What to Do If Your Child Has a High Fever

 

If your child is struggling with a fever, it’s important to remember that what they’re experiencing is a very normal response to illness. When your child is exposed to a germ, their immune system initiates a complex immune response to fight it off, and that response shows up as a fever. 

 
 
 

What is a high fever for a child?

Most people would agree that a ‘normal’ body temperature is 98.6 °F. However, what’s important to understand is that there is a range of normal temperatures both above and below this number, and that a 'normal' temperature is highly dependent on how the temperature is taken.

Rectal temperatures are generally the most accurate, but an oral or armpit (axillary) temperature can be as low as 96 °F and still be considered normal! 

The definition of a fever is a temperature of 100.4 °F or higher in infants and 101 °F or higher in older children and adults. At its highest, a fever can push a child’s temperature to 104 °F or even 105 °F.

 
 
 
What to do if your child has a high fever?
 
 

How to tell if your child has a fever

 
  • Feel — An older study from 1996 actually demonstrated that a caregivers sense of whether their child had a fever was startlingly accurate
  • Take a temperature — Generally rectal temperatures are most accurate but may not be practical in older children. A good quality armpit (axillary) or oral temperature is just as helpful.  We don’t recommend temperature strips, ear thermometers, or temporal artery thermometers as accuracy can be an issue unless significant money is spent on fancy equipment!
  • Don’t get hung up on adding or subtracting degrees. The best policy is to report the temperature as it’s read on the device.  Also, manufacturers will include instructions on how to maximize the accuracy of the device
 
 

By itself, fever is never an emergency - it’s always more important to find out what’s causing the fever. That said, if your child is feeling lousy, lowering the fever can often help them feel better.
— Dr Corey Fish

Lowering your child’s fever without medication

Tepid water sponge bathing

Dress your child in light clothing

Use light blankets

 

Treating a fever with medication

 

Acetaminophen Dosing by Weight*

(*Do not give to infants under 2 months of age without checking with your child's health care provider first)

 
Weight in lbs. Desired Dose 160 mg/5 ml 160 mg Jr. Strength Chewable Tabs & Meltaways 325g Regular Strength Adult Tabs 500 mg Extra Strength Adult Tabs
6 to 11 40 mg 1.25 ml = 1/4 teaspoon
12 to 17 80 mg 2.5 ml = 1/2 teaspoon
18 to 23 120 mg 3.75 ml = 3/4 teaspoon
24 to 35 160 mg 5 ml = 1 teaspoon 1 Jr. Strength Tab or Meltaway
36 to 47 240 mg 7.5 ml = 1 1/2 teaspoon 1 1/2 Jr. Strength Tabs or Meltaways
48 to 59 320 mg 10 ml = 2 teaspoons 2 Jr. Strength Tabs or Meltaways
60 to 71 400 mg 12.5 ml = 2 1/2 teaspoons 2 1/2 Jr. Strength Tabs or Meltaways 1 tab
72 to 95 490 mg 15 ml = 3 teaspoons 3 Jr. Strength Tabs or Meltaways 1 1/2 tabs
96+ 650 mg 20 ml = 4 teaspoons 4 Jr. Strength Tabs or Meltaways 2 tabs 1 tab
 

Ibuprofen Dosing by Weight (6 months and older*)

(*Children under 6 months cannot have ibuprofen)

Desired Dose 50 mg/1.25 ml 100 mg/5 ml 100 mg Junior Strength Motrin Chewables 200 mg Regular Strength Adult Tabs
50 mg 1.25 ml 2.5 ml = 1/2 teaspoon
80 mg 1.875 ml 4 ml = 3/4 teaspoon
100 mg 2.5 ml 5 ml = 1 teaspoon 1 chewable tab,20 ml = 4 teaspoons
160 mg 4 ml 8 ml = 1 1/2 teaspoon 1 1/2 chewable tab
200 mg 10 ml = 2 teaspoons 2 chewable tabs 1 tab
250 mg 12.5 ml = 2 1/2 teaspoons 2 1/2 chewable tabs 1 tab
300 mg 15 ml = 3 teaspoons 3 chewable tabs 1 tab
400 mg 20 ml = 4 teaspoons 4 chewable tabs 2 tabs
 
 

When to come to Pacific Crest

What to do if your child has a high fever?

Neither the height or length of fever are reliable predictors of serious illness. Scary stuff like meningitis may present with fevers that aren’t all that high, and viral illnesses which we often think of as being not all that serious can cause fevers as high as 104 or 105 °F! The short answer is that generally, we recommend you seek care:

  • Any time you’re worried
  • Fever > 3 days
  • Signs of true lethargy - not just sleepy but having a very hard time waking up

 
 
Corey Fish