Special thanks to our friends at Mercy Iowa City for sharing their stories, advice, and medical knowledge with us. Today’s story comes from Tori, who is a provider at their office.
Fevers in Children: “I’ve got chills…they’re multiplying!”
Fevers are one of the topics I find myself spending a lot of time discussing in the office. They can be worrisome for parents and can make our little ones feel absolutely miserable. Given that this cold/flu season seems to be dragging on, and Mother Nature has teased us with Spring only to decide she’s not done with Winter yet, I thought this would be a good time to address all of these questions.
In this post we’ll help you understand your child’s fever, then we will discuss when and how to act on fevers.
When is my child’s temperature considered a fever?
Whether or not your child’s temperature is considered a “fever” depends on his or her age.
For babies younger than 2 months of age, a “fever” is a temperature above 100.4F.
Why so low? Babies haven’t created their own immune system yet and are dependent on Mom’s transplacental antibodies as well as the antibodies she provides in her breastmilk. So, if your baby’s temperature rises above 100.4F, we recommend immediate care in the office or at the Urgent Care/ER.
For children older than 2 months of age a “fever” is a temperature above 101.4F.
After 2 months of age, we are more relaxed about fevers and often tell families that it is okay to give a dose of Tylenol to suffering little ones. They can typically be seen by their pediatrician in the next day or two depending on symptoms.
Why do fevers make my little one feel so miserable?
A fever is the result of the immune system hard at work. It secretes chemicals in response to a virus or bacteria that tells your brain to raise the temperature. When your body temperature rises, the viruses and bacteria can’t replicate as quickly and are destroyed. However, these same chemicals that are trying to help can also make you feel crummy with increased fatigue, headaches, sensitivity to touch, chills, and more.
When can I give my child medicine for a fever?
In general, it’s okay to give a dose of these medicines when your little one is feeling the effects of a fever. A dose of Tylenol/Motrin will bring down the temperature and will also make your child feel much better, which makes it much easier to get pedialyte, gatorade, soup, water or anything else past those vice-like, pouty lips! Again, if your child is less than 2 months old with a temperature above 100.4, you need to call your doctor immediately. Do not give Tylenol, do not pass go, do not collect $200.
Tylenol (acetaminophen) or Motrin (ibuprofen) for fevers?
For fevers, both Tylenol and Motrin are equal options and it often comes down to personal preference of the child and family. Motrin helps more with inflammation, so if you’re treating something like teething, where the pain is caused by the inflammation of the gums, Motrin may be your best bet. Most often I tell my parents if they think their child needs both, then giving both together every 6 hours causes the least amount of confusion while giving the most benefit. Giving Tylenol and Motrin together may seem like a lot, however, they work in completely different ways so this is absolutely safe.
How much Tylenol/Motrin should I give for fevers?
Tylenol can be given to infants older than 2 months every 4 to 6 hours, as needed. Tylenol has infants’ and children’s formulations but they are truly the same concentration no matter which formulation you get, so the dose will remain the same between the two. Follow dosing instructions on the bottle or ask your pediatrician for a weight-based dose for your child.
Motrin can be given to children older than 6 months every 6 hours as needed. Motrin has infants’ and children’s formulations that are DIFFERENT concentrations, so be sure to let your doctor know which one you are using so we can give you the appropriate dose recommendation for your child’s weight.
When should I be worried about a fever?
High fevers can be scary! Our treatment plan isn’t just focused on the temperature, but whether or not the child is behaving normally. If your child has a temperature of 102.5F but is still running, playing and laughing, we are likely to treat that differently than when they have a temperature of 101.9F and are lethargic.
As providers, we understand it’s very difficult as a parent to know where your child is on this spectrum. The good news is that we are always here! Not only are we on-call at night for these types of questions, but we expect them! Never hesitate to reach out to your pediatrician when you are unsure about your child.
I hope this has been helpful to you and please let me know in the comments if there are any topics you would like to hear about in the coming months 🙂
Tori Logan, D.O., FAAP
Dr. Logan received her education at A.T. Still University of Health Sciences, completed her residency at the University of Illinois College of Medicine, and is certified by the American Board of Pediatrics.
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