How to Reduce a Child's Fever
Fever in Children
A fever is defined as a core body temperature above 100.4°F (38°C). Children frequently spike fevers that are quite high, as the body's natural defense against viruses and bacterial infections. While most fevers come down on their own, sometimes it is necessary to reduce a fever for a child's comfort. In some cases, the temperature will become extremely high and should be reduced as soon as possible (in cases where the body temperature is in excess of 105°F, take the child to the emergency room immediately).
Reducing a child's fever may also prevent febrile seizures in children who are prone to them, as some children will respond to a rapid temperature change with a seizure. These seizures are usually benign, but are extremely frightening to parents. By managing a child's body temperature, these seizures may be avoided altogether.
How to Lower a Fever
There are several ways to help lower a child's temperature. Medication (including acetaminophen and ibuprofen) may be used to keep a fever under control. Never use fever reducing medication on a child younger than three months: a fever in a very young infant is an extremely serious event and the child should be evaluated by a medical professional immediately.
Natural methods of reducing fevers include using a tepid sponge bath, undressing the child (or dressing them in light clothes), and giving lots of fluids. Ice pops (such as Popsicles) may help cool a child's temperature and keep them hydrated at the same time.
The ultimate goal is to keep the child's fever below 102°F. If the temperature can be maintained below this level and the child appears fairly alert, the fever can typically be managed at home. If the fever cannot be maintained below 102°F, the child experiences a stiff neck or extreme lethargy, or a rash that does not go away when pressed with a finger, go to the nearest emergency room for evaluation.
Fever Control Medications
The only medications that may be used for controlling fevers in children are ibuprofen and acetaminophen. The appropriate dosing information is located on the medication bottle - follow the instructions carefully and do not give the child more medication than is indicated. Infant formulations of these medications are more concentrated than the "child" formulations - it is important to follow the label directions exactly. If your child's weight or age are not listed on the label, contact your child's doctor to ask about the proper dose.
In general, acetaminophen may be given every four hours and ibuprofen may be given every 6-8 hours. To control a difficult fever, the medications may be alternated. Ibuprofen will control a fever longer than acetaminophen.
Aspirin should never be used in children under the age of 18 years. A condition called Reye's Syndrome may attack a child's liver and brain - this condition is linked to the use of aspirin during a viral illness.
Ice Pops Help Lower Fever
Natural Fever Reducers
Sponge Bath: Place the child in a tub of lukewarm water. Do not fill the tub with cold water, as this will be highly uncomfortable and will create chills. Do not cover the child with wet towels, as this will impede evaporation. This method works by allowing tepid water to evaporate from the child's skin. The evaporation process cools the child in a gentle manner.
Ice Pops: Ice pops, like Popsicles, hydrate the child and may help cool the child internally. This form of fluid may be preferred by a sick child. Some electrolyte replacement solution companies, like Pedialyte, now offer a frozen ice-pop product that may be tolerated better than the liquid version.
Undressing: Dress the child in light clothing. Do not induce chills (if possible) but keep heavy blankets, coats, and thick pajamas away from the child. Use a thin sheet and lightweight pajamas to help keep the child cool.
Natural Fever Reducing Methods
High Fever in Children
If a child's fever spikes about 104°F, he should be taken to the the doctor immediately. If the doctor's office is not open, proceed to the nearest emergency department.
In particular, if a fever cannot be maintained below 102°F with fever reducing medication, a visit to the doctor is in order. If a child has a high fever (above 102°F) with extreme lethargy, a stiff neck, or a rash that doesn't blanch when pressed, take the child to the nearest emergency room immediately. These are signs of meningitis, which is a medical emergency and must be treated with haste.
Baby Fever Chart
Head to the Emergency Room
Call the doctor. Use fever reduction strategies.
>102 with vomiting, stiff neck, or lethargy
Head to the Emergency Room immediately.
Fever with seizure
Fever with seizure
Head to the Emergency Room for the first febrile seizure.
Febrile Seizures in Children
Most common in very young children (3 months - 5 years), febrile seizures occur in up to 5% of all children. When the body temperature changes rapidly, a child may have what is known as a tonic-clonic seizure. This is an extremely frightening time for the parents, and the child is usually rushed to the emergency room.
Children who have had one febrile seizure are more likely to have another. In addition, if one child in the family has febrile seizures, the siblings are at a higher risk of experiencing the same condition.
In general, febrile seizures are benign. The first time a child experiences a seizure with a high temperature, the parents should take the child to the nearest emergency department. The parents should:
- Note the time the seizure started.
- Place the child on his or her side until the seizure is finished.
- Note how long the seizure lasted.
- Call 911 or go to the nearest emergency room.
Most children who experience this phenomenon will "grow out" of the condition by the age of five or six years. A small percentage of children will continue to experience seizures after this time (approximately 2.5% of children who have febrile seizures as young children will develop epilepsy later on).
Types of Thermometers
There are several types of thermometers on the market today. The traditional oral thermometers are usually placed under the tongue. These thermometers are not appropriate for very young children, as they cannot keep the tip of the thermometer in the right location to get an accurate reading.
Many digital thermometers may be used under the tongue or under the armpit. Axillary (under the armpit) measurements are possible with very young children. If a child's temperature is taken under the arm, make sure to inform the child's doctor that it was an axillary measurement. The body temperature reading under a child's arm will be lower than when taken by mouth. All families should have at least one digital thermometer on hand for use with all members of the family.
Most physicians recommend a rectal temperature for infants under the age of three months. If a parent is uncomfortable with this procedure, take the baby in to a doctor's office as soon as possible to have the nursing staff obtain a good measurement. Any fever in a child younger than three months of age needs to be assessed and addressed immediately.
Ear thermometers are generally not accurate for children under the age of six months. If the ear canal is not large enough and pulled into a straight configuration, the reading will be inaccurate. Earwax will also interfere with this type of thermometer. It is best to use an alternative type of thermometer (under the arm or a temporal thermometer) in very young babies.
Temporal thermometers measure the heat in the temporal artery in the forehead. These thermometers are an excellent option for monitoring a child's temperature in the middle of the night. Be sure to follow the directions exactly to get an accurate reading. If any reading is in doubt, confirm with a digital thermometer under the arm.
Another type of thermometer is a pacifier thermometer. These wonderful little devices have been proven accurate for very young babies and offer a great alternative to monitoring a little one's temperature.
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