Illnesses

Fevers

Fever occurs often in children, usually in response to some infection. Even though some people have body temperatures slightly above or below the "normal" reading of 98.6 degrees Fahrenheit (98.6 F), a high temperature or fever deserves attention. In babies and small children, fever is regarded as anything 100.4 F or higher. In school-aged children and older, 99.3 F or higher is considered a high temperature or fever.

Children often run higher temperatures than adults. The degree of the fever is not always a good indication of the severity of the child's infection. On rare occasions, some children may experience fever convulsions, which are related to a rapid climb in temperature rather than a very high temperature. Once a high fever has developed, the risk of a seizure drops.

• YNHH Health Library: Fevers

Is it serious?
While fever itself is not dangerous, it is a sign of infection, and some infections are dangerous to children. The challenge is to figure out whether your child is temporarily uncomfortable or seriously ill.

Infants less than three months old
Any new baby with a fever of 100.4 F or greater needs to see a doctor. Babies this young are at risk for rapidly spreading infections and your pediatrician needs to know about such fevers no matter how healthy the child looks.

Children over three months of age
Your child's appearance and behavior can help you determine how sick your child is. How does he or she act? Your child should still recognize you by smiling or becoming more alert to your voice or touch. Children with fever are often fussy and crying. Crying should be strong and temporarily calmed by your comforting, not weak or moaning or high pitched, or continuous. Check your child's color. If it's unusually pale, blue, spotted or gray, you should call your pediatrician.

Also check for dehydration. If your child's mouth is dry, eyes sunken or if he or she is not urinating at least every eight hours, notify your pediatrician. Also call your doctor if your child does not respond to you or is unable to stop crying.

What you can do at home
If your child isn't showing any of the danger signs of fever, as described above, you can treat the fever at home, using medicine, sponge baths and fluids.

Medicine
1. Acetaminophen (generic acetaminophen, Tylenol and other trade names) is the first medicine to try to control fever. The dosage depends on the weight of your child. We recommend a dose of five milligrams per pound of body weight. For example, a 10-pound baby can be given 50 milligrams of acetaminophen; a 30-pound child can be given 150 milligrams of acetaminophen. Check the bottle to see how many milligrams are in each milliliter of the acetaminophen in your home. If you have any questions about the appropriate dose, check with your pharmacist. Acetaminophen can be given once every four hours.

2. Ibuprofen (generic ibuprofen, Motrin, Advil and other trade names) is also useful for fever control if acetaminophen is not working. It is available in liquid form. The amount depends on your child's weight; give 1 tsp. for every 22 pounds of body weight every eight hours. Some doctors recommend alternating acetaminophen and ibuprofen every four hours if fever is not controlled with acetaminophen alone. If you use ibuprofen, give your child plenty of fluids to drink.

3. If your child is vomiting, acetaminophen suppositories are available. Check with your pharmacist for dosage instructions.

4. If your child hates the taste of the medicine, try Feverall, which is tasteless and can be mixed with any beverage.

5. Do not give aspirin to a child under 18 years old. It has been associated with Reye Syndrome, a liver disease.

6. After giving your child medication, try to keep him or her quiet for about two hours and take the child's temperature again.

What else to try
Sponge Baths: Try giving your child a sponge bath with body-temperature water for about 20 minutes. If your child is an infant or young toddler, place the child on a towel, and place several washcloths moistened with the tepid water over the child's body. Keep the cloths moistened with water. Place an older child in a tub with a couple of inches of lukewarm water and sponge the child's body repeatedly. If the child begins to shiver, stop sponging and dry him or her off. When the shivering stops, begin sponging again. We do not suggest using cold water or rubbing alcohol.

Plenty of liquids: It's important for your child to drink plenty of liquids when they have a fever. Even a few teaspoons of liquid, taken every 10 minutes or so, can keep your child from becoming dehydrated. A vomiting child may not be able to keep formula or solid food down; try products such as Pedialyte, Rehydralyte, Ricelyte and Resol to restore fluid balance. If your child doesn't urinate at least once every eight hours or if he or she has a dry mouth or sunken eyes, call your doctor.

When to call your doctor
You can manage most fevers at home, but your doctor should be called if:

• Your child is less than three months old and has a temperature of 100.4 F or greater.
• Your child seems dehydrated, does not respond to you, is not able to stop crying or becomes pale or mottled-looking.
• He or she has symptoms such as ear pain, painful urination or any unusual severe pain.
• Your child seems sicker to you than you would expect with a cold or flu.
• Fever lasts more than two days.

Reviewed: Robert LaCamera, MD, September 1999
Last revised: June 6, 2007 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.