Definition: A fever is defined as a temperature above normal (100.4 or greater if taken rectally. See chart below.) Fevers are one of the body’s ways of fighting infection. In general, how high your child’s fever is does not matter as much as how sick he or she acts (activity, appetite, fussiness). If your child is acting sick, your doctor, no matter what his/her temperature is, should probably see him.

Cause: Fevers are one of the ways the body fights off infection. Dehydration and other stresses on the body also cause an increase in body temperature.

Expected course: The anticipated course of a fever varies according to the cause. Please follow the guidelines listed below. If you are uncertain about whether or not your child needs to be seen, please do not hesitate to call for advice.

Home Care and Treatment

As indicated by the above chart, be sure to reduce the amount of clothing your child is wearing. Do not chill the child, but keep clothing light and to a minimum to allow the body to lose the heat of the fever.

Dehydration causes fever and fever causes dehydration. If vomiting is not an issue, encourage your child to drink plenty of fluids. This will help keep the fever down and will help keep your child from acting very sick.

Give acetaminophen (such as Tylenol) every 4 hours dosed according to the following chart. Children older than 6 months may have ibuprofen (such as Advil or Motrin) every 6-8 hours. Again, follow the dosing guidelines on the chart on the other side of this paper. Do not give these medicines together. Utilize either one or the other for fever control.

Acetaminophen

Ibuprofen (for children over 6 months of age only)

Call the office…

Immediately if:

• Your child is less than 2 months old and has a fever greater than 100.4 rectally.
• Fever is 103 or higher, especially if under 2 years of age and your child does not perk up within 30-45 minutes after an adequate dose of acetaminophen or ibuprofen
• Your child is crying inconsolably
• Your child is difficult to awaken
• Your child is confused or delirious
• Your child has a seizure
• Your child cannot touch his chin to his chest
• Your child has purple spots on the skin
• Your child is having difficulty breathing even when the nose is clear
• Your child is acting very sick
• Your child has an underlying risk factor for serious infection (like Sickle Cell)

During regular office hours if:

• Burning or pain occurs with urination
• Fever has been present for more than 72 hours
• Fever has been present for more than 24 hours without any obvious cause or location of infection
• Fever went away for greater than 24 hours and then returned
• You have any other questions or concerns