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Photo: Shutterstock Images
Child Parenting Journal is a family publication
providing free child development, health and
parenting information to expectant mums and dads-
to-be as well as parents of children aged 0 – 12 years.
Feature editorial content is restricted to recognized
and qualified experts.
Child Parenting Journal is dedicated to the
memory of Sue and Irene Meeuwissen.
Contributors
The Children’s Hospital at Westmead, Professor
Fergus Hughes, Vicky Nicholls, Radio Lollipop and
the Royal Children’s Hospital (Melbourne).
Distribution
Child Parenting Journal is published quarterly and
distributed through Child and Maternal Healthcare
Services, Family Restaurants, Educational and Play
Venues and Selected Baby and Maternity Retailers.
Circulation: 50,000.
Copyright
Material contained in Child Parenting Journal is
protected under the Commonwealth Copyright
Act 1968. No material may be reproduced in part
or in whole without the written consent from the
copyright holders.
4  Child Parenting Journal
Office
6 Nash Court, Keilor Downs Vic 3038
Postal Address: PO Box 293, Keilor Vic 3036
Telephone: 03 9367 4565 Facsimile: 03 9366 6645
Publisher/Editor
Susan McGregor
Email: smcgregor@childjournal.org
Design and Graphics
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Printer
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Advertising
Susan McGregor
Email: advertising@childjournal.org
General Enquiries
John McGregor
Email: enquiries@childjournal.org
Yearly Subscription
One Year (4 issues) $16
Two Years (8 issues) $29
Disclaimer
Important Notice to Parents!
Child Parenting Journal does not provide medical
advice. All information is provided for educational
purposes only. The contents of Child Parenting
Journal are provided for general educational
purposes only and are not intended to replace
professional medical advice. Although we
have made an extensive effort to ensure our
information is accurate and easy to understand
any medical advice should still be obtained
through a qualified healthcare professional. Never
delay seeking medical treatment or ignore any
medical advice previously given to you because
of anything you may have read in Child Parenting
Journal. If you have any concerns about your
child’s health or questions about anything you
have read in Child Parenting Journal please speak
to a healthcare professional.
Opinions expressed are those of the original
authors and do not necessarily reflect those of
the Publisher.
Contents Baby Special
6 A Healthy Beginning
The Children’s Hospital at Westmead
Best tips to help your baby have a healthy start in life.

10 Parents as Playmates
Professor Fergus Hughes
Discover your special role in baby playtime.

Child’s World
14 The Art of Development
Vicky Nicholls
How painting, drawing and other art experiences can help your child to grow.

20 Helping Children Cope

Royal Children’s Hospital (Melbourne)
How to help your child deal with difficult feelings.

Child Friendly Health

24 Children’s Fever
Royal Children’s Hospital (Melbourme)
Do you know the essential facts about your child’s fever?

29 Tuning In to FUN
The Children’s Hospital at Westmead and Radio Lollipop
Explore a creative way of making a child’s hospital stay fun!

14 The Art of Development

 A Healthy Beginning
Recommendations for feeding and infant health are constantly changing.
Parents often receive conflicting advice that leaves them confused as to
what is best for their child. Dr Jacqui Dalby-Payne and the Feeding Team at
The Children’s Hospital at Westmead answer some common questions that
arise in the first 2 years of a child’s life.
Is it teething or is my baby unwell? symptoms worsen or your child is unwell then
Mild symptoms such as biting, drooling, gum- medical attention should be sought. More serious
symptoms such as high fever, vomiting, diarrhoea
rubbing, irritability, decreased appetite for solid
and rashes other than on the face are generally not
foods and mildly raised temperatures can be
related to teething and once again if your child is
associated with teething. These symptoms can
unwell seek medical advice.
occur a few days before and after the tooth
appears and can generally be managed with Why do babies need solids after
simple measures such as appropriate doses of 6 months of age?
paracetamol. It is impossible to tell the difference After about 6 months of age an infant requires
between some of these symptoms and the more energy and nutrients than can be provided
early presentation of a serious illness so if these by breast milk or formula alone. It takes a number
6  Child Parenting Journal
of months for a baby to begin to take a substantial impact on growth and nutrition. Hospitals in
amount of solid food and starting solids at 6 Australia support the World Health Organisation’s
months allows the baby time to increase their recommendations on duration of breastfeeding
intake of solid food before their natural nutrient and commencement of solids. This is a general
stores are depleted. By 12 months of age a baby policy and decisions about the timing of
should be getting most of their nutrition from commencing solids, particularly in children where
solid food but still require 3 serves of dairy a day there are concerns about growth and nutrition,
to provide adequate calcium for healthy teeth and should be made individually. Health professionals
bones. In addition to the nutritional requirement such as Child and Family Health nurses, General
for solid foods, eating is a natural part of a Practitioners or Paediatricians can assist with this
baby’s development and they should be given decision making.
opportunity to learn and develop this important
When is the right time to stop
life skill in the same way that they learn to
breastfeeding?
talk, walk and use their hands.
As health practitioners we would like
Why wait until 6 months to see all children breastfed along
before giving solids? the guidelines developed by
The current recommendation the World Health Organisation
from the World Health however this is not always
Organisation is that babies possible. The decision to
should if possible, be stop breastfeeding is very
exclusively breastfed for personal and individual.
the first 6 months of life. When the time is right for
They recommend that the baby and the mother will
breastfeeding continue until 2 depend on multiple factors
years of age with the addition involving the baby, mother and
of solids after 6 months. An their family situation. There are
extensive review of studies many health practitioners and
in this area has revealed organisations such as the
that babies who are Australian Breastfeeding
exclusively breastfed Association who
until 6 months of provide support to
age have less women who are
illness from breastfeeding
gastrointestinal and may be
infection which able to help
can be serious in decision
in early making. Whilst
infancy. the evidence
These points to
studies also the multiple
found that benefits
withholding of breast-
solids until feeding
6 months for both
did not baby and

Child Parenting Journal  7

 mother compared with formula, the current range
of formula’s available in Australia will provide
About our Experts
infants with the energy and nutrition they require
to grow and develop into healthy children. Written by Dr Jacqui Dalby-Payne
and the Feeding Team at
When is it safe to give cow’s milk? The Children’s Hospital at Westmead:
Assuming there is no history of allergy or
Speech Pathologist - Stephanie Newton
intolerance and the baby is taking a normal
Child and Family Health CNC -
amount of solid food, it is safe to substitute cow’s
Gillian Patterson
milk for formula after 1 year of age. Before this
time, cow’s milk should not be used as the major Enteral feeding CNC - Leanne Vidler
beverage as it does not have adequate nutrients Paediatric Dietician - Wendy Birks
for a growing infant and is particularly low in iron.
Babies who feed predominantly on cow’s milk at
any age are at risk of iron deficiency. After 1 year of
age it is important to limit cow’s milk consumption
to about 600ml per day or the equivalent of 3 dairy
serves and provide a varied diet of solid food.

Should I give my baby fruit juice?

Many people think of fruit juice as being healthy
however most juices, including those which are
said to be high in vitamin C, contain sugar and
can cause tooth decay. In the past fruit juice was
given to prevent the development of vitamin
C deficiency in babies and small children.
Today this vitamin, which has always
been in breast milk, is also in infant
formulas so fruit juice is unnecessary for
children. Overuse of fruit juices can
cause diarrhoea, decreased appetite
and poor growth as well as dental
caries. If fruit juice is to be given it
should be diluted with
water with the aim of
increasing the water
and decreasing the
juice until the child
is drinking water.
Diluted fruit juice at
meal times can increase
iron absorption and no
more than 125ml total per
day should be given.

8  Child Parenting Journal

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10  Child Parenting Journal
Parents as Playmates
The Role of Caring Adults in Encouraging
Development through Play
We live in an age of increasingly sophisticated
interactive toys and toy manufacturers often claim
that their product is guaranteed to teach essential
cognitive and social skills. It is also an age in which
group child care and intensive peer interaction is
an increasingly common experience for infants and
young children. However, we should remember
that when parents play with infants and young
children they provide an experience that is rarely
matched by play with other children or play
with even the most sophisticated of toys. This is
because a caring adult is able to do what another
child or a toy isn’t able to do.
A parent can structure a play activity, keeping the
child at an ideal level of arousal, so that he or she
is neither bored nor overly excited. If the child
loses interest in a toy or activity, a parent can offer
something new and more interesting to do. If a
child is overly stimulated, a parent can introduce
a quieter more restful activity. Not only does this
parental structuring make play more satisfying for
children, but it eventually helps them to regulate
their own emotional states. They learn how to pick
up the pace of an activity or to slow it down and in
doing so to make the experience more satisfying
to them.
Parents typically demonstrate activities and then
encourage children to imitate. This increases
a child’s confidence in handling materials and
exploring the external world. It may also enhance
a child’s cognitive functioning. As an example,
early in the second year pretend play makes its
appearance and sensitive parents love to engage
in make-believe with their children. A mother may
pick up a toy telephone and speak to the imaginary
person on the other end of the line. She may then
offer the phone to the child so that he or she may
speak. Initially such pretend activities are initiated
by the parent but soon the child will engage in
By Professor Fergus P. Hughes
spontaneous acts of pretense. As he or she does
this more easily the parent will back away and take
a less dominant role. Thus the child is receiving
instruction in and encouragement for pretend
play, which is a wonderfully creative activity that
stimulates the imagination.
Since play involves intense emotional interaction
between parent and child, it facilitates the
attachment process. Playful parents who smile
and laugh a lot and make frequent eye contact
are the easiest to attach to. Play with a parent also
encourages the child to attend to the social aspects
of language because much of this play, particularly
with a female parent, is of a verbal nature.
Mothers and fathers are equally capable of
playing with young children and equally sensitive
to children’s developmental limitations. In fact,
the similarities between the play of male and
female parents far outweigh the differences and
in societies with noticeably egalitarian gender
roles these differences are minimal. Nevertheless,
a number of important differences have been
observed in most Western cultures. For example,
fathers engage in more rousing physical play than
mothers do (such as lifting, bouncing, chasing
and wrestling with their children). Rough play is
especially in evidence when a father is playing
with a male child. Fathers are also more likely
than mothers to try to influence the play, making
suggestions and encouraging children towards or
away from certain activities. On the other hand,
mothers are more likely to try to determine what
the child wants to do and then follow the child’s
lead. While fathers rely more on the sense of touch
in play, mothers are more verbal and more likely
to incorporate a “teaching” emphasis into the play.
They are more likely than fathers to see play as
an opportunity to teach a child about colors, or
numbers, or shapes.
Child Parenting Journal  11

Children seem to benefit from the fact that
mothers and fathers play with them in slightly
different ways. The quieter instructive play of
mothers encourages children to focus their
attention, teaches them about the properties of
the physical world, enhances their self-confidence
by allowing them to take the initiative in play
and calls their attention to the social aspects of
language. There is evidence to suggest that the
rough physical play that fathers favor may be
related to a child’s later social competence.
Children who are socially successful when they go
to school have been found to have fathers who
engaged in a good deal of physical play with them
at home. Why might this be? It seems that rough
physical play teaches children to become involved
in a vigorous and highly arousing social interaction,
12  Child Parenting Journal
to remain
involved for
the duration,
but then to return
to a normal arousal
state when the play
comes to an end. Children
who are popular among
their peers are able to involve
themselves in rousing physical
play with peers, to maintain their
involvement, and then to settle
down when the play is over. Socially
rejected children have difficulty
regulating their arousal levels,
cannot maintain their involvement
in intense group interaction and
often become overly excited and out
of control.
Children’s play has many benefits and
play with a sensitive and caring adult can
significantly enhance those benefits. Young
children don’t need expensive toys. They don’t
need educational programs designed to start them
on the fast track to the most exclusive universities.
They need adults who appreciate children and
childhood enough to realize that play is essential
to healthy child development. Play is what children
do. Most important, children need adults who are
willing, at least occasionally, to do more than just
respect children’s play, but to share in the play
experience themselves.
About our Expert
Professor Fergus Hughes, Ph.D is a
developmental psychologist and previous
Professor of Human Development and
Interim Dean of Liberal Arts and Sciences
at the University of Wisconsin, USA. Prof
Hughes is also the author of several
books on life span development, child
development, children’s play and has
published a number of journal articles on
related topics.
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 Creating art helps
children learn
problem solving skills
and more.

14  Child Parenting Journal

The Art of
Development
For your child art is just fun. For you it can feel like a whole lot of mess. But
researchers have found that art is an important tool in children’s development.
Vicky Nicholls, Senior Art Therapist at the Austin
Hospital’s Child and Adolescent Mental Health
Service and Lecturer in Art Therapy at Latrobe
University, Melbourne says over the last century
there has been a growing interest in the emotional
and psychological aspects of children’s art.
Initially the focus of study was interpreting the
meaning of art. However over time the field of art
therapy has emphasized the importance of the
child’s involvement in the creative process as an
important therapeutic tool.
Thinking through Art
Should I use the red or green crayon? Which
shapes do I need to make a giraffe? Although these
seem like unimportant decisions such choices have
an impact on your child’s overall development.
“Creativity used in art activities assists a child’s
brain development,” explains Vicky. “When
children are allowed to freely make art they are
able, at their own pace to practice decision making
skills and discover their own likes and dislikes. They
are free to follow their passions.”
“Engaging in art requires the child to think and
problem-solve,” says Vicky. “Neuroscientists
have discovered that a brain grows in power and
intelligence when stimulated in this way. Different
regions of the brain increase in size. The more
stimulation - the more synapses (connections
between brain cells) are formed. However it is
important that the activities are playful, as if
the child feels stressed it will inhibit this growth
process and not be helpful at all.”
In her role as Senior Art Therapist Vicky has seen
many children benefit from art. “One boy, who
was often getting in trouble due to extreme
By Vicky Nicholls,
Senior Art Therapist Austin Hospital.
impulsiveness explored, session by session, each
and every art material in the art room. Initially
he had trouble planning and organising how
he would use the materials. Often pouring and
spilling paint and other materials all over the room.
Over time he was able to learn to regulate himself
and take more conscious control over what he was
doing (both in and out of the art room) resulting in
him being able to plan and carry out activities with
the results he desired, rather than the constant
feeling of being out of control. His confidence and
self esteem greatly improving in the meantime.”
Children can use art
to express feelings
that may be too
frightening or difficult
to say out loud
A World of Mastery
The world can be a big place for children where
they often have little control. Art is one activity
where children can feel in control. It also helps
to develop new skills that can increase a child’s
confidence and resiliency to face challenges.
“Young children feel a sense of emotional
satisfaction when they are involved in making art,
whether they are modeling with clay, drawing or
painting,” says Vicky. “The satisfaction comes from
the control they have over the materials they are
using and the autonomy they have in the decisions
they make. Deciding what they will make and what
materials they will use may be the first opportunity
Child Parenting Journal  15
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children have to make independent choices and
decisions. For example, a very anxious young girl
who was refusing to go to school,” explains Vicky
“was initially so paralysed with fear she would
only use a lead pencil and paper. Over time, as she
began to feel comfortable in the art room with me,
she was able to begin to experiment with different
materials and gain a sense of mastery which slowly
transferred into her feeling able to cope with
model clay, for example,
returning to school.”
develop fine motor
Sensing Art dexterity and control. Making
Art is a sensory exploration. The feeling of the art also helps children develop
crayon moving over the page, the cold clammy eye-hand coordination. As children decide how to
feeling of clay on hands and fingers, the liquid construct and fit different elements of a drawing
runny feel of paint, each material offers a particular together or where to place objects in a construction,
tactile experience. Through art children learn they learn how to coordinate what they see with the
tactile perception, which is the ability to distinguish movements of their hands and fingers.
various objects through touch and pressure. Exploring Feelings
Sensorimotor experiences (the interaction of
Children can use art to express feelings that may
sensations and movements) are considered critical
be too frightening or difficult to say out loud.
for children to develop the foundation for cognitive
It is a form of expression without words that
learning and are of primary importance in the
allows children to ‘speak’ of feelings, ideas and
organizational development of the central nervous
experiences that may not be possible with a
system. Another important skill known as sensory
child’s limited language ability. “Art is seen as an
integration (the ability to combine information
expression of a child’s inner world,” says Vicky.
received through several senses and to organize it
“Releasing a feeling onto paper, in a painting or
into meaningful messages) is also learnt through
onto a sculpture can be cathartic. Until the child
playing with paint, clay and other materials.
expresses the feeling they hold the associated
Art also allows the child to develop control of stress and distress in their body without
large and small muscle groups and proprioception understanding what it is or where it comes from.
or body awareness. The large arm movements Expressing feelings in this way can assist a child in
required for painting or drawing build coordination learning more about themselves and the different
and strength. The smaller movements of fingers, feelings that they have. As a therapist I help them
hands and wrists required to cut with scissors or find a language for each feeling developing a

Child Parenting Journal  17

 Art activities can help
increase a child’s
confidence.
visual and verbal vocabulary that they can then
draw on to express themselves to others and
most importantly receive understanding and
acceptance. I have worked with numerous young
people who have wanted to use art to tell the story
of a traumatic life,” says Vicky.
Art is one activity where children
can feel in control
Art can allow the unspeakable to be spoken; the
unacceptable to be expressed in an acceptable
way. All at a pace the child is comfortable with.
A young boy, for example, who was brought to
therapy because he refused to speak created, over
several sessions, a series of rooms from plasticine
that constituted a home.
18  Child Parenting Journal
An environment which in time he was able to
acknowledge he wished he lived in rather than the
turbulent conflict ridden home he came from”. Art
can also provide relief from difficult feelings, one
girl with anorexia often commented how art was
her only escape from the tortuous battle going on
in her mind between her desire to get better and
her anorexia.”
About our expert
Vicky Nicholls is a lecturer in Art Therapy at
La Trobe University and works as a Senior Art
Therapist at the Austin Hospital Child and
Adolescent Mental Health Service.
 Helping Children Cope
By Lesley Bretherton, Deputy Director of the Department of Psychology Royal Children’s Hospital, Melbourne

Dealing with anger, frustration and disappointment is hard for kids.

Do you know how to help your child cope with these difficult feelings?
Understanding Toddlers
Toddlers tend to want things now and find it difficult
to accept disappointment. At this age emotional
demands are strong but the ability to convey them
is weak and toddlers often find it difficult to adapt
to delay and frustration. Language and emotional
self-regulation are still very much in the early stages
of development. Toddlers have no good way to
tell you it was the pink cup they wanted – not the
blue cup. Because they do not have enough words
to express their wants they often resort to crying
or tantrums as a way of dealing with frustration and
disappointment.
Tantrums are very common in children aged 18
months to 3 years old. Toddlers are more likely
20  Child Parenting Journal
to resort to crying and tantrums if they are tired,
hungry, over-stimulated or over-powered so avoid
these situations whenever possible. Often toddlers
become more negative when parents are less able
to respond positively and calmly, for example, in
the supermarket. If a child does throw a tantrum
then parents should try (or at least pretend) to stay
calm and ignore the behaviour (and other people’s
reactions). It is important not to reward tantrums
by giving in. Even giving in occasionally can make
the problem worse. As language ability develops it
provides your toddler with a more effective way of
dealing with feelings, needs and wants so tantrums
decline as the ability to exert more control over the
environment increases.
The secret of success in dealing with a toddler is
not to meet this little person ‘head on’. Physical
removal and distraction away from dangerous
or forbidden situations to an interesting activity
is the way to go. Don’t assume toddlers need an
explanation for every request. Toddlers count
on parents to keep them out of danger and are
happy to accept positive tactful guidance without
explanation. Wait until they are a little older and
have better language and concentration for a
longer explanation. Avoid questions where he or
she can respond with their favourite word ‘NO!’
Be wary about using too many words and offering
choices at this age. For example, don’t say ‘Would
you like to have lunch now?’, instead say ‘lunch
time’ or ‘bedtime’
and lead or carry
the toddler to the
table or to bed. By
all means bring
the toy he or she
was playing with
and gently replace
the toy with finger
food at the table or
incorporate the toy
into the bedtime
ritual, for example,
‘lets put your car here
so it can watch you
get ready for bed’.
Showing interest in
a toddler’s activities
will encourage a co-operative mood on their part.
The most effective behaviour management
technique for toddlers is to praise and compliment
their appropriate behaviour - in other words catch
them ‘being good’ and pay attention to them. The
more you attend to behaviour the more it increases
so it is best to attend to normal, appropriate
behaviour and ignore behaviour you don’t want
– even though it grabs your attention. Attending
to appropriate behaviour also teaches your toddler
about what you want.
Understanding Preschoolers
The typical preschooler is secure and comfortable
with life. They have a good sense of self, an
extensive vocabulary and for the most part can
express their feelings in words, often to the point
of exaggeration - and without regard for the truth!
They delight in swearing especially if this brings an
excited response from parents! They will respond
to firmness and consistency and feel most secure
when they are not allowed to be unreasonable
or rude. They are aware of social demands and
have the ability to change their behaviour at
their parents’ request. Positive recognition of
appropriate behaviour is still a very important
means of shaping preschoolers behaviour – they
want to please you.
Time out can be used
and is understood
by preschoolers, and
even toddlers from
about two years of age,
but should be used
sparingly and for fairly
serious misbehaviors,
for example, breaking
something in anger.
As a guide about one
minute per year of
age is sufficient time
out. Time out is really
removal of attention to
give the child time to
calm down. It involves
placing your child in
a quiet spot away from interesting activities and
away from other people for a short period of time.
Alternatively, you might remove yourself and your
attention from your child. It is good practice to
use a timer as an objective measure of the time.
Use time out as a teaching tool, calmly enforcing it
without anger.
Understanding School Aged Children
School aged children are aware of others in the
world; they have a longer attention span, the ability
to understand and co-operate with others and a
developing respect for authority. Language is well
developed and they can manage their feelings with
Child Parenting Journal  21
 some independence – when things go well! As the
child gets older parents and children can discuss
feelings and explain their point of view. However,
school aged children still need plenty of praise and
approval to guide their behaviour. It is important to
set appropriate limits, guidelines and expectations
on behaviour and consistently enforce these
using appropriate consequences. When your child
is frustrated or angry, take your child’s frustration
seriously, go lightly on advice and communicate
clearly. Avoid criticism and ridicule. Encourage self-
discipline by expecting your child to follow rules
that are set. With older children consequences for
undesirable behaviour
can be agreed on
in advance.
Allowing
the child to
22  Child Parenting Journal
experience natural consequences, for example,
going without if they forget something, will also
help develop responsibility. However, don’t gloat
over the consequence by saying ‘I told you that
you should have taken your coat’. Inappropriate
behaviour can be discussed and solutions
negotiated with older children. However, this
can be challenging and parents need to be able
to manage their own emotions and frustrations
– when emotions run high negotiation skill
diminishes so it is important to allow a cooling off
period and negotiate calmly – parents should model
appropriate behaviour. It is okay for parents to have
the final say when a decision is made – children will
respect their parent’s decision if they believe their
point of view has been heard and considered.
The Perfect Parent?
While positive reinforcement of appropriate
behaviour is the best management strategy for
all children, it is not realistic or even normal
to be positive all the time. Children are
quite capable of coping when their
parents are occasionally insensitive,
unavailable or distracted. On the other
hand, if most daily interactions are negative
or distressing then this might be a sign of
stressed parenting and it is worth seeking
professional psychological help.
A calm and positive parenting
approach can help make
difficult times easier.
About our Expert
Lesley Bretherton (PhD MAPS CCLIN) is a
clinical child psychologist and currently
Deputy Director of the Department of
Psychology Royal Children’s Hospital,
Melbourne. She is also an adjunct senior
lecturer in Psychology at the University
of Melbourne.
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 Children’s Fever
What You Need to Know
By Adrian Hutchinson NP candidate, Di Crellin NP,
Nurse Practitioner service, Emergency Department Royal Children’s Hospital, Melbourne.

Fever is defined as a body core temperature that exceeds

38 degrees Celsius.
There are various locations for measuring body temperature and there will be slight variations in
what is considered a fever:

• Rectal temperature greater than 38° C

• Tympanic (via the ear) temperature greater than 38° C
• Oral (under the tongue) temperature greater than 37.8° C
• Axillary (under the arm) temperature greater than 37.2° C

24  Child Parenting Journal


Treating children’s fever
with medication is not
recommended.
Why does a fever occur?
Fever is a feature of the body’s immune response
to infection or injury. Fever is a defence mechanism
designed to create unfavourable conditions
in the body for infection, while improving the
efficiency of the body’s normal chemical reactions.
Immune responses are triggered by a number
of circumstances, the most common of which is
infection. Infections can be viral or bacterial in nature.
The presence of a virus, bacteria or toxin initiates
the production and activity of immune cells (white
blood cells etc…) to attack the infection or foreign
substance. These cells release inflammatory
chemicals that initiate the centre in the brain which
controls the thermostat (the hypothalamus) to
increase the body core temperature to an elevated
set point (temperature above 38 C). In order to
achieve the elevated temperature set point, the
body initiates responses aimed at increasing the
production of heat (eg: shivering) and those aimed
at reducing heat loss (i.e. narrowing of the blood
vessels – called vasoconstriction). This results in an
increase in the body’s temperature (fever).
Fever should be distinguished from hyperthermia.
Fever is a normal response of the temperature
regulation and in the majority of circumstances
is beneficial. Hyperthermia is the failure of the
body to lose sufficient heat to maintain a normal
temperature, resulting in persistent high core
temperature, which can be harmful.
Having a Fever
Patients with fever and infection may experience
symptoms such as: feeling hot or cold, chills,
headaches, lethargy, muscle aches and pain or
localised pain in the case of a localised infection.
Children with fever sweat to dissipate heat from
the body to control body temperature and have
an increased metabolic rate. This will result in
loss of fluid from the body and therefore children
with fever need extra fluids. A small percentage
of children (approximately 2%) are susceptible to
experiencing seizures with fever. These seizures
are known as febrile convulsions and, although
frightening, very rarely cause harm.
Treating a Fever
Fever in the absence of other symptoms does
not require treatment. The body is responding
appropriately to an infection. Symptoms associated
with fever may require treatment and if these
are distressing to your child then it is reasonable
to seek relief from these symptoms. Simple non-
therapeutic means can sometimes be employed to
relieve these symptoms, such as cold face washers
on the forehead. Pain and discomfort may be
treated with medication.
Paracetamol and Ibuprofen work in similar ways to
interfere with the bodies inflammatory reactions.
Child Parenting Journal  25
 These reactions produce chemicals which act on will result in the body core temperature falling
the centre within the brain that controls the body’s below the elevated set temperature. The body will
thermostat. By preventing the release of these then institute measures to ‘rewarm’ the body (eg:
chemicals Paracetamol and Ibuprofen prevent shivering) to increase body temperature back to
the increase in temperature that occurs in illness. the elevated set temperature.
It is important to realise that these medications
Ensuring the patient has an adequate fluid intake
are only likely to reduce the temperature by
is the only non-pharmaceutical way that is likely to
approximately 1 degree and therefore your child’s
reduce the level of your child’s fever. Adequate fluid
temperature may not return to normal. The
intake should be encouraged in children with fever.
inflammatory chemicals are also responsible for
causing pain and so these medications are also The majority of the available non-pharmaceutical
used to treat pain and discomfort. methods such as: cool face washers to the
forehead should be used
The impact of fever
as comfort measures and
treatment with
not to actively reduce
Paracetamol and
the body’s temperature.
Ibuprofen on the length
If your child complains
of an illness is not clear.
of feeling hot you should
However, there is some
remove sufficient clothing
evidence to suggest
to make them more
that the use of these
comfortable. Alternatively
medications may reduce
if they complain about
the effectiveness of
feeling cold they should
the body’s responses
be warmed until they feel
to infection. This may
comfortable.
mean an increase in the
duration of illness for Using Medications
those children receiving Safely
treatment for fever. Paracetamol and
Paracetamol and Ibuprofen are both very
ibuprofen should only be safe medications which
used to relieve symptoms can be used for children
other than fever that may at home. However, like
be associated with your all medications they have
child’s illness. Symptoms potential side effects
such as headache, muscle and are toxic if given in
aches and pain or other excessive doses or too
specific pain can be frequently. It is essential to
treated with either of these follow the manufacturer’s
agents to provide relief. recommendations for
dosages and frequency
The non-pharmaceutical of administration of
measures frequently used to bring down a fever the medication you are using to treat your child.
have not been shown to have an effect on body This will ensure that your child is not at risk of
temperature. Active measures such as bathing or experiencing these side effects. It is also very
fanning will result in your child losing heat. This important that if you are giving your child more

26  Child Parenting Journal

than one medication that you consult a pharmacist It is also important to recognize circumstances in
or health professional to ensure that they can be which these medications may not be appropriate
safely administered together. This is particularly for your child. Children diagnosed with asthma
important as many preparations available at should not be treated with Ibuprofen although
the chemist to treat childhood illnesses contain they may safely receive Paracetamol. Additionally,
Paracetamol. if your child is drinking poorly and may be
dehydrated they should not receive Ibuprofen. If
Although these medications may be safely used
your child has any medical problems or is taking
by parents to reduce their child’s fever, routine
other medications you should consult their
treatment of a child’s fever is not recommended as
doctor before using any medications including
fever offers some benefit to your child when they
Paracetamol and Ibuprofen.
are unwell. There is also no evidence to suggest
that treating fever with these medications will
prevent febrile convulsions or that their response
to Paracetamol or Ibuprofen is indicative of the
seriousness of the illness. For example: a drop in
temperature following administration of either of
these medications does not prove that your child
has a minor illness.

If you are concerned about your child’s condition

they should be reviewed by their doctor to
Children and
determine the cause of the fever. Babies under the
Aspirin
age of 3 months suffering fever should always be
Aspirin is frequently used in
reviewed by their local doctor to determine the
adults for a range of reasons including
cause of the fever. Otherwise your child should
the treatment of pain and fever. However,
be given plenty of fluids and made comfortable
aspirin is not considered safe for use in
through the course of the illness. Many childhood
children and should not be used to treat
illnesses are associated with pain and discomfort as
your child’s pain or fever. Aspirin has a
well as fever so it may be appropriate to treat them
number of potential side effects and of
with Paracetamol or Ibuprofen to manage these
particular concern for children is the risk of
symptoms.
Reye’s syndrome. This is a potentially life
Your child should not receive Paracetamol or threatening condition which can result in
Ibuprofen for more than two days without liver and brain damage.
consulting their doctor. Continued use of these
medications should be carefully monitored by
a doctor as the risk of side effects increases the
longer they are used. Remember:
All medication should be kept out of reach of This information is provided for general
children and this includes Paracetamol and educational purposes only and is not
Ibuprofen. Although both are safe medications they intended to replace professional medical
will have serious and potentially life threatening advice. If you have any concerns about
effects if taken in large quantities. Every year your child’s health or questions about the
children gain access to these products and are able information contained in this article please
to remove the ‘child-proof’ caps and drink significant speak to a qualified healthcare professional.
amounts placing them at risk of overdose.
Child Parenting Journal  27
 Tuning In
“Being a volunteer for built entertainment
Radio Lollipop makes areas – with music,
you smile, whether games, art, craft and

to FUN!
you’re making pet dancing all available
rocks or creative paper for families needing a
pizzas. In this job I have break from the hospital
met the most amazing environment.
children who day in
“We encourage kids to
and day out inspire
request songs in the
me. Radio Lollipop
room while we play
is something I look
games with them and
forward to every week
even just talk to them
and I can honestly
to give them a little
say it’s the most fun
time-out from the idea
job I’ve ever had,”
of being in hospital.
says volunteer Kristyn
Uno, Connect Four,
O’Donnell.
Twister and guessing
Hospitals treating competitions are
children now strive among a few of our
towards providing most popular activities,”
holistic care by ensuring says Radio Bed Rock
the environment is volunteer Nikkie
child-friendly, playful Beltran.
and less scary for
Children who are
children. In-house radio
unable to visit the
stations are one such
station don’t miss out
service available in a
number of Australian
You don’t usually expect the on the fun. “Radio

hospitals that focus on words fun and hospital to go Bed Rock reaches
together but at Radio Bed Rock beyond the confines
providing a dose of fun
and Radio Lollipop they do! of the  studio,” says
for children needing
Nikkie. “Patients unable
medical care.
to leave their bed or
“Play is essential for a healthier childhood – for ward can tune in to the music and fun via the
intellectual, social and emotional development. special Radio Bed Rock channel. They can ring in
Especially under stressful circumstances play to request songs and win prizes that will later be
should not be neglected,” says Andrew Robertson, brought to them by volunteers, who also do ward
spokesperson for Radio Bed Rock, The Children’s runs saying hi to the kids. As most of the kids are
Hospital at Westmead’s inpatient radio station. “Radio already switched on to the Radio Bed Rock channel
Bed Rock is one of the hospital’s very successful they are eager to make song requests, join our
initiatives that exemplify this holistic practice.” competitions and talk about anything from their
favourite songs and bands to their friends and
In-house radio stations broadcast interactive
what they miss about home.”
entertainment throughout the hospital. Children
can request songs, tell jokes or even sing a Amanda Dearlove, a Manic Monday Crew volunteer
song for listeners over the air: And are always at Radio Lollipop also does ward rounds. “On the
welcome to come and join the fun in the purpose nights that I don’t DJ, I go up to the wards and
Child Parenting Journal  29

Ward rounds with Radio Lollipop.
play games with the kids or do craft activities
depending on what the child wants to do,” she
says. Children always feel part of the fun. “One
night children were asked to listen for the word
‘bear’ in a song,” says volunteer Tricia Fryer. “A 6
year old boy phoned in each time even during the
playing of our last song. I told him a prize was on
the way. The last I heard was him excitedly telling
everyone ‘I’ve won a prize’. What a great end to a
Radio Lollipop show,”
The radio environment also becomes a learning
experience for children adds Nikkie, “as The
Children’s Hospital at Westmead treats kids
from across the country, children are given the
opportunity to meet other young people from a
number of different backgrounds and variety of
ages.” This learning experience extends to the
volunteers as well explains Sana Khan. “As a Radio
30  Child Parenting Journal
Lollipop volunteer my aim is to help reduce the
stress and anxiety both children and their families
experience in hospital. It never ceases to amaze
me how a little bit of play and fun can help the
children forget about what they are going through
and make their stay in hospital more enjoyable. I
have met many children who have taught me to
put life and other obstacles in prospective.”
It would be easy to think that working in a hospital
with children who are ill would be an emotionally
draining and difficult experience but according
to Sana and Michelle Mathews nothing could be
further from the truth. “Every time I volunteer at
Radio Lollipop I am usually having so much fun
that I often wonder where the time has gone
and every time I leave I think I did something
good today. I put a smile on someone’s face,”
says Sana. Michelle agrees. “Being a volunteer at
Radio Lollipop is a very humbling and inspirational
experience. Each night presents a new opportunity
to raise the spirits of young children, but what
most don’t realize is the enormous sense of
appreciation that you receive from families and
their sick children. Some say that they couldn’t
be a volunteer in the hospital because it would
make them sad but children are so courageous
and happy to see you that you can do nothing but
smile. You don’t think you make a difference but
occasionally you are reminded that you mean so
much to these children. It could be a little note to
say thank you, a phone call request to come and
play or a little gift or craft that they have made
especially to give to you. It is truly great to give!”
Like to Know More?
Radio Bed Rock
www.chw.edu.au/kids/bedrock
Can be found at The Children’s Hospital at
Westmead, New South Wales
Radio Lollipop
www.radiolollipop.org
Can be found at selected hospitals in
Queensland and Western Australia
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