Mar 10, 10 | Posted by: David Melbye, M.D.

What’s the deal with fevers?

Let me start by saying that babies under the age of 2 months are different than older kids.  Any baby under the age of 2 months with a rectal temperature greater than 100.4 degrees should be evaluated urgently in a pediatric emergency department.

Having said that, kids over the age of 2 months are a different story. In general a temperature in the 99′s is normal, in the 100′s is “low grade “and above 101 is a fever.  It is important to remember that the height of the fever doesn’t mean anything.  Kids will often spike 103 or 104 fevers with routine viral illnesses.  Fevers also often times last 4-5 days with routine viral illnesses.  The pattern of the fever or other symptoms your child has are much more important in determining the severity of their illness. 

If your child has a temperature of 104 but is smiling at you and wants to play that is OK.  If your child has a temperature of 101 and is having trouble breathing, having trouble staying awake, is irritable and inconsolable, or looks really sick to you, that is bad and you should give us a call or take them in for an evaluation.

Any fevers above 101 that are gone for 24 hours or more and then come back can be a sign of a secondary bacterial infection such as an ear infection.  Fevers that are 101 for 2 or 3 days and then spike up to 104 can also be a sign that something new is going on.

Common symptoms associated with fevers are chills, fast breathing and a fast heart rate.  These things should go away when the fever comes down.  If your child gets a fever as long as they aren’t severely ill you should give them Tylenol or Ibuprofen and see if they are feeling better.  Fevers often spike between 4-6pm and again in the middle of the night.  If you are having trouble with persistent fevers that are making your child uncomfortable you can alternate between doses of ibuprofen and Tylenol every 4 hours.  This means you give the Tylenol and then if they need it 4 hours later give ibuprofen and then if they need it four hours after that give Tylenol and keep repeating.

So in general fevers are very common and if your child spikes a fever of 104 you do not need to rush them to the ER.  As long as they are otherwise ok you can give them some tylenol or ibuprofen and see how they feel afterwards.  Good luck staying healthy this winter and don’t forget to wash your hands!

You can always find a dosing schedule for Tylenol and ibuprofin at www.bayshorepediatrics.com under For Parents.

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