Q: My 7-month-old baby has a 39°C fever after a flu shot and paracetamol isn't working. Can I alternate with ibuprofen?

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Question:

My 7-month-old baby (76 cm, 10 kg) has had a runny nose for a week. This morning, my baby developed a mild fever (37.8°C). We had a scheduled doctor's appointment, and the doctor said it was safe to get the influenza vaccination, so we went ahead with it.

Right after we came home, the fever spiked. I gave paracetamol at 11:30 AM and 3:30 PM, but the temperature was still 38.8°C. It dropped slightly but went back up to 38.5°C at 7:30 PM. I gave another dose at 8:00 PM, but it has been an hour and the temperature is now 39°C. My baby cries when I try to use a tepid sponge bath, so I had to stop.

Where I currently live overseas, doctors do not recommend alternating fever reducers and only prescribe paracetamol. The instructions say to give it a maximum of four times a day. If I give the next dose at midnight, I will have reached the daily limit. Can I buy ibuprofen on my own and alternate the medications?

The paracetamol concentration is 100mg/1ml, and the dosage instruction is 15mg/kg, so I have been giving 1.5ml per dose. The bottle says never to exceed 600mg a day. What should I do if the fever doesn't come down? Should we go to the ER?

Answer:

I understand how worried you must be about your 7-month-old baby's high fever. It is very stressful when a fever does not come down easily after a vaccination.

Current Situation Evaluation:

• Fever after a vaccination is a common reaction (can last 24-48 hours).

• A persistent fever of 39°C combined with cold symptoms for a week requires close observation.

• Your paracetamol dosage is accurate (For a 10 kg baby → 150 mg = 1.5 ml).

What You Can Do Right Now:

1. Dress the baby in light clothing and maintain a room temperature of 24-26°C.

2. Offer small, frequent sips of water or formula every 5-10 minutes.

3. Hold and comfort your baby in a position they find relaxing.

4. Record the baby's body temperature every hour.

Regarding Ibuprofen:

→ It is safe to use for a 7-month-old baby.

→ You can cross-dose (alternate) with ibuprofen 2 hours after administering paracetamol.

→ Ibuprofen dosage: 5-10 mg/kg = 50-100 mg per dose.

When to Go to the Emergency Room:

• Difficulty breathing or chest retractions (chest pulling in).

• No urination for more than 8 hours.

• Lethargy, drowsiness, or lack of response.

• Persistent high fever accompanied by a rash.

• Your parental intuition tells you that something is seriously wrong.

It is possible to have a high fever for 1-2 days following a vaccination, but the baby's overall condition is the most important factor. If your baby is eating well and responsive, you can continue to observe them at home. However, if you are deeply concerned, please do not hesitate to seek medical attention again.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us