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Management of Fever in Children

Fever is a rise in body temperature above the body's normal set point. Normal body temperature is between 97° -99.5° F. However, most doctors consider a temperature of 100.4° F or above as a sign of fever.

What causes a fever?

There are two primary causes for a child to have a rise in temperature - fever and hyperthermia. Fever generally occurs in response to an infection. Hyperthermia, or overheating, can be caused by strenuous exercise or environmental exposure.

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The hypothalamus is in charge of regulating your body's temperature. It determines what your normal body temperature should be. During an infection your hypothalamus receives signals to actually change its normal set point. This is why traditional cooling efforts are ineffective.

In contrast, hyperthermia due to heat exposure is an emergency situation and would be treated differently than a fever.

Treatment of fever

Fever is a very normal response to infection. In general, medication is given primarily to help the child feel better. Contrary to what you may have been taught, how high your child's fever is and how it responds to medication is not a good indicator of the severity of the illness.

Fever can be treated with the use of medications such as Children's Tylenol or Children's Motrin. It is imperative for you to read the dosage instructions carefully and the time interval required between doses. Many forms of Tylenol and Children's Motrin are available and dosages vary accordingly. Some doctors recommend rotating between Children's Motrin and Children's Tylenol. Consult you doctor for any specific medication instructions.

Fever should not be treated with cold baths or alcohol baths. Both can be dangerous and are ineffective in reducing fever. Cooling efforts such as wearing light clothing and reducing air temperature may help provide comfort. These will however be more effective if used after medication is given.

Treatment of hyperthermia

If your child has been exposed to extreme temperatures such as would occur from being left in a hot car or very strenuous exercise, this is an emergency. Your doctor should be called promptly or your child should be taken to an emergency room and an ambulance called if necessary.

When should I call my doctor?

Call your doctor immediately if:

  • Your child is younger than 3 months
  • Your child has a fever above 105°F
  • Your child looks or acts extremely ill
  • Your child has had a seizure

Call your doctor within 24 hours if:

  • Your child is 3-6 months old
  • Your child has a fever between 104° - 105°F
  • Your child has had a fever for more than 24 hours without an apparent cause
  • Your child has had a fever for more than 3 days
  • Your child has accompanying symptoms that may indicate a bacterial infection such as earache, stiff neck, headache, or sore throat

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