Pediatric Fever Management
Hello, I’m Dr. Stacy Baker. I’m a board-certified family physician, owner and medical director of Broken to Better Urgent Care of Rock Hill and Fort Mill, SC. In my 13 years of medical experience, one of the most common questions I get is how to manage pediatric fever.
A fever in a child less than 3 months old is always a medical emergency since the immune system is not well developed yet! This article is in reference to children older than 3 months.
A fever is defined as a temp >100.4 degrees Fahrenheit. The best way to check a temp in young children who cannot tolerate an oral temp is rectally. Forehead and ear temps are not reliable. There is no magic number on the thermometer that needs to be chased when our children have a fever. We say in medicine to “treat the child and not the number.” Meaning, if your child has a temp of 102°F and is happy and comfortable, you don’t need to give any medications. If your child has a temp of 100.6°F but is lying around and miserable, I would treat that! A high fever does not lead to a “fried brain,” as that is a myth. You can treat a fever with Tylenol or ibuprofen. You do not have to alternate. You can alternate, but it is not necessary.
It is normal for your child not to have much of an appetite with a fever or illness. Hydration is the most important in the first few days. I recommend Pedialyte or Gatorade if your child is not eating, rather than plain water.
Fatigue is normal with a fever. Lethargy is not. Lethargy and fatigue are not the same. Fatigue is feeling more tired than normal, but easily aroused. Lethargy means the child cannot be aroused, and Lethargy always warrants an emergency room visit.
It’s important to remember that fever is a natural immune response by the body to destroy the things that make us sick. Think of boiling river water before drinking it to kill off the germs! Most fevers are caused by viral illness, and antibiotics don’t treat fevers or viruses.
The best thing you can do when your child has a fever is to visit your health care provider to determine the underlying cause. If the cause is viral, you can support at home with Tylenol or ibuprofen if your child is uncomfortable, while allowing rest and providing proper hydration!
