Fever is an elevation of the body's temperature that usually occurs in response to an infection. A fever that is mounted in response to an infection is not harmful. The height of the fever does not correlate with the severity of an infection unless it is above 106, at which point a bacterial infection becomes more likely. It is much more important to assess how your child is acting; if your child is playful and attentive, the fever is usually not a cause for alarm. The reason we encourage you to bring you child's temperature down is to make your child more comfortable and to help you assess how your child is acting.
The normal body temperature is 98.6 F orally and 100.2 F rectally. This may vary slightly at different times of the day. Ear thermometers are okay to use as a screening for fever, but for accuracy, we recommend confirming a fever with a rectal temperature for infants and oral temperatures for older children. A temperature less than 100.4 F is not considered elevated.
You may give Tylenol, or any other acetaminophen preparation, every four hours for temperatures of 101 and above. Other acetaminophen preparations include Tempra, Panadol, Liquiprin, and Feverall. Dosages should be according to weight. It is important that the temperature be checked BEFORE the medication is given. Do not give Tylenol to an infant under two months of age since these children need to be evaluated immediately and we do not want to mask the fever.
Aspirin should NOT be given unless advised by a physician.
Lukewarm water baths are another form of fever management and are useful for temperatures above 103. Bathe for at least 20 minutes, sponging the child well, including the head. Alcohol should not be used. Dress your child lightly; do not cover him or her with blankets. We also encourage drinking plenty of fluids.
You may use ibuprofen (Advil, Motrin) as an alternative to acetaminophen. Ibuprofen may be used every 6 hours. We do not recommend alternating between acetaminophen and ibuprofen. Do not use ibuprofen with chicken pox. Ibuprofen should not be used in infants under six months of age.
We should be notified immediately for the following:
- an infant less than 2 months with a temperature of 100.4 or greater rectally
- any temperature of 106 F or over
We should see the following within 24 hours:
- an infant between 2 and 6 months with a temperature over 100.4 rectally
- any temperature over 105 F
- Any child between 6 months and 3 years should be seen with a fever for longer than 48 hours.
- Any child over 3 years of age should be seen if fever is lasting more than 3 days.
- Any child of any age should be seen as soon as possible if they are very ill-appearing or have symptoms that our nurses feel could indicate a severe or bacterial illness.
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