Most parents are confused as to what temperature is actually considered fever. A temperature of 97 is not fever but is a lower than normal temperature. This is usually seen if a person is exposed to the cold for too long a period of time, but is more commonly seen with oral temperatures, where the person is mouth breathing while the temperature is being taken. It can also be seen on a rectal temperature if the thermometer has been left in for too short a period of time or is not properly placed in the rectum. Even though 98.6 is supposed to be average some people run either a little higher or lower. If you have symptoms of an illness, any temperature 99.8-100.8 may be considered a low grade fever. Any temperature 101-102 is mild fever, 102-103 is moderate fever and anything close to 104 is high fever. Please remember to shake down your thermometer before taking you child's temperature. Many a false alarm has occurred when a parent forgets to do this and starts with a thermometer reading of 101 or higher. When your child has fever his/her body is telling you that there is an infection or inflammatory process going on. Having fever does not tell you what is causing it. One could have a viral infection or a severe bacterial infection and not know the difference.

Most parents are overly concerned with how high the fever is or how high the fever is going to go. Unfortunately the height of the fever is not a good indication of how mild or severe the infection your child has. You could have walking pneumonia with no temperature at all and meningitis with 101. You could have the flu and have 104 or just a cold and have 102. This is not to say that the temperatures could be the other way around but just the fact that it could go either way tells you how unpredictable an indicator it is.

The other reason most parents are afraid of high fevers is that they are worried that their child might convulse if the temperature gets too high. Most people don't realize that it is not how high the fever is but how rapidly the temperature goes up that causes a febrile convulsion. Of course if there is a family predilection to febrile convulsions your child will be at somewhat greater risk (about 4 %) over the general population to have them.

If your child appears to have a fever it is best to take his/her temperature with a rectal thermometer (if an infant or young child) or an oral thermometer (if an older child or teenager). The new ear thermometers are extremely good for a child one year or older (if the ear canal is too small you cannot get a proper reading from the ear). Taking a temperature reading directly off the skin is unreliable, especially if the skin is warm for other reasons (e.g. sunburn). The temperature reading should give you a good idea about the fever but it is not really necessary to know if the fever is exactly 101.8 or 102.2.

Once you have decided that your child does have fever you can give Acetaminophen (Tylenol, Tempra, Feverall) or Ibuprofen (Advil or Motrin) or both. Acetaminophen is given in a dose of about 120 mg for every 20 pounds every 4 hours (e.g. a 20 pound infant would take 120 mg or approx. 1.2 ml of the drops or 3/4 tsp. of the liquid). If Ibuprofen is taken it is given in a dose of 1 tsp. for every 22 pounds every 6 hours. A 44 pound child could take 1 tablet if you crush it up or if he /she could swallow it. If the temperature is under 102.6 then you should start by giving the acetaminophen alone every 4 hours. If the fever is greater than 102.6 then you can give both the Acetaminophen and the Ibuprofen at the same time but afterward at the required time intervals. The Acetaminophen should always be given first and then the Ibuprofen added to the regimen if the fever is not going down. Not to confuse the issue but some parents feel that they would rather start with the Ibuprofen because they feel it works better and that is all right too. If your child is vomiting there are Acetaminophen suppositories in strengths of 120 mg and 325 mg and these can be cut in half to the approximate dose. If your child hates the taste of the oral medicine, Feverall is tasteless and colorless and can be mixed in anything.

If you find that the fever is still not budging you can give your child a tepid bath (water that is neither too cool or too warm to the touch) for about 10 to 15 minutes. There is also a product called "cool skin" which is a gel-like sheet that is placed over the child's naked body. It works by extracting the heat from the body and cooling down the skin. Alcohol rub downs are no longer being done, at least in the younger children, since the alcohol vapors can cause a lowering of the blood sugar.

If all of these attempts at lowering the temperature fail then please give your doctor a call so that he/she can further guide you. Remember that the Doctor should be contacted if any fever persists for more than 2 days.