Fever

Fever is not an illness. It is usually a positive sign that the body is fighting an infection. Fevers increase your child’s need for fluids. It can also increase your child’s breathing rate and heart rate. Axillary and rectal temperatures are most accurate. Treatments for fever include:

• Fevers less than 101 degrees do not require treatment unless your child is uncomfortable
• If under the age 6 months, Acetaminophen (Tylenol, Panadol, Tempra, etc.) is the medicine of choice. The dosages listed on the label are appropriate and safe to follow
• Do not give acetaminophen more frequently than every 4 hours or more than five doses per 24 hours.
• If above 6 months, Infant Ibuprofen (Advil/Motrin, etc..) may also be used (be aware of different formulations for children and infants).
• Sponging your child can also help to bring down fever. Be sure the water is lukewarm, not cold. Cold water causes shivering, which may increase your child’s temperature and cause discomfort. Sponging can bring the fever down in 30-45 minutes.
• Dress your child lightly.
• Encourage fluids.

Newborns

To measure your baby’s temperature, place a standard digital thermometer in the baby’s armpit and hold it steady for 3-5 minutes. A rectal temperature may be obtained by gently inserting a clean rectal thermometer, lubricated with petroleum jelly, into the anal opening inserted no more than one inch. Hold in place for 1-2 minutes. Adding (armpit) or subtracting (rectal) a degree is not necessary, provided the proper technique is utilized. Please do not use an ear thermometer or a forehead thermometer as they are inaccurate.

If your baby is 2 months or younger and has an axillary or rectal temperature of 100.4 degrees or higher as measured by a standard thermometer, your pediatrician should be notified immediately. Babies at this age do not give us clear clues when they are not feeling well. So please call if you notice:

• refusal of 2 or more feedings in a row,
• vomiting of 2 or more feedings in a row,
• excessive irritability or lethargy.

Please take your child’s temperature with a thermometer (either under the arm or rectally) before calling your doctor. Ear thermometers, temperature tapes, and saying “he just feels hot” are not accurate or helpful.

Febrile Seizures

Some infant and preschool age children are subject to convulsions (seizures) during febrile illnesses. The child may exhibit stiffening, twitching of arms and legs, rolling eyes, and poor color. A typical febrile seizure lasts less than ten minutes, but it may seem much longer to a frightened parent. No special treatment is needed beyond making sure he is not injured during the convulsion. Call for emergency help if the seizure lasts more than 10 minutes. Take your child to your pediatrician or the emergency room if this is the first seizure. Notify the doctor after each subsequent seizure.

Dosage Charts

Alternating acetaminophen and ibuprofen is generally not recommended, unless your child’s fever is greater than 104 degrees F (orally, rectally, or under armpit) and does not decrease with adequate dosage.

Whenever your child is uncomfortable, for whatever reason and at any age, he/she gains much relief from being held and comforted by a parent or caregiver.

Acetaminophen (Tylenol) Dosage Chart (4-6 hour dosing)

Weight (lbs)	Dose	Children's Syrup	80 mg chew	160 mg chew
6-12	40 mg	1.2 ml
12-17	80 mg	2.5 ml
18-23	120 mg	3.75 ml
24-35	160 mg	5 ml	2	1
36-47	240 mg	7.5 ml	3	1.5
48-59	320 mg	10 ml	3	1.5
60-71	400 mg	12.5 ml	5	2.5
72-95	480 mg	15 ml	6	3
95+	640 mg	20 ml	8	4

Ibuprofen (Advil / Motrin) Dosage Chart (6-8 hour dosing)

Weight (lbs)	Dose	Infant Drops	Children's Syrup	50 mg chew
20-25	100 mg	2.5 ml	5 ml
26-30	125 mg	3 ml	6.25 ml
31-35	150 mg	3.75 ml	7.5 ml	3
36-40	175 mg		8.75 ml	3.5
41-45	200 mg		10 ml	4
46-50	225 mg		11.25 ml	4.5
51-60	250 mg		12.5 ml	5

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Meridian Pediatrics 12065 Old Meridian St., Carmel, IN 46032 TEL: (317) 844-5351 - FAX: (317) 844-0310 For billing inquiries please contact Hannah Medical Consulting: (317) 324-8289