As a rule of thumb, a child has a fever if their temperature is over 100°F. I highly recommend using digital thermometers as they are much faster and easier to read. In fact, I would be surprised if anywhere even sells the old mercury thermometers anymore. Something about heavy metal poisoning, go figure. I love our ear thermometer—we can always get Little Miss to tolerate it and I feel like the results are more reliable than either an oral or underarm measurement. Technically a rectal temperature is the “gold standard” but…good luck with that.
Fever is not dangerous. It is a natural body process and the body will keep the fever under control. No treatment is necessary unless the child is uncomfortable (i.e. unable to sleep, eat, drink or play normally).
One of the biggest fears I have seen with fevers is febrile seizures. Febrile seizures are rare and do not cause any long-term harm. Giving anti-pyretics (the fancy word for medications that bring down fevers) does not prevent febrile seizures. If your child experiences a febrile seizure you will want to have their pediatrician check it out but you shouldn’t be too concerned. Febrile seizures do tend to run in families.
Who should see a doctor?
-Any child less than 3 months old with a fever
-Any child less than 2 years of age with a fever for 24 hours
-Any child older than 2 years with a fever for 3 days
-Children showing signs of dehydration or any other signs of serious illness (trust your gut!)
-Anyone with a temperature above 105°F
What are the treatment options? (**As always this is general information and is no substitute for the opinion of your primary care physician.)
The non-medication options are the oldies but goodies. Dress the child in light layers if they are hot but grab a blanket if they are getting the chills. Keep them hydrated as much as possible and, if they are really uncomfortable, you can use a damp washcloth or sponge to help cool them off.
The medication options are either acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). Ibuprofen should not be used in infants under 6 months old but, other than that, which one you use is personal preference. I prefer to use acetaminophen at our house because it is easier to find a dye-free version (Little Miss tends to projectile vomit her medicine) in a flavor she liked. These medicines should always be dosed based on the child’s weight and using the measuring tool provided by the manufacturer. If the package doesn’t give a dose for your child’s weight call your pharmacist or pediatrician’s office and they will be glad to help you figure it out. Sidenote: this is a good reason to know the number of a local 24-hour pharmacy. Unless, of course, your baby is perfect and only gets sick during normal business hours.
Speaking of perfect children—I have never been able to get our sweet Little Miss to swallow plain acetaminophen. I have tried lots of tricks and had lots of fun cleaning up gag-reflex vomit. I have resorted to “magic applesauce.” We mix her dose of medicine with a small amount of applesauce and she slurps it right up. A couple of precautions here: only use a small amount of applesauce so you know the whole dose got in there and don’t save any “magic applesauce” for later.
I have heard lots of people recommend alternating acetaminophen and ibuprofen but there is NO benefit to this treatment and it increases the risk of medication error. Your best bet is to pick one and stick with it.
If you have a child who is vomiting (lucky you!) and can’t keep any medicine in their stomach, acetaminophen is available in a suppository (lucky you again!). These have been located behind the pharmacy counter in all the pharmacies I have been in so if you can’t find them in the aisles just ask someone behind the counter.
NEVER give a child aspirin. I know they call it baby aspirin and that is super misleading but aspirin is not for babies.
If you want more information on fevers, and especially for some good basic information on febrile seizure, look no further than healthychildren.org (run by the American Academy of Pediatrics).