09/22/2023
Fevers - Frequently Asked Questions
By Jackie Schwarz, DO
Heading into the cold and Flu season and with COVID-19 cases on the rise, here are some reminders about fevers:
WHAT IS A FEVER: 100.4 °F or above (re**al or oral most accurate)
If your child is less than 12 weeks old and has a fever call our office immediately. If your child is less than 8 weeks old we may direct you to a pediatric ER for further testing and possible hospitalization due to your baby’s young age.
If your child has a fever > 105°F call the office immediately.
Children can have a normal variation in their temperatures up to 99-100. This is not a fever. Some kids when teething will have a fever in the 100’s.
Armpit, Ear and Forehead/temporal artery thermometers can vary by multiple degrees from the true core temperature, so the best method of measuring temperatures is re**ally for kids less than 2 years old and in their mouth (orally) for kids above 2 years old.
A fever is the normal body response to infection or inflammation.
A FEVER IS A GOOD THING! Viruses and bacteria are more likely to die and less able to replicate at higher temperatures. A fever is not dangerous in and of itself.
Do I HAVE to give a fever reducer? No!
Is there a specific fever number to give a fever reducer? No!
Fevers can make kids uncomfortable and decrease their appetite. For these reasons we may decide to treat fevers with fever reducers like Acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin). If your child has a fever and is otherwise active, eating, and not uncomfortable YOU DO NOT HAVE TO TREAT THE FEVER AT ALL.
When is a fever dangerous? Research has shown that temperatures > 108 degrees can cause brain damage. Below that a fever is not harmful to our bodies and can be helpful.
Shouldn’t Tylenol or Advil make my child’s fever go away? Not necessarily. Their fever will go away when they are done fighting off an infection.
Tylenol and Advil are fever reducers and are meant to lower your child’s fever. It may go down, but not to a completely normal level. It may only go down 1-2 degrees. This is OK - if the temperature goes down it means the medicine is working.
It’s always worth double checking the dosage of medicine to make sure you are giving the correct amount. Weight based dosing information can be easily found on APL’s website (see link below). The fever will go away when your child’s body is done fighting off the virus. In general fevers with most viral illnesses last 3-4 days.
Can I alternate fever reducer medications? Technically yes, but in general we recommend picking one medication and sticking with it if it is working. To prevent dehydration and keep kids comfortable (for example with Hand Foot Mouth virus) or for children with a history of febrile seizures, sometimes we do alternate Tylenol and Advil every 3 hours. Please be cautious if alternating medications and do not overdose your child.
When should I come in to the office? If your child has a fever for 3 or more days (72 hours or more), they should come in to be seen to make sure a bacterial infection is not causing the fever, which may need antibiotic treatment. Examples of this would be strep throat, an ear infection or urinary tract infection. Please call when our office is open for a same day sick appointment.
Can I give fever reducers with other medications? Yes, it is ok to give fever reducers to keep your child comfortable while they are on antibiotics. You can also give fever reducers while taking Benadryl and allergy medications.
Bottom Line: When Should I worry?
How your child looks is the most telling sign of the seriousness of the infection. You as the parent know your child best. If your child is lethargic (limp and weak), not drinking, having difficulty breathing, or any other concerning symptoms it doesn’t matter how high their temperature is - please call our office to decide if they need to be evaluated in the Emergency Room.
If your child has a 105 fever coming down with fever reducers, call the office during business hours for an appointment within 24 hours.
If your child has fevers for 3 or more days (over 72 hours) they should be seen by a physician. Please call our office during business hours for an appointment.
How to treat a Fever:
Lighter layers, less blankets at night
Lukewarm bath
Tylenol (Acetaminophen) or Motrin (Advil/Ibuprofen) – for APL dosing charts:https://arlingtonpediatrics.com/files/2021/02/Padded-Well-Visit-Handout-Front-Page.pdf
More resources:
https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-Without-Fear.aspx
