Fever is part of the your child's normal response to viral and bacterial
infections. Because these infections are very common in young children, fever is
common as well. Fever is defined as axillary (armpit) temperature greater than
100.5°F. Mild elevation of temperature (up to 101°F ) can be caused by hot
weather or exercise. When this occurs, the temperature should return to normal
after 30 minutes in a cooler environment.
We recommend that you use a digital thermometer to take your child's
temperature. We do not recommend mercury thermometers because the mercury can be
dangerous if the thermometer is broken. We also do not recommend ear
thermometers because they are inaccurate.
Fever is part of the body's immune response to infections, and is controlled by
the "thermostat" in the brain. The most common cause of fever in children is
viral infections, which can last several days and then resolve spontaneously.
Both minor viral infections and more serious bacterial infections can cause high
fever. The other symptoms that your child may have, such as decrease in activity
or difficulty with eating, tell us more about the severity of the illness than
the temperature per se. Fever itself is not harmful to your child unless it is
greater than 107°F. However, please call our office if your child has fever
greater than 104°F, so we can discuss his or her symptoms, and whether an office
visit is needed.
Because the fever itself is not harmful, the only reason to treat fever is to
make your child more comfortable. If your child has a fever but is sleeping
normally or playing, it is not necessary to give medicine to treat the fever.
Acetaminophen and ibuprofen are drugs that reduce temperature by adjusting the
thermostat in the brain back to a normal temperature. Appropriate dosages are
given on the reverse side. Both drugs are safe and effective, though
acetaminophen has a longer track record in children and is a better first
choice. One advantage of ibuprofen is that its effect lasts six to eight hours
rather than four hours for acetaminophen. Because both drugs treat fever in the
same way, it is not beneficial to use both at the same time. We recommend
choosing one drug to use during your child's illness. Ibuprofen should not be
used in children with head injuries or ulcers, because it can increase the
chance of bleeding. It also should not be used in dehydrated children. Neither
drug should be used continuously for more than three days without seeing a
physician to look for the cause of the fever. Aspirin
should never be used for the treatment of fever in children up to the age of
eighteen years.
Sponging your child in lukewarm water can help to lower the temperature more
quickly, and is sometimes helpful in children who are very uncomfortable with
fever. This should be done after giving acetaminophen or ibuprofen to reset the
brain's thermostat, otherwise the child will shiver as the body attempts to
maintain the higher temperature.
Call our office immediately if your child has signs of a serious infection in
addition to the fever. These include age less than 2 months, constant crying or
sleeping, stiff neck, purple rash, breathing problems, inability to swallow,
fever over 104°F, fever for more than 3 days, decreased oral intake or
decreased urination. We are always available to discuss any questions you might
have about fever in your child.
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