Blue Fish Pediatrics
Fax: (713) 467-0536
Medical Plaza 3
915 Gessner, Suite 760
Houston, TX 77024
Health Topics : Fever
1. First and foremost, remember that a fever itself is not dangerous. It is simply a sign that your child has an infection. Do not be afraid of the height of a fever. We commonly see children with 104-105 fevers.2. ALWAYS accurately record temperatures with a thermometer. For kids younger than one year the best place to check is in the rectum. For kids older than one, refer to the thermometer article attached to this handout. When measuring a temperature, we recommend not adding or subtracting a degree, but reporting it as shown by the thermometer. Other information that can be helpful include: serially measured temperatures, when they were taken, where they were measured, and when the last time a fever reducing medication was given. A simple chart documenting these items can be very helpful. Fever is defined as any temperature >100.4 degrees F.
Taking a Rectal Temperature
3. If febrile, a lukewarm sponge bath for 15-30 minutes may be soothing (26-28 degrees Celsius or 78.8-82.4 degrees Fahrenheit is optimal). Repeat this every 2 hours, as needed.
4. NEVER use aspirin in children as it is associated with a dangerous condition known as Reye’s Syndrome.
5. For children younger than 6 months, only use Tylenol (also known as acetaminophen) as Ibuprofen is not as safe in children younger than 6 months.
6. For children older than 6 months, Ibuprofen (name brands include Motrin/Advil, but any brand of ibuprofen is fine) generally works better to keep the fever down. If you are using a single medication, you can give Ibuprofen every 6 hours as needed or you can also use Tylenol every 6 hours. If you desire greater fever control, you can choose to use both medications staggering Tylenol and Ibuprofen. However, you should then give each medication every 8 hours rather than every 6 hours. For example: Give Ibuprofen at 12:00, then Tylenol at 4:00, then Ibuprofen at 8:00, then Tylenol at 12:00, and so forth. Although you can stagger the medications as detailed, it is safest to use a single medication whenever possible.
7. Remember that it takes about 30-45 minutes for the medications to start working. Sometimes, even if you give your child medication, a fever may not immediately drop (even after 30-45 minutes). With time however, most fevers will break (often sooner than later).
Infant’s Tylenol Drops 80mg/.8ml DOSE_______________________every 6hrsChildren’s Tylenol 160mg/5ml (The dose should = 15mg/kg or 7mg/lb)
Infant’s Motrin Drops 50mg/1.25ml DOSE_______________________every 6hrs
Children’s Motrin 100mg/5ml (The dose should = 10mg/kg or 4.5mg/lb)
8. If the fever is not improving or your child is becoming sicker or the fever lasts >2 days, please call us or make an appointment a.s.a.p.
Consumer Reports October 2005 Oral thermometers are tops for temps
Flu season is on the way, as is a “burning” question for coughers and sneezers: Which type of fever thermometer is best? We asked 24 adults and 21 children ages 5 to 14 to test eight oral, ear, and forehead thermometers and found:
* The oral ones proved best overall.
* Price and performance don’t correlate. The best cost less than $15. A $40 children’s ear thermometer was only fair.
* Simple as thermometers are, some have bells and whistles--beeps that tell you when they’re in the right spot or when they’re finished, or soft or curved tips--that can add to convenience.
We based our Ratings primarily on precision, or how widely the thermometers’ results varied from those of our control, the Geratherm Mercury-free Oral thermometer, whose accuracy we verified.
The bottom line. A digital oral thermometer is the best choice for an adult or a child. The best in our tests was the BD Digital Accu-Beep, $10, which beeps when it’s properly located under the tongue. Its only disadvantage is that it takes about a minute to provide a readout. Very good choices that deliver the temperature in less than 30 seconds are Vicks Comfort-Flex, which has a soft tip, and Omron 20 Seconds Digital. Both cost $13.
The top three have a signal to indicate when they’re done and a lifetime warranty. They can be used to take temperatures rectally and under the arm as well as orally. Rectal temperatures are generally considered most accurate for young children. Oral temperatures tend to be as much as 1° F lower than rectal.
The Vicks V920 oral (the only disposable thermometer we tested), $5 for 10, and the Timex oral (the only one that announces its results by speaking), $18, are other very good choices.
Ear thermometers work in just one second but were more expensive and less precise than oral thermometers, perhaps because proper alignment in the ear canal can be tricky. With the forehead thermometer we tested, the Exergen, you press a button as you slide the probe across the forehead, then release the button and read the temperature. It cost $50, wasn’t especially precise, and broke when we dropped it (no others did).
download this information here as a PDF
download FEVER CHART here as a PDF
Fever: Suppository Use
Use Feverall Suppositories in a child who is unable to take Acetaminophen (Tylenol) or Ibuprofen (Motrin/Advil) as a result of vomiting.
Age | Infant’s 80mg | Children’s 120mg | Jr. Strength 325mg |
Under 3 months | ½ Suppository every 6 hours |
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3-11 months | 1 Suppository every 6 hours |
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12-36 months | 1 Suppository every 4 hours |
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3-6 years |
| 1 Suppository every 4-6 hours |
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6-12 years |
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| 1 Suppository every 4-6 hours |
| No more than 6 suppositories in any 24 hour period | No more than 6 suppositories in any 24 hour period | No more than 6 suppositories in any 24 hour period |
How to use Feverall:
1. Gently clean the area around the buttocks with a warm, wet towel.
2. Detach one suppository from the strip.
3. Remove wrapper before inserting suppository by holding suppository upright and carefully peeling wrapper evenly down both sides of the suppository. Avoid excess handling as the suppository is designed to melt at body temperatures. Suppositories should not need to be refrigerated if stored at temperatures below 80 degrees F (27 degrees C).
4. Position the child flat on their back or on one side, with anal opening exposed.
5. Gently insert the suppository well into the rectum. Use fingertip to complete insertion.
If necessary, hold the buttocks together for 30-60 seconds to keep the suppository in place.
download this information here as a PDF
Revised 3.23.09
Disclaimer: These guidelines are to help the caretaker with treatment at home. However, if you are ever concerned about your child’s health, you should see a physician in person.
