There are several medications that can reduce body temperature by blocking the mechanisms that cause a fever. These so–called antipyretic agents include acetaminophen, ibuprofen and aspirin. All three of these drugs appear to be equally effective at reducing fever. However, since aspirin may cause or be associated with side effects, such as stomach upset, intestinal bleeding and (most seriously) Reye syndrome, we do not recommend using it to treat a simple fever. Ibuprofen use is approved for children 6 months of age and older, however, ibuprofen should never be given to children who are dehydrated or vomiting continuously.
Ideally, the dose of acetaminophen should be based on a child’s weight, not his age. The dose of ibuprofen should be based on baseline temperature and weight, not his age. However, the dosages listed on the labels of acetaminophen bottles (which are usually calculated by age) are generally safe and effective unless your child is unusually light or heavy for his age.
Be sure to read and follow the instructions on the manufacturer’s label when using any medication. Following the instructions is important to ensure that your child receives the proper dosages. Acetaminophen may be contained in other over–the–counter medications, such as cold preparations. Read all medication labels to ensure your child is not receiving multiple doses of the same medicine. As a general rule, do not give a baby under 2 years acetaminophen or any other medication without the advice of your pediatrician.
Sponging to ease fever
In most cases, using oral acetaminophen or ibuprofen is the most convenient way to make your feverish child more comfortable. However, in some cases you might want to combine this with tepid sponging or just use sponging alone.
Sponging is preferred over acetaminophen if your child is known to be allergic to, or is unable to tolerate, antipyretic (antifever) drugs (a rare case).
It is advisable to combine sponging with acetaminophen or ibuprofen if
- Fever is making your child uncomfortable.
- He has a temperature over 104 degrees Fahrenheit (40 degrees Celsius).
- He has a history of febrile convulsions or someone else in your immediate family has had them.
- He is vomiting and may not be able to retain the medication.
To sponge your child, place him in his regular bath (tub, bathinette or baby bath), but put only 1 to 2 inches of tepid water (85 to 90 degrees Fahrenheit or 29.4 to 32.2 degrees Celsius) in the basin. If you do not have a bath thermometer, test the water with the back of your hand or wrist. It should feel just slightly warm. Do not use cold water, since that will be uncomfortable and may cause shivering, which can raise his temperature. Seat your child in the water, it is more comfortable than lying down. Then, using a clean washcloth or sponge, spread a film of water over his trunk, arms and legs. The water will evaporate and cool the body. Keep the room at about 75 degrees Fahrenheit (23.9 degrees Celsius), and continue sponging him until his temperature has reached an acceptable level. Never put alcohol in the water, it can be absorbed into the skin or inhaled, which can cause serious problems, such as coma.
Usually, sponging will bring down the fever in thirty to forty–five minutes. However, if your child is resisting actively, stop and let him just sit and play in the water. If being in the tub makes him more upset and uncomfortable, it is best to take him out even if his fever is unchanged. Remember, fever in the moderate range (less than 102 degrees Fahrenheit [38.9 degrees Celsius]) is in itself not harmful.
Treating a mild fever
- Keep your child’s room comfortably cool, and dress him lightly.
- Encourage him to drink extra fluid (water, diluted fruit juices, gelatin–flavored water).
- Avoid giving extremely fatty foods or others that are difficult to digest, as fever decreases the activity of the stomach, and foods are digested more slowly. There is no reason to discontinue giving your child the milk he normally drinks.
- If the room is warm or stuffy, place a fan nearby to keep the cool air moving.
- Your child does not have to stay in his room or in bed when he has fever. He can be up and about the house, but he should not run around and overexert himself.
- If the fever is a symptom of a highly contagious disease (eg., chickenpox), keep your child away from other youngsters and elderly people.