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.

Acetaminophen and Ibuprofen Pediatric Dosage Schedules
Accurate dosages of acetaminophen and ibuprofen for children are based on the weight of the child, although most dosage tables are based on age. These tables assume that most children of the same age will be similar in size. Therefore, if the child is average or nearly average in size, you may determine the correct dose of acetaminophen or ibuprofen from the appropriate table below based on the child's age. However, if the child is large or small for her age, you should determine the correct dose of acetaminophen or ibuprofen from the appropriate table below based on the child's weight. Use measuring cups and droppers supplied with the medication to ensure the correct dose. Write down the time and amount of each dose given. If you have any questions or wish to confirm your chosen dose, consult our office and a nurse can help you.
Correct Dosages of Acetaminophen (i.e. Tylenol® or Tempra®)
Child's
Weight (lbs)
6-11 12-17 18-23 24-35 36-47 48-59 60-71 72-95 96+ lbs
Total Amount (mg) 40 80 120 160 240 325 400 480 650 mg
Infant Drops
80 mg/0.8 ml
0.4 0.8 1.2 1.6 2.4 -- -- -- -- ml
Syrup:
160 mg/5 ml
1.25 2.5 3.75 5 7.5 10 12.5 15 20 ml
Syrup:
160 mg/1 teaspoon
-- ½ ¾ 1 2 3 4 tsp
Chewable
80 mg tablets
-- -- 2 3 4 5 6 8 tabs
Chewable
160 mg tablets
-- -- -- 1 2 3 4 tabs
Adult
325 mg tablets
-- -- -- -- -- 1 1 2 tabs
Adult
500 mg tablets
-- -- -- -- -- -- -- 1 1 tabs
Administer the acetaminophen according to the above table and/or doctor's instructions every four hours as needed. Since acetaminophen pediatric products are available without a prescription, the package label should be read before the drug is administered. Be careful of any over the counter products, particularly those sometimes given for colds, which may also contain acetaminophen. This can lead to an overdose.
Correct Dosages of Ibuprofen (i.e. Motrin® or Advil®)
Child's Age
6-11
Months
12-23
Months
2-3
Years
4-5
Years
6-8
Years
9-10
Years
11-12
Years
12-14
Years
Child's
Weight (lbs)
13-17 18-23 24-35 36-47 48-59 60-71 72-95 95+
Drops
(50mg/1.25ml)
1.25 ml 1.875 ml 2.5 ml -- -- -- -- --
Elixir
(100mg/5ml)
½ tsp ¾ tsp 1 tsp 1½ tsp 2 tsp 2½ tsp 3 tsp --
Chewable Tablets
(50mg)
-- -- 2 tabs 3 tabs 4 tabs 5 tabs 6 tabs --
Junior Strength
(100mg)
-- -- -- -- 2 tabs 2½ tabs 3 tabs 4 tabs
Administer the ibuprofen according to the above table and/or doctor's instructions every six hours as needed. Acetaminophen has a longer track record in pediatrics so we recommend this be used initially. Do not use ibuprofen or after head trauma or with a history of ulcer disease or in cases of dehydration.

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