Children and Fever : What to Do When the Heat Is On

Our six-year-old, Katelynn, came to me yesterday evening with the family thermometer sticking out of her mouth. “I think I’m sick,” she mumbled around the probe. And, indeed, the thermometer’s alarm was sounding, its tiny digital screen blinking 101.5°F.
Houston, we have a fever.

What is a Fever in Children?

According to my pediatrician, when taken orally (in the mouth), a body temperature at or above 100°F (37.8°C) is considered a fever. A temperature like Katelynn’s, between 100°F to 102°F (37.8°C to 39°C) in children, is considered a low-grade fever. Fevers in that range are actually beneficial to fighting infection. As a matter of fact, most of the time a fever is a positive sign that a child’s protective mechanisms are working their magic. So, when possible, I try not to panic at the number I see on the screen. (Exceptions here. Scroll down about halfway.)

Fever Treatment

In my eighteen years as the mother of four children (not to mention my thirteen years as a registered nurse), I’ve handled my fair share of fevers. How I deal with the fever mostly depends on how my child is acting. As a rule, I typically start with non-pharmaceutical options.

Home Remedies for Fevers

1. Cold compresses — placed to the forehead, armpits, and/or back of the neck, they usually feel pretty good after the child gets past the initial shock of having a cold, wet washrag dropped on their sizzling skin.
2. Lukewarm bath — a soak with Mr. Bubble may offer some relief. Tub water should be a bit cooler than what is normally comfortable, but never, ever cold.
3. Light layers of clothing and bedding — it can be tempting to bundle up a little one who has the chills, but I try to remember that doing so will likely only increase the fever, which is the opposite of my goal.
4. Lots of fluids — blue popsicles seems to have particularly magical fever-reducing powers.
5. Distraction via movie-watching — Monsters, Inc., Nanny McPhee, and The Princess Bride are faves around here.
6. Rest — if possible, restrict activities to those which can be performed on a mattress in a semi-reclined position (see Distraction).

If I’ve tried a combination of home remedies and the fever simply isn’t abating, and my child is feeling miserable, I progress treatment to include pharmaceutical relief.

Medicine for Fever

• Acetaminophen (Tylenol) — usually works within 20-30 minutes, but only lasts a few hours (can be given every 4-6 hours).
• Ibuprofen (Motrin, Advil) — sometimes takes up to 45 minutes to work, but lasts several hours (can be given every 6-8 hours).
• Important Note #1: DOSE BY WEIGHT, not by age.
• Important Note #2: Your pediatrician may advise you to alternate Tylenol and Motrin. This can be very effective, so call your child’s doctor for specific instructions.
• Important Note #3: If you aren’t averse to the insertion method, Tylenol suppositories can be a lifesaver when your child has a fever with nausea and vomiting, or at night, when he or she is spiking 103°F, but isn’t really cognizant enough to perform actual chewing and swallowing.

It’s been about twenty hours and, fortunately for Katelynn (and me), we have been able to control her temperature and misery with a combination of the above Home Remedies and one dose of acetaminophen. Right now she’s holding steady at 99.9°F, and seems to be feeling worlds better, as evidenced by her refusal to adhere to the Rest portion of my treatment.