Fever in Children: Management

Managing fever in children

Fevers are usually treated when a person is in discomfort, and this applies to both children and adults.

It’s also important to remember that fever is a sign that something else is going on in the body and that treating it does not treat the underlying cause of the fever.

However, in children < 3 months old, a temperature > 100.4°F requires immediate medical attention.

Temperature taken rectally is the recommended method of assessing fever in children up to 3 years old. For children older than 3 years of age, other methods of taking a temperature are forehead, orally (under the tongue), or in the ear or armpit. Armpit temperatures are the least accurate.

As with adults, other symptoms accompanying the fever should be assessed, as well as “red flag” symptoms that would require medical care.

Management of fever

Nonpharmacologic management of fever
Parents of children with fever may receive the following recommendations when their child has a fever:Dress the child in light-weight clothing, since excess clothing traps body heat, causing the temperature to rise

Encourage the child to drink plenty of fluids, such as juices, or to eat popsicles

Give the child a lukewarm bath

Place cold washcloths over certain areas of the body such as the forehead, groin, and wrist
Pharmacologic management of fever

The general recommendations for managing fever in children are that infants under 3 months of age with a fever of ≥ 100.4°F should be seen by a healthcare provider regardless of other signs and symptoms, while children 3 months of age and older can be observed and/or treated with over-the-counter medications unless exhibiting any “red flag” symptoms.

Treatment with medicines should only be recommended if the child’s temperature is > 100.4°F or at a lower temperature if he/she seems uncomfortable.

Ibuprofren and acetaminophen are first-line treatment choices for fever in children 6 months of age or older. Both are considerd equally effective and generally well tolerated.