Comfort and Care
Step 3: Soothe Your Child
Once you see that three-digit number on your thermometer, don't instantly head for the medicine cabinet. Fever reducers are meant to make your ill child more comfortable, but if she is playing and otherwise in good spirits -- and the fever is 103 degrees or lower -- you don't have to bring the fever down, says Dr. Huggins. Once that temperature hits 104 degrees, however, definitely give a fever reducer to stop it from going any higher. You don't want it to reach 106 degrees, says Dr. Huggins. "Fever cannot hurt you neurologically until you get up toward the 107- to 108- degree range."
If you do decide to medicate, there's another very important number you must know: your child's weight. (Unsure of your baby's weight? Try this trick: weigh yourself on the bathroom scale. Then get on the scale again, holding your child. Subtract the difference and you have her weight.) It's the first question your doctor will ask you when you call to find out the proper dosing, and you should call if you don't know how much medication to give. Otherwise, if your child weighs less than you think, you'll be giving her too much medication. And if she's gained weight, she won't get enough medicine to lower the fever.
Improper dosing is common and dangerous. More than 50 percent of children are given the wrong amount of medication, according to a recent review of 70 American and British studies published in the Journal of Advanced Nursing. Not knowing a child's correct weight is one cause of this mistake, but so is underestimating the ill effects of overmedicating. "Sometimes if it's a really high fever, parents will double the dose," says Anne Walsh, RN, lead researcher of the review. "But overdosing can cause liver toxicity." Also, if you're giving your child cold medicine for a stuffy nose only, make sure it doesn't contain a fever reducer. And if you give your stuffy and feverish child cold medicine designed to relieve both symptoms, make sure you don't administer separate ibuprofen or acetaminophen (e.g., infants' or children's Tylenol or Advil).
So what fever reducer should you use? First, as a reminder: Never give a child aspirin. It can cause a dangerous condition called Reye's syndrome. That said, you should never give any medicine to a baby less than 2 months without first calling your pediatrician, and ibuprofen is approved only for kids 6 months and older. Acetaminophen is recommended mostly for low-grade fevers, and ibuprofen is used for fevers above 102 degrees. Many parents prefer ibuprofen at night -- it lasts six hours rather than four. If your child is vomiting, you might want to use an over-the-counter acetaminophen suppository.
There are other ways to lower a child's temperature. "If she has a fever, we dress her coolly, in a T-shirt and panties, and give her cool baths," says Boston mom Kelly Quinn of her 3-year-old. "I give her cool compresses and lots of water." For compresses, use only water and no alcohol, which is dangerous when absorbed through the skin. Another dated practice is bundling a child up so the fever breaks. This is counterproductive and will raise her temperature, says Dr. Krol. Sponge baths do work when done properly: 20 minutes in tepid water that's cool enough to bring down the fever but warm enough so that she won't shiver. (Add warm water throughout the bath to keep the temperature consistent.)
Step 4: Monitor Progress
How long will your child be sick? A fever of 103 degrees or higher rarely lasts more than a day. If it does, call your doctor. Make an appointment if three days have gone by and a fever higher than 100.4 degrees is lingering. Antibiotics may be necessary to help fight any existing infection.
Illnesses can have other scary symptoms besides fever. Seizures are a common parental concern but are relatively rare, occurring in only 1 in 25 children, according to the AAP. They usually last less than a minute and are most common between 6 months and 5 years of age. Once your child has had one seizure, especially if he was less than 15 months old at the time, he is at risk for others. Children with a family history of febrile seizures are also at greater risk.
The good news is that while they are incredibly frightening, febrile seizures are generally harmless and short. Seek medical attention if a seizure lasts for about 10 minutes, says Dr. Krol. Delirium (seeing things that aren't there, being frightened for no reason) is another cause for concern. These symptoms usually accompany very high fevers and disappear once the fever comes down. But call your doctor; he'll likely want to see your kid to rule out any dangerous infections.
Step 5: Road to Recovery
Is baby's temperature coming down? Great. Has your sleepy child started begging you to turn on her favorite show? Even better. You don't know exactly how long an illness will last, but once you and your child have gone through it, celebrate -- it means your baby's immune system is stronger than before. Pat yourself on the back too. You'll be more confident the next time around -- and you can be certain there will be a next time.