Tuesday, March 22, 2011

Fevers and Tylenol/Ibuprofen Dosage

Fever is the body’s normal response to infection.  Most fevers are due to viral infections, and range from 101 to 104 degrees F.  Fevers due to viral illnesses generally last for 2-3 days though sometimes longer.  The height of the fever does not relate to the seriousness of the illness.  What counts is how sick your child acts or looks.

Fever is a symptom of illness, such as pain and cough.  Rather than being harmful, fever can be a benefit.  Evidence shows that the body’s immune system is more effective at higher temperatures.  Fever by itself does not cause brain damage or other harm, though there may be some theoretical risks if the temperature is > 107 degrees.

The main purpose of taking the temperature is to determine if a fever is present or absent.  If your child’s temperature is above 100.4 F (38 C), he or she has a fever.  Since we are interested mainly in the presence of fever and not the exact level, any method of taking temperatures is acceptable except forehead strips.  Rectal and tympanic (ear) methods are the most accurate in children, but axillary and oral are reasonable alternatives.

Treatment of Fevers:
The goal of fever treatment is to help the child feel more comfortable, not to make the temperature normal.  A child with a fever can be made comfortable through extra fluids, less clothing, and reduced activity.  External cooling is rarely necessary and is generally uncomfortable.  Do not wake your child to treat a fever.

Acetaminophen and Ibuprofen are two over the counter medicines used to treat fevers.  Do not use aspirin.  Generic brands are as effective as name brands and less expensive.  Please note that medicines for fever reduction come in varying concentrations.  Acetaminophen drops are 3 times more concentrated than the liquid form.  A serious mistake is to give the drops at the liquid dose.  A common mistake is to use the dropper (from the acetaminophen drops) for the less concentrated liquid.  As with all medications, please keep these medications out of sight and reach of your children.  If you need to use fever-reducing medications for more than 3 days, please consult your doctor.

Call immediately if your child:
¨      Is less than 3 months old and has a temperature > 100.4 F (38 C)
¨      Looks or acts sicker than the level of the fever
¨      Is crying inconsolably, whimpering, having difficulty breathing, hard to awaken, very pale or mottled, or looks dehydrated (decreased wet diapers, dry mouth or decreased tears)
¨      Has a fever > 104 F
¨      Has a seizure (which can occur in 2-3% of children regardless of fever medication)
¨      Has symptoms not mentioned above that are concerning to you

Alternating Acetaminophen and Ibuprofen:
Though theoretically helpful, most fevers can be treated with either acetaminophen or ibuprofen alone.  If you do use both, the last confusing method would be to give each medication every 6 hours, so that one or the other is given every 3 hours.

We know as parents it can be confusing to get different dosage amounts from different medications or pharamacies.  It is best to always give in "ml" (millileter) dosage instead of teaspoons. Most pharamacies have free syringes and you can pick one up the next time you are at the grocery store. Here is a little break down so it is not so confusing:

1 tsp = 5 ml

1/2 tsp= 2.5ml

1/4 tsp = 1.25ml

If you have any questions about the dosage you are giving your child please call our office at anytime to speak to a nurse.

For complete dosing information for Tylenol and Ibuprofen, click here.  

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