Medical Information Center    
Fever in Children 101
 

 
 

 
 
Faraz Ahmad MSIII, Yingshan Shi, MD , Rachel Caskey, MD Contributors
The page started on 03/10/08, updated on 06/11/09
             
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General
Fever is the body’s normal response to infection and helps your child fight the virus or bacteria.
A fever is:
  Rectal temperature ≥100.4 ○ F (38 ○ C)
Oral temperature >99.5 ○ F (37.5 ○ C)
Axillary temperature >99.5 ○ F (37.5 ○ C)
Fever is a symptom, not a disease. A fever very rarely causes harm, however, see below for recommendations on when to contact your health care provider.
 
Common Causes

Infectious diseases, both viral and bacterial infections can cause high fevers (fever due to a viral illnesses typically lasts 2-4 days).
Certain medications
Heat stroke
A mildly higher temperature (between 99-100 degrees) can be caused by teething, too many clothes, a hot bath, hot weather, or exercise.

 

Taking Your Child’s Temperature

Always read and follow the thermometer’s instructions
If your child is younger than 1years old, take his or her temperature in the rectum: after lubricating the thermometer with petroleum jelly, gently place 2/3 inch of the tip into the rectum while holding your child to prevent movement
If your child is older than 1years old, you can take the temperature under the armpit or in the mouth if they let you
For more detailed instructions on taking your child’s temperature, click here.
Do not use a mercury thermometer

 

Call or see doctor if

Your child is less than 3 month old with temperature of 100.4 ○ F (38 ○ C) or above by rectum
Your child is 3-6 month old with fever >101 ○ F (38.2 ○ C)
The fever is over 104 ○ F (40.0 ○ C)
Your child looks or acts very sick, such as seeming very irritable, confused, or dehydrated
Your child has one of these other symptoms: stiff neck, rash, purple spots on skin, trouble breathing, ear pain, joint swelling or limping, abdominal pain, bloody poop, seizure, painful urination, cannot swallow, or lots of drooling
Your child has had a fever for 3 days or more
The fever went away for over 24 hours and then returned
Check with physician and look online information about Kawasaki disease if your child has had fever for 5 days or more
You have questions or concerns

 

Treatment
Always take your child's temperature before you treat the fever!
Always check the temperature again after you open the baby's wraps for 5 to 10 minutes
You should treat your child’s fever if it is >102 ○ F or if your child is uncomfortable
If you plan to treat the fever:
  Use either Acetaminophen (Tylenol, Panadol) or Ibuprofen (Advil, Motrin)
If your child is vomiting or does not like to take medicines, use over-the-counter Acetaminophen suppositories (FeverAll) with same dose as oral Tylenol.
You can give Tylenol every 4 to 6 hours or Motrin every 6 to 8 hours with food
Do not give both Tylenol and Motrin within the same period without speaking with your physician
Do not use aspirin for fever control in infants and children
Dress baby/child lightly to be comfortable in your home's temperature (keep the room around 70 ○ F if possible)
Encourage your baby/ child to drink to prevent dehydration
Sponge your child with lukewarm water if fever over 104 ○ F and not resolving from medicines. If your child starts shivering, take him/her out of the bath and dry off. Shivering can raise the body temperature.
Call your physician if you have any questions or concerns
 

Common Dosages for Fever Medications

 
Age
Weight (pounds)

Tylenol (Acetaminophen)
Dosage AAP

Motrin (Ibprofen)
Dosage AAP
Infant Drops
80 mg/dropper
(0.8 mL)
Liquid
160 mg/tsp
(1tsp=5.0ml)
Infant Drops
50 mg/dropper
(1.25 mL)
Liquid
100 mg/tsp
(1tsp=5.0ml)
0-3 months
6-11
Call physician
Call physician
4-6 months
12-14
1 dropper, 0.8ml
½ tsp, 2.5ml
Call physician
7-11 months
15-17
1 ¼ dropper, 1.0ml
3/5 tsp, 3.0ml
1¼ dropper, 1.5ml
3/5tsp, 3.0ml
18-20
1 ½ dropper, 1.2ml
¾ tsp, 4.0ml
1½ dropper, 1.8ml
¾ tsp, 4.0ml
12-23 months
21-23
1 ¾ dropper, 1.4ml
¾ tsp, 4.0ml
2 dropper, 2.5ml
1 tsp, 5.0ml
24-26 2 dropper, 1.6ml 1 tsp, 5.0ml 2 dropper, 2.5ml 1 tsp, 5.0ml
2-3 years 27-31 2 dropper, 1.6ml 1 tsp, 5.0ml 2½ dropper, 3.0ml 1¼ tsp, 6.0ml
  32-35 2 ½ dropper, 2.0ml 1¼ tsp, 6.0ml 3 dropper, 3.75ml 1½ tsp, 7.5ml
4-5 years 36-43 3 dropper, 2.4ml 1½ tsp, 7.5ml 3 dropper, 3.75ml 1½ tsp, 8.0ml
  44-47 3¾ dropper, 3.0ml 1¾ tsp, 9.0ml 4 dropper, 5.0ml 2 tsp, 10.0ml
6-8 years 48-54   2 tsp, 10ml   2 tsp, 10.0ml
  55-59   2 tsp, 10ml   2½ tsp, 12.5ml
9-10 years 60-65   2½ tsp, 12.5ml   2½ tsp, 12.5ml
  66-71   2½ tsp, 12.5ml   3 tsp, 15ml
11-12 years 77-87   3 tsp, 15ml   3½ tsp, 17.5ml
  88-95   3½ tsp, 17.5ml   4 tsp, 20ml
Tylenol 10-15mg/kg/dose, every 4 to 6 hours, maximum 4-5 times a day for well-hydrated child. Check with physician if your child doesn't hydrate well.
Motrin 10mg/kg/dose, every 6 to 8 hours with food, maximum 4 times a day
 
 
Online Information
 
 
General
 
     
 
Guidelines
 
     
 
Kawasaki Disease
 
     
 
 
     
 
 
     
     
     
     
 


Additional Online Information and References
FamilyDoctor.org: Fever in Children: When Your Child Has a Fever AAFP
FamilyDoctor.org: Fever in Children and Infants AAFP
University of Chicago Comer Children's Hospital: Fever
Fever and Taking Your Child’s Temperature Kids Health
Cincinnati Children’s Hospital Medical Center: Fever
Fever and Children MedlinePlus

http://www.nlm.nih.gov/medlineplus/fever.html Fever

Kawasaki
http://www.uchicagokidshospital.org/online-library/content=P01801
http://www.cincinnatichildrens.org/health/heart-encyclopedia/disease/kawasaki.htm
http://kidshealth.org/parent/medical/heart/kawasaki.html
Kawasaki Disease Foundation: http://www.kdfoundation.org/


Fever
Evaluating Fever of Unidentifiable Source in Young Children AAFP http://www.aafp.org/afp/20070615/1805.html
The National Guideline Clearinghouse™ (NGC) Evidence based clinical practice guideline for fever of uncertain source in infants 60 days of age or less.
The National Guideline Clearinghouse™ (NGC) is Evidence based clinical practice guideline for fever of uncertain source in children 2 to 36 months of age.


References

AAFP: Familydoctor
AAP: American Academy of Pediatrics http://patiented.aap.org/
CCH: Cincinnati Children's Hospital medical Center http://www.cincinnatichildrens.org/health/
KDF Kawasaki Disease Foundation, Canada http://www.kdfoundation.org/
KH: KidsHealth, Nemours Foundation http://www.kidshealth.com/
Medline: National Library of Medicine, NIH http://www.nlm.nih.gov/medlineplus/medlineplus.html
NGC: The National Guideline Clearinghouse http://www.guideline.gov/search/detailedsearch.aspx
Uckids: http://www.uchicagokidshospital.org/