Introduction to fever – Dr Paul Miller

This week’s topic is an introduction to fever. Whether you prefer Peggy Lee’s or Aaron Neville’s version of the classic tune or perhaps even the Black Keys original song of the same name, as a parent you’ll be dealing with fever. The good news is that fever is a manageable and usually benign state.

Fever is defined as 2 separate Temperatures > 100.4 F at least 4 hours apart. Fever is a natural response to chemicals called cytokines that are released by  cells of the immune system when activated. It usually indicates an infection but there are other conditions which can cause it. A fever is adaptive — it helps the body to fight infection better than at basal temperature (98.6 on average). So if the Temperature is less than 101.5 consider NOT treating it if the child otherwise appears and seems well. Don’t wake a child to take a temperature unless there is other cause for alarm (e.g.rapid breathing or profuse sweating, chills, etc.).

Temperatures above 102 are generally uncomfortable, so I would recommend treating in that instance. Fever is not harmful unless it goes extremely high, say 106/107.

Treatment of fever includes giving either Tylenol (acetaminophen) or Motrin/Advil (ibuprofen). View our dosage charts/instructions here. Aspirin is not recommended for children. In addition you may loosely clothe the child and place a cool washcloth over their head or chest. Do not use rubbing alcohol or ice baths. Know that Acetaminophen comes as a rectal suppository which is handy in case of fever with vomiting. Fevers lasting more than 5 days or fever in a child less than 2 months old requires urgent evaluation.

Become familiar with the correct dosage of medicines for your child and you should be able to manage most cases of fever without needing to head to urgent care or the ER. And remember that we’re here for any questions.

  • Paul Miller, M.D., F.A.A.P.

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