Fever – Making Your Child Comfortable

While most fevers don’t require a call to me, there are certain circumstances when a fever could indicate something more serious.

Call me immediately if your child has a fever and:

Looks very ill, is unusually drowsy or is very fussy
Has been in an extremely hot place, such as an overheated car
Has additional symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea
Has a condition that suppresses immune responses, such as sickle-cell disease or cancer or is taking steroids
Has had a seizure
Is younger than 2 months of age and has a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher

A child older than 6 months of age who has a temperature below 101 degrees Fahrenheit (38.3 degrees Celsius) probably does not need to be treated for fever, unless the child is uncomfortable. Observe his behavior. If he is eating and sleeping well and is able to play, you may wait to see if the fever improves by itself.

In the meantime:

Keep his room comfortably cool
Make sure that he is dressed in light clothing
Encourage him to drink fluids such as water, diluted fruit juices, or a commercially prepared oral electrolyte solution
Be sure that he does not overexert himself
There are also medications you can give your child to reduce her temperature if she is uncomfortable. Both acetaminophen and ibuprofen are safe and effective in proper doses. Be sure to follow the correct dosage and medication schedule for your child. Remember, any medication can be dangerous if you give your child too much.

Ibuprofen should only be used for children older than 6 months of age. It should not be given to children who are vomiting constantly or are dehydrated. Do not use aspirin to treat your child’s fever. Aspirin has been linked with side effects such as an upset stomach, intestinal bleeding and, most seriously, Reye syndrome.

If your child is vomiting and unable to take medication by mouth, I may recommend a rectal suppository for your child. Acetaminophen suppositories can be effective in reducing fever in a vomiting child.

Read the label on all medications to make sure that your child receives the right dose for her age and weight. To be safe, talk to me before giving your child any medication to treat fever if she is younger than 2 years of age.

An alternative to over-the-counter medications is to sponge your child with lukewarm water. Sponging may reduce your child’s temperature as water evaporates from her skin. I can advise you on this method.

I might recommend that you try sponging your child with lukewarm water in cases such as the following:

Your child’s temperature is above 104 degrees Fahrenheit (40 degrees Celsius)
She is vomiting and unable to take medication
She has had a febrile seizure in the past
Do not use cold water to sponge your child, as this could cause shivering. That could increase her temperature. Never add alcohol to the water. Alcohol can be absorbed into the skin or inhaled, causing serious problems such as a coma.

Usually 5 to 10 minutes in the tub is enough time for a child’s temperature to start dropping. If your child becomes upset during the sponging, simply let her play in the water. If she is still bothered by the bath, it is better to remove her even if she has not been in long enough to reduce her temperature. Also remove her from the bath if she continues to shiver because shivering may increase body temperature.

Do not try to reduce your child’s temperature to normal too quickly. This could cause the temperature to rebound higher.

Be sure to call me if your child still “acts sick” once the fever is brought down, or if you feel that your child is very sick. Also call if the fever persists for