My child has a fever. What should I do?

By Erin Dobie, CNP

Fever is one of the most common reasons parents seek medical attention for their child or infant. All kids get fevers at some point. Studies reveal parents are most worried about fevers due to the fear that they can cause brain damage or even death. But, there is no evidence to support these concerns.

As a nurse practitioner in the Emergency Department at Children’s Hospitals and Clinics of Minnesota, I frequently see kids with fevers. The questions from parents are usually the same. I wanted to answer some of those questions here.

What is a fever? Fever is defined as a body temperature greater than 100.4°F (38°C). It is part of the body’s natural defense mechanism and a normal body response to fight infection. Fevers help the body fight infections by stimulating the immune system. Fevers slow the growth and reproduction of the virus or bacteria. They also increase production of antibacterial substances in the immune system.

Should I treat a fever? Otherwise healthy children and infants (3 months and older), whose temperature is between 100.4 and 102°F (38.0-38.9°C), do not require any medication to reduce the fever unless the child is uncomfortable. Consider how your child is acting before treating with medication. Is he/she still playful? Drinking and urinating? These lower grade fevers help the body fight off illness. Fevers greater than 102°F do not always indicate a more serious illness. Does your child have other specific symptoms or complaints that are concerning or need medical attention? It’s important to remember to treat the child, not the fever.

When should I call my child’s health care clinician? You should call your child’s physician or nurse practitioner if your child is:

    • younger than 3 months old with a rectal temperature of 100.4°F or higher
    • crying and can’t be consoled or extremely irritable
    • somewhat difficult to wake up
    • refusing to drink fluids
    • experiencing painful urination
    • not vaccinated

If your gut tells you something wrong or if your child has a chronic condition, then you should also call.

When should I call 911? Pick up the phone if your child has:

    • trouble breathing
    • purple spots on skin
    • extreme difficulty waking up

Which medication should I use to treat my child with a fever? Acetaminophen (Tylenol) and Ibuprofen (Motrin or Advil) are two fever-reducing medications recommended for children and infants. Do not give Ibuprofen to infants younger than 6 months. Do not give Aspirin to children of any age. Be aware that many other over-the-counter medications often contain acetaminophen. Therefore, please read the labels carefully to reduce the risk of overdosing your child. Medication dosages are unique for children based on your child’s weight.  See Fever Dosage Charts for more information.

Remember, treating the fever with these medications doesn’t treat the illness causing the fever so when the medications wear off, the fever will most likely return until the body is done fighting off the illness.

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