Fever in Children Treatment

Self-Care at Home

The 3 goals of home care for a child with a fever are to reduce the temperature, prevent dehydration, and monitor for serious or life-threatening illness.

The first goal is to make the child comfortable by monitoring and reducing the fever to under 102°F (38.9°C). This is done using a thermometer and medications and dressing the child appropriately. A warm water bath can also be helpful.

• To check your child's temperature, you will need a thermometer. Thermometers available are glass mercury, digital, and tympanic (used in the ear).
• Stay away from tympanic thermometers, the jury is still out about their accuracy.
  • Glass thermometers work well but may break and take several minutes to get a reading.
  • Digital thermometers are inexpensive and obtain a reading in seconds.
• It is best to check an infant's or toddler's temperature rectally.
  • Hold the child chest down across your knees.
  • Spread the buttocks with one hand and insert the thermometer lubricated with a water-soluble jelly about 1 inch into the rectum with the other hand.
• Oral temperatures may be obtained in older children who are not mouth breathing or have not recently had a hot or cold beverage.
• Acetaminophen (Children's Tylenol, Tempra) and ibuprofen (Children's Advil, Children's Motrin) are used to reduce fever.
  • Follow the dosage and frequency printed on the label.
  • Remember to continue to give the medication over at least 24 hours or the fever will usually return.
  • Do not use aspirin to treat fever in children, especially for a fever with chickenpox. It has been linked to Reye's syndrome which causes liver failure. Ibuprofen use in chickenpox is also being questioned.
• Children should not be overdressed indoors, even in the winter.
  • Overdressing keeps the body from cooling using evaporation, radiation, conduction, or convection.
  • Most practical is to dress the child in a single layer of clothing and cover the child with a sheet or light blanket.
• A sponge bath in warm water will help reduce a fever.
  • This is usually not needed but may more quickly reduce the fever.
  • Put the child in a few inches of warm water and use a sponge or washcloth to wet the skin of the body and arms and legs.
  • The water itself does not cool the child. The evaporation of the water off the skin does, so do not cover the child with wet towels.
  • Contrary to the popular folk remedy to reduce fever, under no circumstances should rubbing alcohol be used in a bath or rubbed on the skin. Alcohol is poisonous to children.

The second goal is to keep the child from becoming dehydrated. Humans lose extra water from the skin and lungs during a fever.

• Encourage the child to drink clear fluids such as non-carbonated drinks without caffeine or juice (not water). Water does not contain the necessary electrolytes and glucose. Other clear fluids are chicken soup, Pedialyte, and other rehydrating drinks available at your grocery or drug store.
• Tea or other caffeine-containing products should not be used. They act as diurectics and increase urination and fluid loss. This is not the effect you want.
• Your child should urinate light-colored urine at least every 4 hours if well hydrated.

The third goal is to monitor the child for signs of serious or life-threatening illness.

• A good strategy is to reduce the child's temperature to under 102°F (39.0°C).
• Also, make sure the child is drinking enough clear fluids (not water).
• If both these conditions are met and your child is still ill appearing, a more serious problem may exist.

Medical Treatment

Your doctor may or may not be able to tell you the exact cause of your child's fever.

Viral infections of the respiratory system are the most common cause of fever. Antibiotics do not cure or help with viral infections.

• If your doctor diagnoses a bacterial infection, your child will be started on antibiotics.
  • Urinary tract infections, ear infections, throat infections, sinus infections, skin infections, gastrointestinal infections, and pneumonia may be treated with antibiotics at home.
  • Your child may receive oral antibiotics or a shot or both.
• Children diagnosed with bacterial meningitis are always admitted to the hospital.

Additionally, your doctor may give acetaminophen (Tylenol) or ibuprofen (Advil) for fever.

Dehydration may be treated by giving oral or intravenous fluids.

• If a child is vomiting, an anti-nausea drug may be given by injection or by rectal suppository.
• After a period of time, oral fluids will be attempted.

If your child's condition improves after reducing the fever, treating dehydration, and serious bacterial infections have been ruled out, the doctor will more than likely discharge your child from the emergency department for further care and monitoring at home.