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How To Care For Your Child With Fever
  • Do not be afraid of fever. Fever is the body's way to fight an infection.
  • If your baby is less than 3 months old and has a rectal temperature over 100.4°, call our office IMMEDIATELY. This can sometimes indicate a more serious infection.
  • Over 3 months of age, fever is present when your child's rectal temperature is over 101°.
  • Many children become uncomfortable when their temperature is over 101° rectally, and for that reason, we recommend treating the fever.
  • Fever caused by a virus may last up to 4 days. Call our office if the fever lasts greater than 4 days.
  • If your child becomes sick with a fever (coughing, difficulty breathing, vomiting, watery diarrhea, lethargic or irritable) or just not acting normal - please call the office. Never feel uncomfortable about calling.
  • All fevers do not require antibiotics. Most fevers in children are caused by viral infections, which get better without antibiotics. Antibiotics do not treat viral infections.

TREATMENT
  • Keep your child dressed comfortably when fever is present. When your child has fever, the body controls the fever by allowing heat loss through the skin (this is why your child's skin feels warm when fever is present). Overdressing your child may prevent normal heat loss through the skin.
  • NEVER use heavy covers, blankets, or quilts to cover your child. A single sheet is all that is necessary.
  • NEVER use alcohol baths. The alcohol can be absorbed through your child's skin and make your child sick.
  • Keep the room temperature between 68-72°. Humidifier (winter) will help your child sleep more comfortably.
  • The best method to quickly lower your baby's fever is with a tepid bath. The water temperature should be warm to touch. In order to be most effective, your child's entire body, up to the neck, should be under water. It may be necessary for you to get in the bath with your child. Keep the bathroom warm. If your child becomes more irritable with a bath, do not use this method.
  • Wrapping your child in cold towels, or just sponging with cool water is not as effective in lowering fever.
  • Continue to offer your child plenty of fluids. For babies under 1 year, breast milk or formula should be continued. If your child will not drink, please call the office.

TREATMENT WITH ACETAMINOPHEN AND IBUPROFEN
  • These medicines will help make your child more comfortable and lower the fever. Do not become alarmed if your child's temperature does not return immediately to normal when using these medicines.
  • Fever of 104° does not mean your child is sicker than a child with a fever of 101°. Some children become irritable, lethargic or listless with fever. If your child improves (more pleasant and playful) when the fever is reduced, then we know it is more the fever that is making your child uncomfortable than the actual infection.
  • Continue giving these medicines for at least 12 hours after your child's temperature has returned to normal (less than 101°).
  • If your child is irritable, lethargic or listless when the fever is reduced, please call our office.

HOW OFTEN ARE THESE MEDICINES GIVEN
  • Acetaminophen: every 4 hours
  • Ibuprofen: every 6 hours (not under 6 months of age)

CAN ACETAMINOPHEN AND IBUPROFEN BE ALTERNATED?
  • Please call our office before alternating these medicines.
  • Acetaminophen can be alternated with Ibuprofen every 6 hours so that one drug is administered every 3 hours.
    Example: Acetaminophen followed by Ibuprofen 3 hours later and Acetaminophen again 3 hours later and Ibuprofen again 3 hours later.

WHERE TO TAKE THE TEMPERATURE
  • Rectal temperatures are the most accurate (especially under 6 months).
  • Ear temperatures over 6 months of age.
  • Oral temperatures over 4-5 years of age.
  • Axillary (armpit) and Forehead temperatures are the least accurate.

RECTAL TEMPERATURES
  • Lay your child across your lap face down.
  • Before you insert the thermometer, apply some Vaseline to the end of the thermometer or use a pre-lubricated thermometer cover.
  • Spread the buttocks apart and gently insert the rectal thermometer 1/2 inch (enough to cover the tip of the thermometer) Hold your child still while the thermometer is in.
  • Leave the thermometer in your child's rectum until you hear a beep.

ORAL TEMPERATURES
  • Be sure your child has not had a cold/hot drink within the last 30 minutes.
  • An accurate temperature depends on proper placement. Place the tip of the thermometer under one side of the tongue and toward the back of the mouth. Have your child hold it in place with the lips and fingers (not the teeth) and breathe through the nose, keeping the mouth closed.
  • Leave it in place until you hear a beep.
  • If your child can't keep his or her mouth closed because of nasal congestion, use saline nose drops to loosen the mucus and then suction out the mucus.

EAR TEMPERATURE
Since most ear canals have a slight bend, it is important to use the following simple ear canal straightening technique. This will make it easier for the thermometer to view the warmest part of the eardrum.

Children up to 1 year of age:
  • Using your free hand, grasp the earlobe at the top.
  • Gently, but firmly, pull the earlobe straight back and insert the thermometer into the ear canal and press the activation button. Hold in the ear canal until you hear a beep (1-3 seconds).

Children over 1 year of age:
  • Using your free hand, grasp the earlobe at the top.
  • Gently, but firmly, pull the earlobe up and back and insert the thermometer into the ear canal and press the activation button. Hold in the ear canal until you hear a beep (1-3 seconds).

AXILLARY TEMPERATURES
  • Place the tip of the thermometer in a dry armpit.
  • Hold your child's arm tightly against his or her side until you hear a beep.
  • If you are uncertain about the result, check it with a rectal temperature.

STRENGTHS OF ACETAMINOPHEN AND IBUPROFEN
  • Acetaminophen Infant Suspension: 160 mg/5 ml: comes with a syringe.
  • Acetaminophen Children's Suspension: 160 mg/5 ml: has a measuring cup.
  • Ibuprofen Infant Concentrated Drops: 50 mg/1.25 ml: comes with a syringe.
  • Ibuprofen Children's Suspension: 100 mg/5ml: has a measuring cup.

ACETAMINOPHEN / IBUPROFEN COMBINATION COLD MEDICINES

Many over the counter cold, cough and flu medicines also contain acetaminophen and ibuprofen. Always read the ingredients of any medicine before giving to your child. Avoid using these combination medicines to lessen the chance of overdosing on acetaminophen or ibuprofen.

Acetaminophen Dosage Chart
(Give every 4 hours)
Use child’s weight (not age) to determine the appropriate dose

Weight Age Dose in mg Infant's Suspension 160 mg/5 ml Children's Suspension 160 mg/5 ml Children's Chewable 80 mg Junior Strength Chewable 160 mg Suppository 80 mg 120 mg 325 mg
6-11 lbs 0-3 mo 40 mg 1.25 ml ¼ teaspoon __ __ ½ of 80 mg
12-17 lbs 4-11 mo 80 mg 2.5 ml ½ teaspoon __ __ One 80 mg
18-23 lbs 12-23 mo 120 mg 3.75 ml ¾ teaspoon __ __ One 120 mg
24-35 lbs 2-3 yrs 160 mg 5 ml 1 teaspoon 2 1 Two 80 mg
36-47 lbs 4-5 yrs 240 mg __ 1½ teaspoons 3 Two 120 mg
48-59 lbs 6-8 yrs 320 mg __ 2 teaspoons 4 2 One 325 mg
60-71 lbs 9-10 yrs 400 mg __ 2½ teaspoons 5
72-95 lbs 11 yrs 480 mg __ 3 teaspoons 6 3
>96 lbs >12yrs 640 mg __ 4 teaspoons 8 4

Acetaminophen Suppositories
***Remove silver wrapper and carefully insert suppository into the rectum***


Ibuprofen Dosage Chart
(Give every 6 hours)
****Do not use under 6 months****

Weight Age Dose in mg Infants Drops Concentrated (2 times stronger) 50 mg/1.25 ml Children's Suspension 100 mg/5 ml Children's Chewable 50 mg Junior Strength Chewable 100 mg
12-17 lbs 6-11 mo 50 mg 1.25 ml ½ teaspoon __ __
18-23 lbs 12-23 mo 75 mg 1.875 ml ¾ teaspoon __ __
24-35 lbs 2-3 yrs 100 mg 2.5 ml 1 teaspoon 2 1
36-47 lbs 4-5 yrs 150 mg __ 1½ teaspoons 3
48-59 lbs 6-8 yrs 200 mg __ 2 teaspoons 4 2
60-71 lbs 9-10 yrs 250 mg __ 2½ teaspoons 5
72-95 lbs 11 yrs 300 mg __ 3 teaspoons 6 3
>96 lbs >12yrs 400 mg __ 4 teaspoons 8 4

Ibuprofen Infant Drops are twice as strong as the Children’s suspension.
Use child’s weight (not age) to determine the appropriate dose


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