CALL YOUR DOCTOR IMMEDIATELY IF ANY ONE OF THE FOLLOWING EXISTS:
- Your child is less than 3-months-old and the temperature is over 100.5 in their bottom (if you are unsure of how to take a rectal temperature, please contact your doctor's office).
- Your child is very fussy, will not stop crying.
- Your child's fever is over 105.0 in their bottom. If taking the temperature in the ear with an ear thermometer, recheck the temperature in the mouth under the tongue, or under the arm if over 2 years old.
- Your child can't move their neck up or down or side to side, like shaking their head "yes" and "no." If your child is younger and unable to respond to commands, please call their name and have them turn to look at you when responding.
- Your child has deep red or purple spots that look like bruises that could be a rash.
- Any trouble breathing other than their nose being stuffy.
- Your child is hard to wake up, acts confused, not walking, talking, or playing as well as normal.
- Your child has been bitten by a tick within the past two weeks.
- Your child has sickle cell disease and the temperature is over 100.5 by mouth or under their arm. DO NOT TAKE RECTAL TEMPERATURES ON CHILDREN WITH SICKLE CELL DISEASE.
- Your child has a problem with their immune system, such as cancer, HIV, anemia, or has had their spleen taken out.
CALL YOUR DOCTOR'S OFFICE FOR AN APPOINTMENT THE FOLLOWING DAY IF ANY ONE OF THE FOLLOWING EXISTS:
- Your child is from 3 to 6 months old and has a fever. A fever in a child is defined as a temperature taken in the bottom reading greater than 100.4, temperature greater than 99.5 taken in the mouth under the tongue, or a temperature of 99.0 if taken under the arm. Rectal temperatures are the most accurate method of checking to see if your child has a fever.
- Your child has had a fever for more than three days.
- Your child had a fever that went away for more than 24 hours then came back.
- Your child has any other symptoms, such as a runny nose or cough, pain when they urinate, ear pain, or a cut or scratch that looks red, is painful when you touch it, and is draining pus.
- Your child probably has a virus. There is no medicine to treat viruses, and they usually last two or three days. Fever means the body is fighting off an infection. How high the fever is does not mean how sick your child is. The fever is not dangerous for your child until it is 106 degrees or higher. How sick your child looks and acts is more important than what the temperature is.
- Make sure your child is drinking plenty of fluids, including juice, milk, water, and popsicles.
- Don't overdress your child. Putting heavy clothes and blankets on the child can hold the heat in the body and make the temperature go up. Use a light blanket if your child is cold or having chills.
- Fever reducing medicines such as Tylenol and Motrin aren't necessary unless the fever is over 102.0 and/or your child is uncomfortable. They won't bring the temperature back to normal, but they should bring the temperature down and make your child feel better.
- For children who are 3 months or older, Tylenol can be given every 4 -6 hours. The dose is based on the child's weight. You may not give Tylenol to a child under 3 months old.
- For children who are 6 months or older, Ibuprofen can be given every 6-8 hours. The dose is based on the child's weight. You cannot give Motrin to a child under 6 months old.
- Never give your child aspirin until they are in their late teens.
- If your child's fever has been over 102.0 for more than 24 hours and giving one fever medicine is not controlling the temperature, you can alternate Tylenol and Motrin every three hours. For example, if you gave Tylenol at 12 pm, you can give Motrin at 3 pm, and Tylenol again at 6 pm. This can be done for 24 hours only. Please make sure your child's temperature if more than 102.0 when alternating medicines.
- If your child is still uncomfortable or still has a temperature of more than 104.0 one hour after giving Tylenol or Motrin, you can sponge your child off with water or put him in a lukewarm bath with the water temperature from 85-90 degrees. Always give the fever medicine before sponging, or the fever will come back quickly. You can sponge your child for periods of 15 to 20 minutes as often as needed. Don't expect to get the temperature back to normal. Be sure not to use water that is too cool, this will make the child shiver and make the temperature go up. If your child begins to shiver, stop bathing, make the water warmer or stop sponging and use a cool washcloth on the forehead instead. If the child screams or fights about the sponging or bathing, stop because this can raise the temperature also. Never add alcohol to the bath water or sponge the child with alcohol, it is dangerous for the child to breath in the fumes.
CALL BACK IF
- Your child's fever goes above 105.0 degrees in their bottom, or over 104.0 under the arm, and over 104.5 by mouth under the tongue.
- If your child has any problems breathing, such as gasping for breath or their mouth is turning blue or purple.
- If your child seems to be getting worse.
- If you have any other questions or concerns.
- Behman, R., M.D., Kilegman, R., M.D., Nelson Essentials of Pediatrics, pg. 776, W. B. Saunders, 1998