RECOMMENDATIONS FOR THE CARE OF FEVER

 

In most cases, you do not need to worry about fever.  It is more important to assess how your child is acting (listless, lack of appetite etc.), not just the temperature.  Fever is a symptom of disease, just like a cough or runny nose. A child who looks very ill even without a fever should be checked. We should check any infant less than 2 months of age who has a temperature over 100.4 degrees. In certain circumstanc­es, serious illness may be present in small babies without a fever, especially if chest congestion is present or they seem very listless or weak.  In such situations, we urge you to call the office for an appointment.

Some fever is actually helpful. Your child's body is better able to defend itself against viral infection (the cause of most colds and "flu") at above normal temperature. We do not recommend treating fever until the temperature reaches 101.4° - 102°. The only reason for “treating” fever is to make the child more comfortable. 

 The temperature may or may not come down to the absolute “normal” temperature with treatment or may come down and then go up again.  This is okay.  Our concern is with the child, not fever.  If your child looks or acts significantly ill, he or she should be seen.

 Normal body temperature is not a single temperature, but a range of temperatures influenced by age, time of day and the measurement site. Temperatures should be taken rectally in all children under 4 weeks of age, and can usually be taken orally in older children.  Other means of assessing your older child’s temperature are: the earscan thermometer (set for the “Oral Equivalent”) or the temporal artery thermometer. 

 If you need directions on how to use a digital rectal thermometer, please ask for our handout called “Fever and Your Child”.  Mercury thermometers should not be used. The AAP encourages parents to remove mercury thermometers from their homes to prevent accidental exposure to this toxin.

 Children with fever should not be covered or dressed warmly.  The extra heat must be allowed to escape from the body.  With any fever, extra amounts of liquids such as juices, water, Jell-O, broth, or even popsicles and ice chips should be given to replace the extra liquids the body uses up with fever.  If the child is not eating, the fluids should be Pedialyte or Pedialyte popsicles.

 


ASPIRIN, ACETAMINOPHEN (Tylenol) AND IBUPROFEN (Motrin/Advil)

 Do not use aspirin at all unless directed by a doctor.  It has been associated with Reye's Syndrome, a potentially fatal condition. We recommend that acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) be used instead of aspirin.

 Ibuprofen and acetaminophen (Tylenol) are available without prescription. One advantage of ibuprofen is that it has a longer duration of effectiveness. Ibuprofen is not recommended under 6 months of age.

 The doses for ibuprofen and Tylenol (acetaminophen) are below.

  


COMBINATION FEVER, SORE THROAT, COLD MEDICINES

 

Do not use acetaminophen or ibuprofen indiscriminately as a general treatment for colds or other illnesses.  Acetaminophen overdosage can cause severe problems, including destruction of the liver and death.  Ibuprofen overdose can be toxic to the kidney and can also cause severe or fatal problems.  We recommend giving Tylenol (acetaminophen) or ibuprofen separately from cough and cold medicines (do not buy the combination product) and only if needed for fever or pain/discomfort.



 CONTROL OF FEVER

     

Control of the fever should always begin by removing most of the child's clothing.  This allows heat to escape from the body.  Then give acetaminophen or ibuprofen, according to the following dosage tables. Sponging with water or alcohol is not recommended. 

 

 

 “CURE” OF FEVER

 

It is important to realize that treating the fever will not "cure" the fever.  It will probably lower the fever somewhat but will not permanently return the body's temperature to normal.  It gives only partial, temporary relief of the fever.  This is okay.  Our reason for treating fever is to try to make the child more comfortable. 

 
 
 
 HIGH FEVER

 

High fever may often signify diseases such as strep throat, pneumonia, urinary tract infection, ear infection, or more serious conditions which would require specific medication and care.  Call us to make an appointment if your child has a recurrent very high fever (over 104 degrees) or one that won't come down below 104 degrees.  Remember that a child can be very sick without having a high fever.  Evaluate how the child is acting, not just the tempera­ture.

 

 

RECOMMENDED DOSES* OF ACETAMINOPHEN  (TYLENOL)

(*May be given every 4-6 hours up to 5 times a day)

 

WEIGHT           Infant/Children's Elixir *   CHEWABLE     CHEWABLE JR.

                                 (160mg/5ml)               (80mg/tab)              (160mg/tab)

                                  (80mg strength no longer being produced after 5/23/17)


 6-11 lbs                 1/4 tsp (1.25ml)

12-17 lbs.               1/2 tsp (2.5ml)                                      

18-23 lbs.               3/4 tsp (3.75ml)            l.5 tab

24-35 lbs.                 1 tsp (5ml)                 2 tabs        

36-47 lbs.              1.5 tsp (7.5ml)              3 tabs         

48-59 lbs.                2 tsp (10ml)                4 tabs                       2 tabs                 

60-71 lbs.              2.5 tsp (12.5ml)            5 tabs                     2.5 tabs

72-95 lbs.                3 tsp (15ml)                6 tabs                       3 tabs

 

Always use a proper measuring device – a device is included in the package. Kitchen spoons are not accurate measures. Always dose by weight if known, otherwise, dose by your child’s age.

 

RECOMMENDED DOSES* OF ACETAMINOPHEN (TYLENOL) Continued

(*May be given every 4-6 hours up to 4 times a day

 

WEIGHT            JR STRENGTH SWALLOWABLE or SPRINKLE

                                                       (160mg)

 

48-59 lbs.                   2 tabs          2  caps

60-71 lbs.                   2.5 tabs       2.5 caps

72-95 lbs.                   3 tabs          3  caps

95 lbs. and over         4 tabs           4  caps

 

 

MAXIMUM RECOMMENDED DOSES OF IBUPROFEN (ADVIL/MOTRIN)

                    (May be given every 6-8 hours over 6 months of age up to 4 times/day)

 

 

    ORAL

SUSPENSION

CHEWABLE

CHEWABLE

 

   ADULT

WEIGHT

DROPS

100mg/5mL

TABLETS

TABLETS

CAPLETS

  TABLETS

 

  50mg/

1.25mL

 

50mg

100mg

100mg

   200mg

Pounds

 

 

 

 

 

 

12-17lbs

   1.25ml

1/2 tsp 

 

 

 

 

18-23lbs

   1.875ml

3/4 tsp

 

 

 

 

24-35lbs

   2.5ml

1  tsp

2 tab

1  tab

 

 

36-47lbs

 

1 ½ tsp

3 tab

1 ½ tab 

1 ½ cap

 

48-59lbs

 

2 tsp

4 tab

 2 tab

2  cap

1 tab

60-71lbs

 

2 ½ tsp

5 tab

2 ½ tab

2 ½  cap

 

72-95 lbs

 

3 tsp

6 tab

3 tab

3 cap

 

96 lbs & above

 

4 tsp

8 tab

4 tab

4 cap

2 tab