A fever is an increase in your child's body temperature. With a few exceptions, fever may be a sign of illness. It is also what some people consider a part of the defense system against illness. In any case, a temperature above 100.4° should be considered a fever. Any temperature over 100.4° in an infant under two months of age should be reported to us immediately. A rise in temperature, along with other signs of illness, may indicate a need to have your child examined. In babies, where the signs of illness are not as clearly defined as in children and adults, fever is often the only indication that something is wrong.
Pacifier and Tympanic (ear) thermometers are not always accurate. We prefer digital models.
- Getting ready: Don't give hot or cold liquids before taking an oral temperature. Stay with your child and make sure he or she remains still.
- Taking the temperature rectally (the preferred method, especially in babies). Laying the baby on its back with the legs held together, or laying on its stomach, insert the metal tip of the thermometer with a small amount of lubricant about 3/4 to 1 inch. Don't worry about hurting your baby doing this. Even if he is squirming, you can't perforate the rectum. Be confident otherwise your baby's fussing will make you think that it hurts! Hold the thermometer in place until your digital thermometer beeps.
- Taking the axillary temperature. Either a rectal or oral thermometer may be used, but this method is not consistently reliable.
- Taking an oral temperature. This is not advisable before the age of four. Place the bulb end of an oral thermometer under the tongue. Tell your child to close his or her mouth but not to bite the thermometer. Leave it in place until the digital thermometer beeps.
- Reading the thermometer. Do not add or subtract degrees. The temperature is what the thermometer reads.
- Caring for thermometers. After each use clean the thermometer and wipe. Store the thermometer in its original container.
The main reason for treating a fever is to make your child feel more comfortable. After two months of age, you may use acetaminophen (Tylenol and many generics which are equally effective and much less expensive) on an every four hours basis. Acetaminophen is over-the-counter (non-prescription).
There will be times that we will recommend Ibuprofen (Motrin, Advil and many generics). Ibuprofen is advantageous in several respects: it brings the fever down faster, it lasts longer (it is given every six hours), and it seems to provide stronger pain relief than acetaminophen. While it is technically recommended to be used only for high fevers (greater than 102.4o), it has been our experience that it works very well for the lower temperatures as well. In addition, it does not seem to cause as much stomach upset in children as it often does in adults. Ibuprofen cannot be given until after 6 months of age.
Remember, do not use aspirin in infants or children, unless we specifically prescribe it. Contrary to what some people will tell you, ibuprofen is not aspirin, and as far as we currently know, does not lead to Reye's syndrome.
In infants less than two months of age report any temperature over 100.4° rectally. In infants over two months and less than one year of age, report any temperature over 102.0° rectally.