Fevers, body temperatures of 100.4 or higher, can be scary. Children usually look puny and tired when they have a fever. They don't act like themselves, and often they don't want to eat or drink. Fortunately, fevers themselves are not dangerous. We pay attention to fevers because they are often a sign of an infection. When the immune system detects an infection, it will raise the body's temperature to help it fight the infection better. Don't worry about a fever getting too high or causing brain damage; the body is not going to cause a temperature that will injure itself. How high a fever gets matters less than how your child is doing otherwise. Is she drinking OK and staying hydrated? Is he breathing OK? Is she responding to your appropriately?
If your child is a newborn, unvaccinated or immunocompromised, they are at a higher risk of serious infection and you should call your doctor if they develop a fever. Otherwise, if your child is healthy, up-to-date on their shots, and over 6 months old, you can reduce the fever with acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) and watch them at home for a few days. Most fevers in this group are caused by viruses that have to run their course and do not respond to antibiotics. Call your doctor or seek care right away if your child is having difficulty breathing, dehydrated or not responding to you. Also, if your child develops a purple rash, she should see a doctor as soon as possible.
If a fever lasts for more than a few days, and especially 5 or more days, go ahead and make an appointment with your doctor to get your child checked. Sometimes, fevers are caused by ear infections or other infections that should be treated, such as urinary tract infections. Also, if you know that your child has been exposed to a specific illness such as influenza or strep throat, it is worthwhile getting your checked by your doctor, as these illnesses can be treated. When influenza is going around, try to see your doctor within 1-2 days of the onset of symptoms, as the anti-flu treatment should be started at the beginning of the illness to help the most.
We reduce fevers with acetaminophen or ibuprofen because children often feel much better when the fever goes down. Since these medicine do not treat the infection causing the fever, the fever will often return when these medicines wear off. If you have questions about dosing for acetaminophen or ibuprofen, check with your doctor's office. Dosing for acetaminophen and ibuprofen in children is based on weight, not age.
When your child has a fever, dress him comfortable in light clothing. Do not rub alcohol on him; rubbing alcohol on the skin does not help a fever and can harm your child when applied all over. Also, do not give your child an ice bath or cold bath, which will not help with a fever and will be uncomfortable. You can give your child a lukewarm bath, but this is unnecessary. Make sure that your child is drinking fluids. Offer water, popsicles, juice, broth, milk, or oral rehydration solutions such as Pedialyte. I usually advise against juice, but when your child is sick, it is okay to give her whatever she will drink! Avoid beverages that contain caffeine, which cause your child to urinate more and increase the risk of dehydration.
Remember that these are general guidelines about fevers that apply to healthy children. Always check with your doctor for any specific recommendations for your child, based on his or her health needs!