My child has a fever, what should I do?

Your 3 year old wakes you up at 3 am. He is crying, I'm sick. Big tears are rolling down his face, he feels hot. you check his temperature, it is 104 degrees fahrenheit. Or, another scenario, your 6 week old has a little cough, she feels warm. You check her temperature and it is 100.4 degrees farenheit. No matter the age of your child, or the number of children you have, at some point every parent is going to have a sick child with a fever. So, what do you do? Should you give tylenol or motrin? Should you go to the doctor? Should you go to the ER? How high does a fever need to be before it is too high? What about febrile seizures?

To start, we will discuss some very general age guidelines. If your child is under 2 months of age and has a temperature of 100.4 or higher, you should go to the ER, and bring extra clothes, formula, diapers, etc. You are likely looking at a hospital stay. If your child is between 2 and 3 months of age, you should call your pediatrician if they have a fever. Some pediatricians will see them in the office, others will send them to the ER. The bulk of this article will focus on children who are over 3 months old. Why? Once your child has developed a little bit better immunity there are more things you can do for your child at home if a fever develops.

Is it ok to give my child medicine for a fever? Yes, if your child has no allergies, or known conditions to prevent you from doing so. An infant under 6 months of age should not be given ibuprofen. The other names for ibuprofen are advil and motrin. Tylenol (also called acetominophen) can be used at any age, and can be given every 4 hours as needed. In children all medication doses are based on weight. So, I will give you the appropriate dosing information in the manner that healthcare professionals calculate them. That being said, I expect the majority of you will opt for the simpler route that I am going to suggest. The easiest way to know the appropriate amount of medication to give your child is to ask your pediatrician at each visit, or to follow the bottle directions. If, however, you want to make sure you are giving as much as is safe then you can follow this. Acetominophen is typically dosed at 15 mg/kg. It can be given every 4 hours. Ibuprofen is dosed at 10mg/kg. It can be given every 6hours, again not to children under 6 months. I will not go step by step through the calculations here, because I believe the majority reading will not find it necessary.

Can other medications be given with fever medications? Can they be given together? The answer to both questions is yes. You should however be cautious that you are not giving two medicines that contain acetominophen or two medications that contain ibuprofen. That is a common way to accidentally overdose your child.

I've heard that if fever gets to high it causes brain damage, is that true? Fever, does not in and of itself cause brain damge. However, there are diseases like meningitis that can cause brain damage and also cause fever. Febrile seizures are relatively common in children. They typically occur when the fever shoots up suddenly, rather than when fever reaches a certain temperature. If your child has a febrile seizure it can be very scary. In this situation you should lay them on their side and make sure they are not near anything that they might hurt themselves on. You should also watch them to make sure that they are still breathing during the seizure. Make note of the time that is started, and the time that it stops. If you are near a phone, you can call 911. If it is determined that your child had a febrile seizure there is a very good chance you will return home again in a few hours.

At any age, if your child is having difficulty breathing you should be seen by a doctor. If your child is not drinking well and has not urinated for 6 hours your child should also be seen. Beyond that, you know your child. A fever with no other symptoms can usually be treated well at home. However, as with any medical advice, if you are ever concerned or have questions please call your doctor.