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Davis Square Family Practice
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Deborah Bershel, MD
Michelle Clark, NP
Carmen Phillips, NP
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Barbara Kaplan, LICSW
Christopher Mulvey, NP
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Fever in Children
Please note: I have removed Tylenol (acetaminophen) as a fever reducer as it has been suggested  in a very large worldwide epidemiological study that there is a strong  linear correlation between the development of asthma and how much Tylenol a child gets in the early years of life. It obviously can be used but as ibuprofen did not show this association I am recommending its use preferentially. But, if your child is not complaining it may be wise to leave the fever alone and not treat it with medication.

Fever is an elevation of your child's temperature beyond normal. Normal temperature is orally 98.6 F or 37 C and rectally 99.2 F or 37.3 C. You cannot accurately tell the extent of fever by touch but if you want to get a general sense you should use your wrist and not your hand. Check your child's temperature with a thermometer for an accurate measurement. Fever is a symptom of an illness, most commonly an infection. Fever in babies under six months of age can be an indication of a serious illness and your child's practitioner/doctor should be contacted promptly.

In part, the fever represents your child's immune defenses responding to illness. Consequently, a fever often needs reduction solely for your child's comfort. Fevers themselves usually are not harmful (they don't cause brain damage) .Reducing the fever alone does not eliminate its cause. The cause of the fever must be determined and treated appropriately. However, it may be of value to keep the fever within reasonable limits, particularly if it exceeds 102. F or 38.8 C, if it becomes quite uncomfortable for your child.

A number of simple measures may be taken to help control a fever. You should dress your child lightly to allow the body heat to escape. That's right! It is a misconception to bundle the child to cause the fever to burn out. Keep the room temperature cool. Encourage your child to drink plenty of fluids, particularly cool fluids.

Bathing your child in lukewarm water is more comfortable to the child than sponging or rubbing with alcohol. (Alcohol fumes can be dangerous.) Immerse as much of the body, except the head, in the bath as possible. (Cold water enemas can be dangerous and should not be used.)

You should use ibuprofen--the common aspirin substitute (never use aspirin)--in doses appropriate for your child's weight or age (typically 5-10 mg per 10 kg or 22 lb). These should be used every four times per day if the temperature rises about 102. F (38.8. C) orally, 102.6. F (39.2. C) rectally. These medicines and the above measures only help reduce a fever. Often these do not bring the temperature to normal. These measures do not prevent the temperature from rising again.

You should contact your practitioner/doctor if your child appears severely ill and/or has alarming symptoms other than fever. If the cause of your child's fever is apparent, such as a cold, it is not necessary to call. However, if your child's condition worsens at any time or does not improve within three days, the practitioner/doctor should be contacted. If the fever lasts more than 24 hours without apparent cause you should call us.

From Instructions for Parents, Second Edition, to be published in July 1992, by permission of Sunbelt Medical Publishers, Tallahassee, Florida.

Last screened and modified by Dr. Bershel 1/2010