Ask the Pediatrician: Treating a fever

Q:  With many adults and children being treated for the flu, and other winter illnesses, treating fevers is all-too common. What do parents need to know when their child runs a fever?

A: First, a few facts about fevers that are important to review. It is a myth that different temperatures mean a fever for different people. I hear commonly from parents, “my child normally runs low, so a fever for him means only 99”. Average temperatures are just that, average, and a normal temp can be 97 to higher than 99. A true fever is 100.5 or greater for everyone - young or old. Nearly all fevers do not pose a risk to children, they simply give us a hint that the child is fighting off an illness. Young children can run temperatures of even 104 or 105, and they are not harmed by this, but certainly do feel poorly. Doctors suggest treating a fever to help a person feel better, so they can rest and recover, and drink fluids and other important ways of taking care of themselves, not because a fever is dangerous. If your child is feeling poorly, treat that, not a number on a thermometer.

Q: When should a parent be worried about a fever?

A: The bottom line is always, when your parental instinct says that your child is very ill, then they should be seen by their pediatrician. A fever that lasts more than 5 days may need to be evaluated, a child that has a seizure due to a fever obviously needs to be seen, or with symptoms that may point to a bacterial infection such as severe ear pain, breathing problems, or bloody diarrhea deserve a check-up. Any infant age 3 months or younger should be evaluated by a physician if their temperature is above 100.5, with temperature being taken rectally.

Q: What do you recommend for fever treatment?

A: For infants under 6 months old, they can be treated with acetaminophen, with the dose being 12 mg per kg of weight:

Acetaminophen (Tylenol) - all ages
concentration 160 mg/5 mL (5 mL = 1 teaspoon), every 4 hours
6-11 pounds, 0-3 months, 1.25 mL
12-17 pounds, 4-11 months, 2.5 mL
18-23 pounds, 12-23 months, 3.75 mL
24-35 pounds, 24-36 months, 5 mL


Older than 6 months, children can be treated with acetaminophen or ibuprofen, with the dose being 10 mg per kg:

Ibuprofen (Motrin, Advil) - older than 6 months old
concentration 50 mg/1.25 mL (1/4 teaspoon, every 6 hours
12-17 pounds, 6-11 months, 1.25 mL
18-23 pounds, 12-23 months, 1.875 mL
concentration 100 mg/5 mL (5 mL = 1 teaspoon), every 6 hours
24-35 pounds, 2-3 years, 1 teaspoon
4-5 years, 1 ½ teaspoons
6-8 years, 2 teaspoons

Please call your pediatrician with questions.