Fevers: To treat or not to treat???

For those of you that wonder if you should treat a fever, here is what you need to know:

What is a fever? By definition, a true fever is a temperature of 100.5F and above.  To treat or not to treat does not always depend on the thermometer.  I worked with an awesome pediatrician that taught me, “Look at the child, not the numbers.”  This is great advice!  A fever is not an illness, it is the body’s defense against  illness.  Don’t be scared of a fever in a healthy child.  It’s burning up the germs!

When should you treat a fever?  Is the child uncomfortable or lethargic?  Is he in pain?  Is his temperature 101.0 and rising? If yes is the answer to any of these questions, it’s time for Motrin or Tylenol.  Keep in mind, when the medication wears off (4-6 hours) the fever will probably return.  The body’s immune system elevates body temperature in defense of the offending organisms.  Most viruses and bacteria do not tolerate much change in temperature.  So, if the numbers on the thermometer are 99-100, don’t medicate, let the elevated temperature burn up those germs.  

Does Tylenol (Acetaminophen) or Motrin(Ibuprofen) work better?  Typically, Motrin will work more quickly, usually within 20-30 minutes; but every child is different, some children will respond better to Tylenol.   Beware of a child that takes Motrin and then runs around the room thinking he’s Superman. As soon as the Motrin wears off, he is going to crash as his temperature rises.  Tylenol and Motrin will not get rid of fevers indefinitely.  Children under 6 mo should not be given Motrin, Tylenol is acceptable for children of this age.  If a child is less than 2mo of age, and has a temperature of 100.5F, ALWAYS have the child examined by a pediatrician.  

Aspirin should NEVER be used to treat a fever in children.

Many parents wonder if they should trust their temperature taking skills.  Anal temperatures are not necessary in children over 6 months of age.  Many parents ask me if they should add a degree to the temperature if they take it under the arm (axillary)? Not necessarily, if the thermometer is placed properly, axillary temperatures can be quite accurate.  I personally think the easiest way to take a child’s temperature is in their ear with a tympanic thermometer.  It’s least invasive and kids don’t seem to mind as much.

One of the most important things to remember about fevers is how easily they can cause dehydration.   It is very important to encourage lots of fluids during a fever.  If the child doesn’t have an appetite, no big deal, but they MUST DRINK!  Drinking just water is not good enough, having an electrolyte replacement drink is preferable.   Drinks that contain caffeine do not count as fluid intake.

Regarding febrile seizures:  Keep in mind, they occur most often in children 6mo – 5 yrs.  The incidence of febrile seizures is 2-5% in this populations.  Just because a child has a febrile seizure does not mean he has a seizure disorder; but once a child has one febrile seizure, they are at higher risk for febrile seizures in the future.  Any child with a history of febrile seizures should be treated aggressively with medication to minimize the fever.  I will cover febrile seizures more in depth in another post.

Hope this information helps you through your parenting journey! Good luck!

For more information, please refer to:

NIH/Medline’s website about fever.

Motrin dosing

Tylenol dosing

5 thoughts on “Fevers: To treat or not to treat???”

  1. Katie that is awsome advice. I know a lot of moms that have always wanted to know which was best, Tylenol or Motrin. I have alway preferred Motrin for my children. Thank you for the great breastfeeding advice 13 years ago… I will definitely be looking for some advice on teenage boys! Do you think you could help me with that?lol!!!

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