The average normal oral temperature is 98.6°F or 37.0°C.

Fever has been defined as a rectal temperature over 100.4°F or 38.0°C.

Fever remains the most common concern for which parents bring their child to the emergency department.



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Accurately, fever is a healthy way in which the body fights infection.  However, the main concern is  how sick the child looks and the age of the child.  

Fever may indicate the presence of a serious illness, but usually a fever is caused by common infections which are not serious. The part of the brain called the hypothalamus controls body temperature.

Temperature strips on the forehead are inaccurate.

Ear thermometers are not very reliable in children less than 6 months.

Rectal temperatures are generally thought to be the most accurate for checking a young child's temperature.

Do not give tylenol in infants less than two months with a fever. If you are concerned your baby under 3 months feels warm, take a rectal temperature. Call your doctor immediately if above 100.4 or take baby to the nearest emergency room.

Call doctor right away or take child to emergency department

• The child is less than two months old.
• Constant crying, irritable, inconsolable and acting sick after taking 1-2 hours of tylenol or motrin for fever.
• Drooling more than usual and difficulty swallowing.
• Stiff neck or headache out of proportion to fever.
• Purple spots on the skin - may be large or pinpoint.
• Difficulty breathing, unless it is due to a stuffy nose.
• Difficult to arouse, confused or delirious.
• Having his/her first febrile seizure.

Febrile Seizure: treatment and prognosis

    A child who has a febrile seizure usually doesn't need to be hospitalized. The vast majority of febrile seizures are harmless.

    If the seizure is prolonged or is accompanied by a serious infection, or if the source of the infection cannot be determined, a doctor may recommend that the child be hospitalized for observation.

    Prolonged daily use of oral anticonvulsants, such as phenobarbital or valproate, to prevent febrile seizures is usually not recommended because of their potential for side effects and questionable effectiveness for preventing such seizures.

     There is no evidence that febrile seizures cause brain damage. But, certain children who have febrile seizures face an increased risk of developing epilepsy. These children include those who have febrile seizures that are lengthy or that recur within 24 hours and who have cerebral palsy, delayed development, or other neurological abnormalities.

Home treatment for not so urgent fever

• Give tylenol  for infant less than 2-6 months of age, schedule to be seen the next day.
• Give tylenol or motrin for fever if the child is older than 6 months age.  As the child is getting older, you can watch low fever (less than 101.5) at home for 1-3 days base on the situation. 
• If the associated symptoms such as an ear ache, sore throat, urinary burning or frequency and  persistent cough appears, office visit need to be arranged quickly.  If fever is more than 104, especially if child is less than two years old, office visit same day or the very next day will be needed.

• Aspirin
  Aspirin is generally not recommended in pediatrics. This is because of the past association linking Reye’s syndrome to aspirin usage in children with chickenpox or influenza.
• Less clothing
  Children should not be over bundled while having a fever.
• Sponging
  Sponge baths are usually not necessary for low -grade fevers.  Never use alcohol or ice in the bath. Lukewarm washcloths or sponges rubbed briskly over the skin with the child in 2 inches of water is the best technique.

ACETAMINOPHEN (tylenol) AND IBUPROFEN (motrin) DOSAGES

• Both medicines are best dosed by weight, not age.  Formulary is as follow:  5mg/lbs body weight,  max of 600mg for teens.
• Always measure with a dropper, dosage cup or other accurate measuring device. 
• Liquid medicines may be mixed in with soft foods or liquids.   Chewables may be crushed and added to the food.  Mix the medicine with a small amount of food or drink, so you can make sure the child takes it all.
• One teaspoon = 5 ml. or cc. (milliliters or cubic centimeters)

The oral, rectal, ear (tympanic), and armpit (axillary) are the most commonly used places for measurements.

A rectal or ear (tympanic membrane) temperature reading is 0.5 to 1°F (0.3 to 0.6°C) higher than an oral temperature reading.

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