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Your Child or Baby Has a Fever, Now What?

More than almost any other common condition, fever causes parents to worry. They look at their red-cheeked child and wonder if the fever itself is harmful or if it’s a sign of a more serious illness. Indeed, the majority of the calls to our practice are related to fevers in children.

In most cases, fever is not serious and, if anything, is a good sign the child’s body is working to fight an illness. One common myth is that the higher the fever, the worse the illness. While extremely high fevers (over 104 degrees F) call for action, usually there is not much difference between a 100-degree fever and a 102-degree fever. Since many types of bacteria and viruses don’t like hot temperatures, fever is nature’s way of fending off disease.

Should I call the doctor?

Any infant age three months or younger with a fever should immediately be seen by the doctor. After that, the data is less absolute. The American Academy of Pediatrics (AAP) recommends parents call the pediatrician within 24 hours for fever in children one year old or less. You should also call if other symptoms—such as neck pain, persistent vomiting, or diarrhea—are present.

When should we give our child fever-reducing medicine?

When using fever-reducing medications, remember that your goal should not be a certain temperature or number, but your child’s comfort level. Fever-reducing medications such as acetaminophen often only reduce a child’s fever by about one degree, which can be just enough to allow your child to sleep comfortably. If you feel that you cannot make your child comfortable with adequate medication dosing, it is probably time to call your child’s provider.

If your child is sleeping, wait until she wakes up to give her the medicine. That’s also a good time to offer a drink of clear liquid such as water to make sure the child stays well hydrated.

What kind of medicine should I use?

I recommend parents try Tylenol (acetaminophen) first. If the fever does not go down after 30 to 45 minutes and the child is uncomfortable, parents can then give an appropriate dose of ibuprofen. Then, parents should stick with the single medication that worked best rather than alternate medicines.

Giving too much medication can be very dangerous. To avoid overdosing, parents should write down when medication was given, what type, and how much, especially for those doses given in the middle of the night or if there is more than one sick child in the house. While acetaminophen is one of the safest medications available when taken properly, acetaminophen poisoning is not uncommon and is a leading reason why children undergo liver transplants.

What’s the best dosage for my child?

Fever-reducing medications come in different strengths. Infant drops are extremely concentrated and require less medication to treat a child. Whether the medication comes with a dropper or cup, always use the measuring device that comes with the medication. Be very cautious about using cold medicines, which often also contain either acetaminophen or ibuprofen. We doctors don’t recommend these combination medications as the cold products don’t work in children younger than two and there’s the potential for overdosing—in fact, a November 2007 recall prompted the removal of many infant cough and cold medicines from store shelves. Read all medicine labels very carefully.

Check these medical dosage charts for the appropriate amounts for your child:

Be sure to call your doctor or local pharmacist for simple dosage questions.

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