Fever

Parenting in the Early Years

Fever

A fever is a sign that the body is trying to fight off some type of disease. The degree of fever does not always indicate the severity of an illness. While a fever is cause for concern, it is generally not cause for alarm.

A fever is one of the ways the body fights infection. Children will frequently have temperatures of 101° F to 104° F with common illnesses.

Other symptoms may accompany fever, including thirst, chills, loss of appetite and fatigue.

If your child seems uncomfortable and warm, don't rely on touch. Take your child's temperature.

Temperatures will vary throughout the day often warmer in the evening. Your child has a fever if the temperature is above:

  • Rectal 38° C or 100.4° F
  • Oral 37.5°C or 99.4° F
  • Axillary (underarm) 37.2° C or 99.4° F
  • Ear Thermometer 38°C or 100.4° F

A digital thermometer is easy to use and the least expensive.

If you have an old mercury thermometer, remove it from the home because if broken it is poisonous. Call the local waste disposal center to find out where to drop off hazardous house-hold products or when the next collection is occurring.

Ear thermometers are convenient but not always accurate. If you need help taking your child's temperature obtain assistance from your doctor's office.

Do not rely on feeling the skin or using fever strips because both are inaccurate.

When to Call the Doctor

A fever is an important way that the body fights off infection and does not necessarily require treatment.

When to be Concerned

If your child appears unusually sick, is having significant pain, her temperature is over 104° F (40°C rectally), or if the fever lasts longer than 48 hours, contact your doctor. Fevers of 100.4° F taken rectally in an infant under two months should be reported to your doctor and your child needs to be seen.

Infrequently, a child may have a seizure when the body temperature rises very quickly. Febrile seizures occur in up to 4 percent of children. Febrile seizures are frightening but usually brief, and do not cause permanent problems or brain damage. If a seizure occurs, place the child on his side and be sure that he is breathing. If not, begin CPR and call 911. If the seizure is brief, contact your doctor for an urgent evaluation or transport your child to a nearby medical facility or ER to be evaluated.

The main concern when your child is ill and has a fever is to figure out if the illness is serious and needs to be evaluated or treated. When in doubt, a call to your doctor can help you decide. The second concern is to keep the child comfortable. Remember the body runs a fever to help fight the infection and it is not always necessary to treat a fever. If your child is running a fever but does not seem uncomfortable, anti-fever medicine is not needed. When your child is running a fever, provide extra fluids to maintain hydration.

Please take your child's temperature before calling your doctor.

Treating the Discomfort Associated with Illness and Fever

First, take the child's temperature. Encourage liquids frequently and remove most of the child's clothing.

The skin is the body's radiator and must be exposed for body heat to escape. If the child complains of being chilled, cover with a light layer of clothing, then uncover when the chill passes. There is no reason to change the room's temperature.

Do not give aspirin to a child with influenza, a viral infection or the chickenpox. This has been associated with Reye's Syndrome (a serious disease that can cause severe brain and liver injury). For this reason, we recommend using acetaminophen (Tempra®, Tylenol® or generic acetaminophen) or ibuprofen rather than aspirin.

Guidelines for Treating a Fever

  • Give acetaminophen every four hours or ibuprofen every six hours if your child appears uncomfortable.
  • It takes about 45 minutes for discomfort and a fever to respond after giving anti-fever medication. Anti-fever medications do not always bring the fever back to normal, but they usually make your child feel more comfortable and lower the fever.
  • It is not necessary to wake your child from a comfortable sleep to take a temperature or give medication. Sleep is extremely valuable for an ill child.
  • If your child has a high fever (over 104° F rectally), contact your doctor. You may bathe your child in lukewarm, not cold, water for 15 to 20 minutes. This method can be expected to reduce the fever about one or two degrees over an hour's time. Do not use alcohol to bathe your child.
  • Check the dose and strength of anti-fever medicine you are using before giving it to your child.

Information About Medications Used to Treat a Fever

Anti-fever medicines are the major cause of accidental poisoning in children. Keep all medications in a safe place.

Acetaminophen products come in varying strengths. The following table will assist you in determining the correct dose based on your child's weight. You may then select the product to be given. Each product is clearly marked with the number of milligrams of medicine in each volume of liquid or in each tablet. In selecting the weight of your child, pick the weight closest to the lower weight, (e.g. if your child weighs between 19 and 23 pounds, use the dosage schedule for a weight of 18 pounds).

Ibuprofen products come in infant drops at 50 mgs. per 1.25 cc. (one dropper), children's liquid at 100 mg. per teaspoon; children's chewable tabs at 50 mgs. and 100 mgs.; and an over-the-counter product as 200 mg. tablets.

Acetaminophen can be given every four hours. Ibuprofen can be given every six hours.

Studies have shown that alternating ibuprofen and acetaminophen can lead to complications often caused by confused dosing. Avoid alternating medication unless specifically instructed by your doctors office. Overdosing or extended use of ibuprofen can cause kidney problems and extended use or overdosing of acetaminophen can cause liver disease.

Pediatric Acetaminophen and Ibuprofen Recommended Dosages

Weight in Pouds and (Kilograms) Milligrams of Acetaminophen Milligram Ibuprofen
Over 6 lbs (2.7) 40 mg 25 mg
Over 12 lbs (5.3) 80 mg 50 mg
Over 18 lbs (8.2) 120 mg 50-80 mg
Over 24 lbs (10.9) 160 mg 100 mg
Over 30 lbs (13.6) 200 mg 100-135 mg
Over 35 lbs (16.0) 240 mg 150-160 mg
Over 47 lbs (21.4) 320 (325) mg 200-215 mg
Over 60 lbs (27.3) 400 mg 250-275 mg
Over 73 lbs (33.3) 500 mg 300-330 mg
Over 95 lbs (43.3) 650 mg 400-425 mg