Fever

A fever is a temperature elevated above the normal range.  A fever is a temperature of greater than >101 degrees orally, >100.5 degrees rectally or using a Temporal Artery Thermometer or  >100 degrees under the arm.  (For instructions on taking temperatures see Taking Your Child’s Temperature at the beginning of the Acute Illness Book).  Fever is a part of the body’s response to an illness.  Most fever in infants and children are caused by viral illnesses and can be managed at home.

Treatment of fever should depend upon what other complaints are present.  A fever without change in appetite, activity or in sleeping behavior needs only the additions of fluids to the diet.  When behavior or daily routine seems changed by the fever, reducing fever with medicine is indicated to restore normal behavior.

Ibuprofen (Advil, Motrin) is preferred in children over the age of 6 months.  Acetaminophen (Tylenol) is also acceptable. (See dosage chart)  Aspirin should no longer be used because of the possible association with Reye’s syndrome.  Sponge baths are generally not helpful.  They only make the child cold and more uncomfortable.

Call the office if.. 

  1. Infants with fever younger than 4 months.
  2. Fever longer than 24 hours if less than 12 months or longer than 2 days if greater than 12 months.
  3. Neck stiffness with irritability.
  4. Irritability which does not improve with lowering of the fever.
  5. Sore throats lasting longer than 24 hours.
  6. If constant coughing, or wheezing or difficulty breathing.
  7. Persistent vomiting.
  8. Bloody diarrhea.
  9. Joint or extremity swelling.
  10. Pain or blood in the urine.
  11. Very lethargic.
  12. Refuses to drink.

ACETAMINOPHEN DOSAGE (FOR FEVER AND PAIN)

Child’s   weight more than (lb)

7

14

21

28

42

56

84

112

lb

Totalamount   (mg)

40

80

120

160

240

325

480

650

mg

Drops80   mg/dropper

½

1

2

3

dropper

Syrup160   mg/5cc(1tsp)

½

¾

1

2

3

4

tsp

Chewable80 mg tabs

2

3

4

6

8

tabs

Chewable160   mg tabs

1

2

3

4

tabs

Adult   325 mgtabs

1

2

tabs

Dosage: Above dose is given every 4-6 hours as needed.  Adult dose is 650 mg.

IBUPROFEN DOSE (FOR FEVER AND PAIN)

Child’s   weight more than (lb)

12

18

24

36

48

60

72

96

lb

Totalamount   (mg)

50

75

100

150

200

250

300

400

mg

Drops(ml)

1.25

1.875

2.5

__

__ __

__

__

ml

Syrup100   mg/5cc(1tsp)

½

3/4

1

2

3

4

tsp

Chewable50 mg tabs

2

3

4

5

6

8

tabs

Jr-   Strength100   mg tabs

1

2

2   ½

3

4

tabs

Adult   200 mgtabs

1

1

2

tabs

Dosage: Ibuprofen dose is every 6-8 hours as needed. Adult dose is 400 mg (a physician may prescribe a larger dose). Note:  Don’t use Ibuprofen < 6months of age (Safety not yet established).