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Fever in children: when your child has a fever.

What is a normal temperature?

A normal temperature is about 98.6[degrees] when taken orally (by mouth). Temperatures taken rectally (by rectum) usually run 1[degree] higher than those taken orally. So a normal temperature is about 99.6[degrees] when taken rectally. But temperatures may vary several degrees during the day, even in healthy children. Many doctors define a fever as an oral temperature above 99.4[degrees] or a rectal temperature above 100.4[degrees].

What's the best way to take my child's temperature?

You may think you can tell if your child has a fever by touching his or her forehead. But this isn't an accurate way to tell.

Fever strips, which are placed on the child's forehead, are also not accurate. Neither are temperatures taken from under a child's arm. The most accurate way to take your child's temperature is orally or rectally.

In a child younger than about four years, take the temperature rectally. In an older child, take it orally.

Here are some tips on taking your child's temperature:

* The thermometer should show a temperature lower than 98.6[degrees] before taking a temperature. You can run cool water over the red end to lower the reading. Some thermometers must be shaken to lower the reading.

* Don't bundle your baby or child up too tightly before taking the temperature.

* Never leave your child alone while taking the temperature.

* Be sure you use the right thermometer. Rectal thermometers are thicker than oral thermometers.

* If you're taking your child's temperature rectally, coat the tip of the thermometer with petroleum jelly (Vaseline) and insert it half an inch into the rectum. Hold the thermometer still for two minutes. Never let go of the thermometer.

* If you're taking your child's temperature orally, place the end of the thermometer under the tongue and leave it there for two minutes. Don't let your child bite on the thermometer.

* After you're done using the thermometer, wash it in cool, soapy water.

When should I try to lower my child's fever?

Fevers are more frightening than they are harmful. They're usually just a sign that the body is fighting an infection. The main reason to treat your child is to make him or her feel better. When your child is achy and fussy, you may want to give him or her some medicine.

How much medicine is needed to lower a fever?

Acetaminophen is a medicine that relieves pain and lowers fever. It's sold in stores as Tylenol, Tempra, Panadol or Datril. Ibuprofen, another pain-relieving and fever-reducing medicine, usually costs more than acetaminophen but is not more useful.

How much acetaminophen children need depends on their weight and age, as shown in the chart below. When the age and weight categories in the chart don't match, use the weight of your child as the main guide in figuring out how much acetaminophen to give.

These doses may be a little higher than what's on the medicine package. If you have any questions about the right dose, ask your family doctor.
Age                 Weight                (Every 4 hours)
0 to 3 months       Less than 13 pounds   Ask your
                                           family doctor
4 to 7 months       13 to 17 pounds       80 mg
8 to 18 months      18 to 23 pounds       120 mg
1 1/2 to 3 years    24 to 32 pounds       160 mg
4 to 5 years        33 to 45 pounds       240 mg
6 to 7 years        46 to 61 pounds       320 mg
8 to 9 years        62 to 78 pounds       400 mg
10 to 11 years      79 to 98 pounds       480 mg
12 to 13 years      99 to 131 pounds      650 mg
14 years or older   132 or more pounds    650- 1,000 mg

Why not use aspirin to lower my child's fever?

Aspirin can cause Reye's syndrome in children who have the flu or the chickenpox. Reye's syndrome is a serious illness that can lead to death. Because it may be hard to tell if your child has one of these infections, it's best not to use aspirin unless your family doctor says it's okay. Acetaminophen is a safer choice to use in children with a fever.

Are there other ways to help my child feel better?

Yes. Here are a few:

* Give your child plenty to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself.

* Keep your child quiet. Moving around can raise the temperature even more.

* Keep the room temperature at about 70' to 74[degrees].

* Dress your child in light cotton pajamas so that body heat can escape.

* If your child is chilled, put on an extra blanket but remove it when the chills stop.

Will a bath help lower my child's fever?

Used together, acetaminophen and a lukewarm bath may help lower a fever. Give the acetaminophen before the bath. If the bath is given alone, your child may start shivering as his or her body tries to raise its temperature again. This may make your child feel worse.

Your doctor may suggest giving your baby a sponge bath after giving acetaminophen if the fever reaches 103[degrees] or if your baby or child has ever had a seizure during a fever. In a few children, seizures can be caused by a fast rise in temperature.

Don't use alcohol for baths because it can be absorbed through the skin. Also, don't use cold water because it can cause shivering.

When should I call the doctor?

A saying doctors use is, "Don't treat the thermometer, treat the child." This means that your child's behavior is more important than the number on the thermometer. You can follow the guidelines below to help decide when to call your doctor, but it's important to call your doctor whenever you feel that your child needs help or if you have any questions.

* Under one month old. Call your family doctor right away if your baby's temperature goes over 100.4[degrees] rectally, even if he or she doesn't seem sick. Your doctor may want to see your baby and may want to put him or her in the hospital to find out what's causing the fever. Babies this young can get very sick very quickly. Also call your doctor if your baby has any of the warning signs listed below, even if he or she isn't running a fever.

* One to three months old. Call your doctor if your baby has a temperature of 101.4[degrees] (even if your baby doesn't seem sick) or a temperature of 100.4[degrees] that has lasted more than 24 hours. Also call if your baby has any of the warning signs listed below.

* Three months to two years old. If your child has a fever of 101.4[degrees], watch how he or she acts. Call the doctor if the fever rises or lasts for more than three days, or if your child has any of the warning signs listed below. If the temperature is 103[degrees], call your doctor even if your child seems to feel fine.

* Over two years old. If your child has a fever of 101.4[degrees], watch how he or she acts. Call the doctor if the fever rises or lasts more than three days, or if your child has any of the warning signs listed below.

Tips on giving medicine

* Don't give more than five doses in one day.

* Don't give a baby younger than four months old any medicine unless your family doctor tells you to.

* Read labels carefully. Acetaminophen comes in different forms: drops, liquid elixir, chewable tablets and caplets. Each form is a different strength.

* Don't replace the drops with elixir because the drops are stronger.

* Fill the dropper to the line when using drops.

* For liquid elixir, use a liquid measuring device to make sure you give the right dose. Get one at your drug store or ask your pharmacist.

Call your doctor if your child has any of these warning signs

Changes in behavior

Constant vomiting

or diarrhea

Dry mouth

Earache or

pulling at ears

Fever comes and goes

over several days

High-pitched crying


Not hungry



Severe headache

Skin rash

Sore or swollen joints

Sore throat

Stiff neck

Stomach pain

Swelling of the soft

spot on the head

Unresponsive or limp

Wheezing or problems



This brochure provides a general overview on this topic and may not apply to everyone. To find out if this brochure applies to you and to get more information on this subject, talk to your family doctor.
COPYRIGHT 1992 American Academy of Family Physicians
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Publication:Pamphlet by: American Academy of Family Physicians
Article Type:Pamphlet
Date:Jan 1, 1992
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