An infant less than 2 months of age with a fever of 100.4°F or higher should be examined as soon as possible by Dr. Eisner or Texas Children’s Hospital E.R. Infants and young children can not tell you what’s wrong. While a fever may be due to a virus requiring conservative treatment only, it may also be due to a potentially fatal infection such as meningitis. Serious bacterial infections will have a much better outcome if detected and treated early.
A child of any age with a fever of 101°F or higher or a persistent low grade fever should be seen in the office. If your child’s fever is high at night and low the next morning, bring your child in to the office. The fever will most likely go up again that night. A child should not go back to school until 24 hours fever free.
WHAT IS A FEVER?
Fever is not a disease. It is a symptom of an underlying problem. What the illness is and how serious it is depends on the other symptoms and how the child looks after the temperature is brought down. Younger children under 4 years old tend to have higher fevers when ill. Fever usually goes up at night. High fever below l06.0°F does not cause brain damage, but it can lead to other problems such as convulsions if not watched closely and treated.
Getting the temperature down helps your child feels and look better. It is worth treating a fever over l00.4°F, particularly if your child tends to run high fever, or has a history of febrile convulsions.
- Fever medications are very helpful, but remember they may take 45 minutes to take effect. There are Tylenol (acetaminophen) and Motrin (ibuprofen) dosage charts attached to this handout. Tylenol and Motrin doses may be staggered, as long as Tylenol doses are at least four hours apart, and Motrin doses are at least six hours apart. For example, if you give Tylenol at 12 (Noon) and after an hour (1PM) fever is still high, Motrin may be given. Then wait 4 hours (4PM) from the first dose of Tylenol for the 2nd dose to be administered. As for Motrin you may administer the 2nd dose if it’s been 6 hours (6PM) since the first dose of that medication.
- Keep the child lightly dressed. Bundling does not break a fever. Keep the room at a comfortable temperature.
- Give your child cool liquids or a popsicle.
- Sponging may be very helpful, but may be reserved for temperature over 103.0°F. Completely undress the child and place the child on a towel. Thoroughly wet the child’s hair and body with cool water, and then sponge the child with cool water especially under the arms and the inner thighs. Sponging is much better than just sitting in the water, since the sponging results in much more evaporation and heat loss. Continue for 20 to 30 minutes, and then re-check child’s temperature. Use cool water for sponging, but do not use ice or very cold water. Suppositories for fever can be very useful if your child is vomiting and cannot hold down oral fever medications.
- Suppositories of Tylenol go under the names of Acetaminophen and Fever-All, and are available over the counter. See attached dosing sheet.