Fever

Fever is a normal, helpful response to infection that frequently accompanies a minor illness, but sometimes is a symptom of a serious infection such as meningitis. Only at a level of 106°F or greater is fever itself dangerous. About 5% of toddlers may have a convulsion with high fever. After 2 months of age you child’s appearance (rather than the height of the temperature) is the best indicator of the seriousness of the illness.

If your child is near-normally active, alert, smiling, making eye contact and taking fluids, then you can just observe him for any change and schedule an appointment, if necessary, during office hours.

If your child is lethargic and not taking fluids, then first give a fever-reducing medication and a lukewarm bath (see below) and retake the temperature in 30 minutes. If the child becomes active and playful, rest assured that he does not have a serious illness. If you are unsure of your child’s condition, call us immediately.

Taking the Temperature

We recommend buying a digital thermometer that is accurate, easy to read and much quicker than older mercury thermometers. We do not recommend ear thermometers (thermoscan), especially for young infants and newborns because they are not consistently accurate. Take a rectal or axillary (armpit) temperature if your child is under 1 year of age. An oral (under the tongue) temperature can be taken in older, cooperative children.

Axillary (Armpit) Temperature:

Place the tip of the digital thermometer into the child’s dry armpit. Fold the child’s arm across the chest and hold the arm tightly in place until the digital thermometer beeps (approximately 30 seconds). Sometimes an axillary temperature will underestimate the actual temperature. If you are in doubt (i.e. child feels hotter than the thermometer indicates), take the temperature rectally.

Rectal Temperature:

Place the child stomach down across your lap on a flat surface. Lubricate the tip of the thermometer with petroleum jelly. Carefully insert the thermometer about 1 inch. Stabilize the thermometer in place with one hand pressed against the buttocks. Leave the digital thermometer in place until it beeps (approximately 30 seconds).

Oral Temperature:

Be sure that your child has not had a cold or hot drink or food for at least 10 minutes. Place the tip of the thermometer underneath the tongue. Teach your child to hold the thermometer in place with his lips and fingers – not his teeth. In order for the temperature to be accurate your child must keep his mouth completely closed and breathe through his nose. Leave the digital thermometer in place until it beeps (approximately 30 seconds). If your child cannot keep his mouth closed because his nose is blocked, then take an axillary temperature.

Call the Office Immediately:

  • Less than 2 months of age, temperature greater than 100.4°F rectally
  • Temperature greater than 105°F at any age
  • Severe lethargy that doesn’t improve with fever-reducing medication and cool bath
  • Stiff neck, severe headache or sensitivity to light
  • Purple rash
  • Cries inconsolably or cries if you touch him
  • Convulsion, difficulty breathing, joint swelling
  • Child refuses to take fluids or vomits bile
  • Seems to have trouble breathing or breathes hard
  • Child’s appearance makes you very uncomfortable

Home Treatment of Fever

Fever Reducing Medications

Acetaminophen (Tylenol)

Use if temperature is over 102°F and your child is uncomfortable. Tylenol can be given every 4-6 hours (maximum 5 doses in 24 hours). Dosing based on child’s weight. See dosage chart here.

Ibuprofen (Advil, Motrin)

Do not use for children under 6 months of age. Can be given every 6-8 hours as needed. Dosing based on child’s weight. See dosage chart here.

Aspirin

Aspirin is NOT recommended for use in children (under 18 years of age) with fever because of the risk of Reyes syndrome.

Lukewarm Bath

Sponge-bathing can be used to help reduce a fever if it is over 104°F a half hour after medication has been given. Use lukewarm (85-90°F) water (no alcohol or ice). Have your child sit in about 2 inches of water and continue to wash the skin for about 15 minutes. Raise the water temperature if your child begins to shiver.

Fluids

Encourage your child to take extra fluids. Pedialyte or Gatorade are good choices.

Observation

Keep clothing to a minimum and watch for development of symptoms of serious infection (see above).

For More Info

Click here for more information regarding fever.