Fever describes the increase in body temperature to above normal range. It is the body's reaction to viral or bacterial infections such as ear, bladder or chest infections and pneumonia. Though fever can cause aches and pains, weakness, discomfort and decreased alertness, it is not normally harmful on its own and can be a clue that an infection is developing. The following information describes some steps you can take when your child has a fever.
Taking a Temperature
There are a number of places on the body that will give you an accurate reading; however, the location may differ according to what your child will tolerate. For instance, rectal thermometers are used for newborns and young children if tolerated; children less than five years old can tolerate armpit temperatures; and children over five can usually safely use an oral thermometer.
It's also important to choose the right thermometer. Digital thermometers can be used in the mouth, armpit or rectum and give the temperature much faster than glass thermometers. They are more expensive, but also more sensitive. If you prefer to use a glass thermometer, remember that both oral and rectal thermometers are available.
When using a glass thermometer, the mercury must begin below 38°C (98°F) to ensure an accurate reading. To do this, hold the thermometer by the top (not the bulb), quickly snap your wrist to shake down the mercury.
Directions for digital thermometers vary, so it's best to follow the manufacturer's instructions.
How to Take a Temperature
- Rectal. Place the child on their back or side. Lubricate the tip of the thermometer with Vaseline and carefully insert the thermometer ½ inch in the rectum, holding the legs to prevent kicking and possible injury. Remove the thermometer when the mercury stops rising, usually one to two minutes.
- Armpit or Auxiliary. Place the tip of the thermometer on a dry armpit, close the armpit and hold the arm against the chest for four minutes.
- Mouth. Wait at least thirty minutes after eating or drinking before taking an oral temperature. Place the thermometer under the tongue in one of the pockets on either side of the mouth and use the lips or finger - not the teeth - to hold it in place for at least three minutes. Breathe through the nose.
- Ear. There are a number of different thermometers that allow you to take your child's temperature from their ear. Directions vary, so read the instructions from the manufacturer.
Cleaning a Thermometer
Wash a glass thermometer in lukewarm soapy water, rinse with alcohol and dry. Wash only the tip of the digital thermometer with lukewarm water and wipe off with alcohol.
Managing Your Child's Fever
| Age |
Temperature |
Management |
| Less than 3 months |
Any rise in temperature |
Take your child to see a doctor.
Children under 3 months do not show usual signs and symptoms of illness, and often do not have a fever during infection. Serious illness in this age group can go unnoticed until it becomes life threatening. |
| 3 to 24 months |
Less than 38.5°C |
Keep your child at home, encourage him/her to rest quietly and give plenty of fluids to avoid dehydration.
Medication for fever may be given to the child.
Watch for signs of rising temperature or worsening of the illness, e.g. irritability, poor feeding, difficulty in rousing, or delirium. |
| |
Over 38.5°C |
Contact your doctor for advice.
Try to reduce fever by enhancing body heat loss and giving medication. Remove excessive clothing, blankets and keep the room's temperature at 21-22°C (69.8 -71.6°F).
Keep your child quiet and give fluids to avoid dehydration. Place in a lukewarm bath or use a sponge to decrease fever and make more comfortable. Do not use cold water because this could cause rapid cooling and shivering, which can cause the brain to increase the body temperature. Do not use alcohol for sponging because it can be absorbed through the skin and the fumes can be inhaled. |
| |
Over 40°C |
Contact your doctor immediately.
There is likely an infection that could require prescription medication. |
Fever Medication
Medication to reduce fever is usually given to make the child more comfortable, to prevent dehydration and possibly prevent febrile seizures. It treats the symptoms of a fever, but not its cause.
Acetaminophen or ibuprofen can be used to reduce fever. Acetylsalicylic Acid (ASA, Aspirin) should not be used for children because it is associated with Reye's syndrome, a rare but potentially deadly disease.
Appropriate Dosage
Acetaminophen: give every 4 hours if needed to a maximum of 5 doses per day according to the Age/Weight chart below.
| Weight |
Age Group |
Single Dose
(mg) |
| Lbs |
Kg |
| 6-11 |
2.5-5.4 |
0-3 mos |
40 |
| 12-17 |
5.5-7.9 |
4-11 mos |
80 |
| 18-23 |
8.0-10.9 |
12mos-3 yrs |
120 |
| 24-35 |
11.0-15.9 |
2-3 yrs |
160 |
| 36-47 |
16.0-21.9 |
4-5 yrs |
240 |
| 48-59 |
22.0-26.9 |
6-8 yrs |
320 |
| 60-71 |
27.0-31.9 |
9-10 yrs |
400 |
| 72-95 |
32.0-43.9 |
11-12 yrs |
480 |
Ibuprofen: give every 6 to 8 hours if needed to a maximum of 3 doses per day according to the age chart below.
| Age Group |
Single Dose (mg) |
| Under 2 yrs |
Consult doctor |
| 2-3 yrs |
120 |
| 4-5 yrs |
200 |
| 6-8 yrs |
250 |
| 9-10 yrs |
300 |
| 11-12 yrs |
380 |
Compiled by Roberta Rusk
Comox Pharmacy, Comox, B.C.
Edited by Megan Stiles
Last Reviewed: September 2001
