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A fever is alarming for parents. The heat radiating off of your child’s forehead is hot enough to boil water, and he is listless, not himself. Take a deep breath. How are you taking his temperature? Between the age 0-3months, we prefer that you take his temperature rectally. What was that? Yes, you can do this! Take a digital thermometer, add some petroleum jelly to the tip of it and insert it into the rectum until the metal part is hidden from view. It should beep in a couple of seconds with the reading. This is what your pediatrician will want to know. A fever is defined as 100.4 degrees F or greater. When taken under the arm, sometimes people will add a degree, but just give the actual reading when talking to your pediatrician. Even if your child normally runs 97 deg F and now is 99.7, she does not have a fever. Her temperature is simply elevated. No number is too high. Some children may mount a temperature to 105 or 106. Yes, they look and feel miserable during this time. But she will be okay. Most fevers are created in our bodies to signal and combat inflammation and infection. We ask about them so much because they give us clues as to the timing and type of process going on in your child’s body. We don’t ask how high because we are concerned that beyond a certain level your child won’t be safe. Our bodies are rarely able to mount damaging temperatures as high as 108 or 109 on their own. If your baby is between 0-1month old and has a temperature, do not give him any medicine, and call your pediatrician right away. If your baby is between 1-3 months of age and has a fever after getting immunizations, you may give Tylenol over a 24-48hr period, but if the fever persists into the third day or your child has any other concerning signs (i.e.: excessive sleepiness, irritability, skin-color changes, decreased eating or urination, vomiting) call your doctor. If baby is 1-3 months of age and has a fever without any other symptoms, you should call your doctor. If he also has cold symptoms, you may chose to give him Tylenol and monitor him closely until your doctor’s office is open. Do not wait longer than 3 days to have your child 1-3months of age with fever evaluated by a physician. Over the age of 3 months, you can usually observe your child for 2-3 days before notifying your doctor of a fever. However, with little girls, especially, if they have no other symptoms they could be harboring a urinary tract infection. If at any point your child worsens and shows any of the concerning signs listed above, you should notify your pediatrician. Treat the child, not the number. If your baby is older than 6 months, a parent can fairly reliably recognize when their child is hot. If she is eating well, smiling a you, but feels warm, let her be. If she is cranky, clingy or doesn’t want to sleep or eat, try a dose of acetaminophen. If it has been over 45 minutes since you gave the acetaminophen and she is still not acting like herself and feels warm, give her some ibuprofen also. Ibuprofen should be reserved for children older than 6 months. Also try a lukewarm washcloth to her forehead. Do not keep checking her temperature, and do not wake her up to check to see if she has a fever! I do not recommend alternating every 2 to 3 hours between acetaminophen and ibuprofen. It can become confusing and can overwhelm the kidneys. You have to be careful. There are two types of acetaminophen and two types of ibuprofen for kids. The concentrations are different. They are labeled as infant or children’s. The infant form usually has a dropper. Infant ibuprofen usually comes in 50mg/1.25ml and infant acetaminophen is usually 80mg/0.8ml. Children’s ibuprofen is 100mg/5ml (one teaspoon). Children’s acetaminophen is 160mg/5ml. Check to make sure that the label on your box matches this. The maximum dose of acetaminophen is 15mg per kilogram(that is, NOT IN POUNDS). Therefore, anywhere between 10-15mg per kg is an appropriate dose. The maximum dose of ibuprofen is 10mg per kg. If you have a 22 lb child, you divide by 2.2 to get 10kg. Multiply 10 by 10 and get 100mg for ibuprofen. If you are giving infant ibuprofen, then that would be two times a full dropper or 2 x 1.26 = 2.5ml roughly, or if you are giving the children’s ibuprofen it would be roughly one teaspoon. *DOSING DIAGRAM FOR FEVER MEDICINES HERE


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