FEVER: A FRIEND OR FOE ? When a child has a fever, it’s usually an indication that he has some kind of infection. The fever can often seem dramatic without actually being serious;
the height of fever is not an indication of the severity of the illness, and wide swings in temperature don’t necessarily indicate either a worsening or an
improvement in your child’s illness. It’s natural for a youngster’s fever to be lower in the morning and higher in the evening.
A normal temperature in a small child is usually below 100.0 degrees F. The
best and most accurate way to take a temperature is with a digital rectal thermometer, and it’s the only accurate way to take a temperature in a baby
or infant. If your child has a fever, it’s important to give plenty of fluids and rest. If your child has a fever but you made plans to do something, cancel your plans and stay home. Give plenty of fluids, and you can start your child on
ACETAMINOPHEN (Tylenol), every 4 hours. If the fever is above 102.6 degrees, switch to IBUPROFEN (motrin, or advil); you don’t have to wait
before giving Motrin if you’re switching. (Please see the dosing charts below) If your child is under 2 months of age, or looks particularly ill even after
giving fever medicine, call the office or doctor. ACETAMINOPHEN (TYLENOL)* DOSING
may be given every 4 hours as needed. do not exceed 5 doses in a 24 hour period
the factor that best determines the correct dose of medication for your child is his or her weight
WEIGHT OR AGE
*FOR FEVER GREATER THEN 100.4 IN AN INFANT < 3 MONTHS, CONTACT YOUR PHYSICIAN FIRST. IBUPROFEN (MOTRIN OR ADVIL)* DOSING
may be given every 6 hours as needed. do not exceed 4 doses in a 24 hour period
WEIGHT OR AGE
* IBUPROFEN SHOULD NOT BE USED IN CHILDREN
UNDER THE AGE OF 6 MONTH
**REMEMBER: IBUPROFEN CHEWABLE TABS COME IN TWO DIFFERENT STRENGTH (50MG AND 100MG)
We have found that generic version of these medications are as effective as the brand version and may save you money. We encourage
NOTE: Medications may come in different size bottles with different size droppers. Please make sure you read the dropper/medication
dispenser carefully to ensure the correct dosage for your child. If in doubt, please call the office.
When to call the doctor if your child has a fever
Please note that the following are guidelines only. Your child's general appearance and
the way he or she is acting are usually more important indicators of illness than the
height of the fever. You should always call if your child looks or acts significantly ill for
any period of time or if you are concerned about worsening health
Call immediately if:
Your child looks or acts very ill for any period of time. You think your child has had a seizure. Your child is less than two months old and has a temperature greater than
Your child is over two months and less than twoyears old, and the fever is over
102ºF and he or she is not acting well.
Your child is over two years old, feverish, and does not look well, and does not
perk up significantly after an appropriate dose of fever medicine.
Your child is crying inconsolably. Your child cries if you touch him or move him. Your child is difficult to awaken. Your child complains of a stiff neck and cannot touch the chin to the chest
Purple spots are present on the skin, and these do not blanch (whiten) when
Breathing is labored and no better after the nasal passages are cleared. Your child is unable to swallow anything and is drooling saliva. Your baby's fontanelle ("soft spot") is bulging when he or she is sitting up
There is redness or swelling around the eye or pain with eye movements. There is redness, tenderness, or swelling over an arm or leg. Your child walks with a limp or refuses to move a leg joint. Your child has a compromised immune system (e.g., the spleen has been
removed, the child is undergoing chemotherapy or is HIV-positive) or sickle cell anemia.
You have any other concerns
about fever that make you feel an immediate call
Call withing 24 hours if:
Your child suffers from a burning sensation or pain during urination. Your child complains of ear pain. Your child complains of sore throat and any of the following: swollen glands,
headache, abdominal pain, rash, or joint pain.
Your child voids dark urine 3 or 4 weeks after a sore throat. Your child's fever lasts more than 48 hours without any obvious cause or
Call during regular office hours if:
Your child's fever is greater than 101.5ºF for more than 72 hours The fever has been normal for 24 hours and then returned. Your child has a history of seizures with fever, and you wish to review fever
You have other concerns or questions regarding fever.
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Mitchell RKL Lie, C Janneke van der Woude Department of Gastroenterology, Erasmus University Hospital, Rotterdam, the NetherlandsDisclosure: No potential conflict of interest. Citation: EMJ Gastroenterol. 2013;1:82-91. Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticoster