Fever

Fever alarms parents more than any other sign of illness. This is understandable since fever usually means that the child has an infection. Often it is difficult to determine the nature and seriousness of an infection at its onset. Observing a child for a short time may yield other symptoms such as rash, vomiting or sore throat.

Fever occurs when the body’s immune system is active. The immune system may be active due to inflammation such as in teething, or as part of the body’s infection-fighting process. Fever is helpful because most viruses and bacteria are unable to live or multiply at high temperatures; fever, therefore hinders the progress of the infection.

When to call the doctor if your child has a fever

The question of when to notify the doctor of a fever depends on the age of the child.

In infants less than two months old any fever should be discussed with a doctor.

For older children, a temperature of 102°F, if it lasts longer than 48 hours, should be discussed with the doctor.

In general, you can learn a lot more about how ill your child is by looking at them, rather than looking at the number on the thermometer.

A child’s behavior provides the best clue of how serious an illness is. Fevers drain children of energy. This makes them more cranky, clingy and sleepy than usual. When the fever is down, however, they should be able to show interest in toys and family. Most children lose their appetites when sick, but they should still drink liquids well.

Normal body temperature is 98.6°F measured under the tongue. However, body temperature varies between 97-100.3°F over the course of a given day, whether a person is well or sick. If the temperature stays at or higher than 100.4°F for more than a few hours, fever is present.

Measuring the temperature accurately is important.

For infants, it is necessary to take it rectally; for toddlers, one can take it under the arm and in children over 4 years old, under the tongue.

Managing a fever in infants and young children:

• The most common reason for infants to have an elevated temperature is absorbing warmth from their environment, whether being cuddled closely by a loved one or wrapped/swaddled in blankets.
• If your infant feels warm, undress them to their diaper and allow them to cool to ambient air for 5-10 minutes.
• If your infant still feels warm, check a rectal temperature.
• Call us immediately at (804) 282-4205 if your infant is 2 months old or younger & has a rectal temperature of 100.4°F or greater. Do not give Tylenol.
• For older infants and children of all other ages, focus on the comfort level of your child.
• If your child has a fever but is staying hydrated, breathing comfortably and acting normally, you do not need to do anything.
• Give your child plenty of fluids. This will make him feel better, help him lower the fever and prevent dehydration.

Giving medication for fever:

• Acetaminophen (common brand Tylenol) is the medication of choice, if needed, for fever in children.
• Ibuprofen is unsafe for infants under 6 months old because it can harm their immature kidneys.
• Aspirin should not be used in children due to the risk of Reye Syndrome.

• Doses of acetaminophen can be given every 4 hours as needed for comfort.
• Do not exceed more than 5 doses of acetaminophen in 24 hours.
• Check labels of any other medicines you are giving for the active ingredient “acetaminophen”, especially cough/cold preparations.
• Use the enclosed dropper, measuring cup or a device used for measuring medicines, do not use a household spoon to measure the medicine
• The most accurate way to dose any medication for children is according to weight. Use age-based dosing only if a weight is not available.

Weight	Age*	Acetaminophen Infant/Children’s Oral Suspension  160mg/5ml	Acetaminophen Children’s suspension  160mg/5ml	Acetaminophen Children’s Meltaways   80mg/tablet	Acetaminophen Junior Meltaways   160mg/tablet
6-11 lbs	0-3 mo	1.25 ml (40mg)	n/a	n/a	n/a
12-17 lbs	4-11 mo	2.5 ml (80mg)	2.5 ml	n/a	n/a
18-23 lbs	12-23 mo	3.75ml (120mg)	5 ml	n/a	n/a
24-35 lbs	2-3 yrs	5.0 ml (160mg)	5 ml	2 tablets	n/a
36-47 lbs	4-5 yrs	n/a	7.5 ml	3 tablets	n/a
48-59 lbs	6-8 yrs	n/a	10 ml	4 tablets	2 tablets
60-71 lbs	9-10 yrs	n/a	12.5 ml	5 tablets	2½ tablets
72-95 lbs	11 yrs	n/a	15 ml	6 tablets	3 tablets
96 lbs and over	12 yrs	n/a	n/a	n/a	4 tablets

*use only when wt not available