Fever –- Medications

Many healthcare providers will ask that you not use medication to treat your baby's fever so that you can follow the course of the fever, especially in a baby who appears well, is eating and sleeping fine, and behaving normally. Don't give a baby younger than four months old any medicine unless your family doctor tells you to. Although healthcare providers may have slightly varying approaches to fever, there are a few accepted rules to follow.

Types of medication
Acetaminophen that found in Tylenol®, Parasol®, Tempra®, etc. is available in liquid, chewable, and suppository forms. It should not be given more often than every four to six hours.

Ibuprofen that found in Motrin®, Advil®, etc. is available in liquid and chewable forms. Check with your baby's provider before using ibuprofen in a child under one year of age.

Aspirin can cause Reye's syndrome in children who have the flu or the chickenpox. Reye's syndrome is a serious illness that can lead to death. Because it may be hard to tell if your child has one of these infections, it's best not to use aspirin unless your family doctor says it's okay. Acetaminophen and ibuprofen are safer choices to use in children with a fever. So, never give that to your children.

Many combination cold and cough medications contain fever-reducing drugs such as ibuprofen or acetaminophen. Check the labels carefully and don't give your toddler a separate fever reducer if he's taking one of these combination products.

You can also try to lower your toddler's fever by sponging him down with lukewarm (not cold) water or giving him a lukewarm bath. Never try to reduce a fever by sponging down your toddler with rubbing alcohol. Rubbing alcohol can be absorbed into your child's bloodstream through the skin.

Dosing
Acetaminophen products for treating fever in infants usually come in liquid form to be given by mouth. The infant type is usually labeled as "infant drops." Be sure you know exactly what type of liquid form you have because there are many types available, and the strength of medication will vary. Acetaminophen also can be given rectally as a suppository.

If you are giving your child a liquid form of acetaminophen, be sure you know exactly what type of liquid form you have, as there are many types available and the strength of medication will vary.

Dosing is based on your child's weight, so be sure to ask your child's provider for an appropriate dose. It may change as your child grows. Don't give more than five doses in one day. Read labels of all medications carefully.

Don't replace the drops with elixir because the drops are stronger.

Giving medication your baby or toddler
Liquid medication in the form of infant drops usually comes with a medicine dropper. It is best given by leaning your infant back slightly and putting the dropper in one of her cheeks. Fill the dropper to the line when using drops. For liquid elixir, use a liquid measuring device to make sure you give the right dose. Get one at your drug store or ask your pharmacist.

Check with your pharmacist or your child's provider about the possibility of mixing or crushing medicine in with foods or drink. Never assume it's OK, since certain mixtures may make the medication ineffective.

Never tell your child that medications are candy in an attempt to get her to take it. From as early as the toddler years, teach your child that medications should be taken only when she is sick and when given to her by an adult.

Rectal suppositories are not generally the first choice at this age. However, they are very quick and easy. More than half the parents I talk to shudder at the thought, and there are definitely toddlers who won't tolerate insertion of a suppository.

However, when children are very sick, vomiting, or refuse other forms of medicine, this is a reasonable alternative if medication is necessary to bring down a fever. It easiest to have your toddler lay on her back with legs folded up to her belly (like I'm changing a diaper).

Using a little petroleum jelly on the suppository, you can easily and gently slide it into your child's rectum. Gently hold your baby's buttocks together to keep the suppository from slipping out. Be aware that every now and then, inserting a suppository can trigger your child to have a bowel movement. If this occurs immediately following the suppository, you can repeat the dose. But if it occurs more than a few minutes after inserting a suppository, discuss with your child's provider when another dose should be given to avoid overdosing your child.

The other ways to help children feel better

• Give your child plenty to drink to prevent dehydration (not enough fluid in the body) and help the body cool itself.
  
• Keep your child quiet. Moving around can raise the temperature even more.
  
• Keep the room temperature at about 21oC (70 oF) to 23 oC (74 oF).
  
• Dress your child in light cotton pajamas so that body heat can escape. Don't over bundle your child. If your child is chilled, put on an extra blanket but remove it when the chills stop.