The body’s average temperature when it is measured orally is 98.6°F, but it normally fluctuates during the day. Mild elevation can be caused by exercise, excessive clothing, a hot bath, or hot weather. Warm food or drink can also raise the oral temperature. If you suspect such an effect on the temperature of your child, take his or her temperature again in a half-hour. Your child has a fever if the:
- Rectal temperature is over 100.4°F.
- Oral, axillary or ear temperature is over 99.5°
- Tactile fever is evident. Tactile fevers are more accurate than we used to think; however, if you’re going to call your child’s doctor about a fever, actually take his or her temperature.
- Rectal temperature is most accurate and the preferred method of evaluating fever in the child under 3 months of age
Treat All Fevers with Extra Fluids and Less Clothing.
Encourage your child to drink extra fluids, but do not force him or her to drink. Popsicles and iced
drinks are helpful. Body fluids are lost during fevers because of sweating. Clothing should be kept to a minimum because most heat is lost through the skin. Do not bundle up your child; it will cause a higher fever. During the time your child feels cold or is shivering (the Chills), give him or her a light blanket.
Acetaminophen Products for Reducing Fever
Children older than 2 months of age can be given any one of the acetaminophen products. All have the same medication, though each product has it’s own concentration. Please refer to the dosing chart in this section for accurate dosing based on weight. Remember that fever is helping your child fight the infection. Use drugs only if the fever is over 101° F (39 °C) and preferably only if your child is also uncomfortable. Give the correct dosage for your child’s weight every 4 to 6 hours, but no more often. Two hours after they are given, these drugs will reduce the fever 2 to 3° F (1 to 1.5° C). Medicines do not bring the temperature down to normal unless the temperature was not very elevated before the medicine was given. Repeated dosages of the drugs will be necessary because the fever will go up and down until the illness runs its course. If your child is sleeping, don’t awaken him for medicines.
Caution: The dropper that comes with one product should not be used with other brands.
All ibuprofen products are now available without a prescription. Give the correct dosage for your child’s weight every 6 to 8 hours as needed. Ibuprofen and acetaminophen are similar in their abilities to lower fever, and their safety records, are similar. One advantage that ibuprofen has over acetaminophen is a longer-lasting effect (6 to 8 hours instead of 4 to 6 hours). Children with special problems requiring a longer period of fever control may do better with ibuprofen.
The American Academy of pediatrics has recommended that children (through 21 years of age) not take aspirin if they have chickenpox or influenza (any cold, cough, or sore throat symptoms). This recommendation is based is based on several studies that have linked aspirin to Reye’s syndrome, a severe encephalitis-like illness. Most pediatricians have stopped using aspirin for fevers associated with any illness.
Alternating Acetaminophen and Ibuprofen
If your are instructed by your physician to alternate both products, do it as follows:
- Use both if the fever is over 104°F (40° C) and unresponsive to one medicine alone.
- Give a fever medicine every 3 to 4 hours (acetaminophen every 6 hours and ibuprofen every 6 hours). I.E. (acetaminophen at noon, ibuprofen at 3:00, acetaminophen at 7:00, etc)
- Only alernate medicines for 24 hours or less, then return to a single product.
Sponging is usually not necessary to reduce fever. Never sponge your child without giving her acetaminophen first. Sponge immediately only in emergencies such as heatstroke, delirium, a seizure from fever, or any fever over 106° F (41.1° C). In other cases sponge your child only if the fever is over 104° F (40° C), the fever stays that high when you take the temperature again 30 minutes after your child has taken acetaminophen or ibuprofen, and your child is uncomfortable. Until acetaminophen has taken effect (by resetting the body’s thermostat to a lower level), sponging will just cause shivering, which is the body’s attempt to raise the temperature. If you do sponge your child, sponge her in lukewarm water (85° to 90°F). Sponging works much faster than immersion, so sit your child in 2 inches of water and keep wetting the skin surface. Cooling comes from evaporation of the water. If your child shivers, raise the water temperature or wait for the acetaminophen to take effect. Don’t expect to get the temperature below 101°F. Don’t add rubbing alcohol to the water; it can be breathed in and cause a coma…
Call our Office IMMEDIATELY if . . .
- Your child is less than 3 months old.
- The fever is over 105°F.
- Your child acts or looks very sick.
Call our office within 24 hours if . . .
- Your child is 3 to 6 months old.
- The fever is between 104°F and 105°F especially if your child is less than 2 years.
- Your child has had a fever more than 24 hours without an obvious cause or location of infection.
- The fever went away for more than 24 hours and then returned.
- You have other questions or concerns.