since Dengue is endemic in Singapore, we also devoted some time understanding this illness:
Note Of Thanks
The best part about giving lectures, for me, is the Q & A segment because it allows me to understand what caregivers want to know. Last night the attendees asked many questions, often drawing from their own experiences as parents or childcare teachers. I loved how engaged they all were.
I was particularly grateful for everyone who put in time and work to make last night a success. This includes the team from AWARE who managed the logistics as well as the kind sponsor of the goodie bags http://www.mightysprouts.sg.
Although wonderful things can result from good intentions, much hard work goes on behind the scenes. Just as pearls are beautiful gems borne from grit over time! Thank you, Carrie K for bringing us together in your gem of a campaign.