Management of Fever

Fever is a symptom, not a disease. It is usually a sign of infection. Fever is part of your child’s defenses against infection, helping to “burn out” the germ causing bacteria.

When your child has an infection, antibiotics may be required, but only if the infection is caused by bacteria. Fever is more often caused by viruses than by bacteria.

Infants and children frequently get temperature elevations as high as 104 degrees Fahrenheit (40 degrees Centigrade). This degree of fever is not harmful in itself and is NOT a medical emergency.

Temperatures taken by ear probes and temporal (forehead) probes are not as reliable and we urge you not to use them. Digital thermometers are inexpensive and are very accurate. The most accurate temperature is taken rectally. An axillary temperature (taken high up in the child’s armpit) is an acceptable alternative. The oral (mouth) temperature is best only in children over four years of age. It is inaccurate if liquids have been taken recently, whether hot or cold, if the mouth is open or if your child cannot hold it under the tongue.

When reporting fever to our nurses or doctors, please DO NOT add or subtract degrees because it is very confusing. Just be sure to take the temperature accurately and report which method was used.

If your child has fever, there are several things you can do to help relieve discomfort:

1. Give plenty of cold fluid (popsicles, Jello, tea, ice chips, etc.). Appetite for food is usually decreased with fever but should improve when the child begins to feel better.

2. Dress your child lightly and remove all tight fitting clothing. Bedclothes should also be light.

3. Fever reducing agents (acetaminophen or ibuprofen) can be used. Remember that your child will usually have a fever for 2-3 days with most illnesses even if antibiotics and other measures are used. After
   your child has been examined by the doctor and treatment has begun, if he/she becomes quite ill with difficulty breathing, extreme sleepiness, severe vomiting or other symptoms not anticipated by the doctor, we
   should be notified again.

 

We do not recommend aspirin with fever due to the possibility of developing Reye syndrome.

1. If the fever is over 104 degrees, in addition to fever reducing analgesics, you can sponge with water that is lukewarm (neither hot or cold). Rub the skin briskly with a washcloth, especially in the area of the armpits, back and groin or place the child in a tepid bath. We do not recommend bathing with rubbing alcohol.

2. REMEMBER, acetaminophen and ibuprofen can be dangerous so return bottle to a safe place and don’t exceed the recommended dosage of acetaminophen or ibuprofen.

YOU NEED TO CALL OUR OFFICE DURING REGULAR OFFICE HOURS IF:

1. Your child seems very ill.

2. Fever continues for more than 24 hours and your child has not been
   examined in the office.

3. Fever of any degree if your child appears very ill and has not been
   examined in the office.

YOU NEED TO CALL AT ANY TIME IF:

1. Your child is less than 3 months old and has a rectal temperature greater than 100.4 degrees F. and has not been seen by the doctor.

2. Fever of greater than 105 degrees F. and has not been seen by the doctor.

3. Your child is extremely irritable and cannot be consoled, regardless of
   the temperature.