Caring for Your Child’s Fever
What is a child’s normal body temperature?
A child has the same body temperature range as an
adult:
• 36.5°C – 37.5°C (97.7°F - 99.5°F) when taken by
mouth.
• 36°C – 37.3°C (96.8°F - 99°F) when taken under an
armpit.
• 36.6°C - 37.9°C (97.9°F – 100.2°F) when taken
rectally.
•
What is a fever?
• A fever is a symptom and not a disease. It is the
body’s natural way to fight infections and results in
a raised body temperature.
• Causes of fevers may include:
 Viral infections such as influenza and parvovirus
(‘fifth disease’).
 Bacterial infections such as urinary tract
infections and pneumonia.
 Immunizations. Fevers may occur 1 to 14 days
after a child or adult gets immunized, depending
on the types of vaccines they received.
•
How can I tell if my child has a fever?
• Safe and accurate temperature taking is important
especially in young children. Electronic digital
thermometers are recommended for use.
When should I be concerned about my child’s fever?
Take your child to a doctor, nurse practitioner or
emergency room immediately if they have any of
these symptoms:
• A fever over 38°C (100.4°F) and is less than 6 months
of age.
• Has had a fever for more than 3 days.
• Develops small purple spots on his/her skin that may
look like bruises or a rash.
• Has a seizure or convulsion (‘a fit’ or shaking)
whether or not they have a fever.
• Struggles with you, seems confused or delirious, is
unresponsive or you have difficulty waking your child.
• Has problems breathing.
• His/her skin colour does not look right or becomes
grey, pale or blue.
• Refuses to stand or put weight on his/her legs.
• Cries constantly and you cannot settle him/her.
• Does not use an arm or leg normally.
• Has repeated vomiting and/or diarrhea even if they
don’t look like they are dehydrated.
• Cries when going to the bathroom, or if his/her pee
smells bad.
By armpit:
• Place the thermometer high up in the centre of the
armpit making sure it touches bare skin on all sides.
• Hold the child’s arm close to his/her body.
• When the thermometer beeps, remove it gently and
read the temperature.
By mouth (can be used for older children):
• Place the thermometer probe under their tongue
(remind the child not to bite down on the
thermometer).
• When the thermometer beeps, remove it gently and
read the temperature.
• Wait 20 minutes after your child has a drink before
taking their temperature by mouth.
Rectally:
• Apply a lubricant or petroleum jelly (like Vaseline®)
on the thermometer probe so that you can easily
insert it.
•
•
Lay the child down and spread their buttocks with
one hand and gently insert the thermometer probe
into the rectum about 1.25 cm (0.5 in.) to 2.5 cm (1
in.). Don't force it into the rectum.
Hold the thermometer in place with your fingers
and press the child's buttocks together to keep the
thermometer in place.
When the thermometer beeps, remove it gently
and read the temperature.
Wash the thermometer well after rectal use. To
prevent spreading bacteria, don’t use it to take oral
temperatures.
Notes:
• Ear (tympanic) thermometers are quick but the result
may not be accurate.
• Forehead strips, pacifier (soother) and disposable
thermometers are not accurate and should not be
used.
• Glass thermometers can cause mercury poisoning if
they break.
How can I treat my child’s fever?
Comfort measures include:
• Dressing your child lightly and covering with a sheet.
• Bathing your child in lukewarm (never cold) water for
less than 15 minutes (stop the bath if your child starts
shivering).
• Encourage your infant to breastfeed or formula feed as
often as possible to prevent dehydration (infants do
not need to be given additional water or other fluids).
• Encourage your child to drink water or diluted juice or
eat popsicles, gelatin and ice chips, and watch for signs
of dehydration (e.g., their pee is dark colored or they
are thirstier than usual).
Medication to manage fevers:
• ASA (Aspirin®) should NOT be given to anyone under
20 years of age due to the risk of Reye’s syndrome
• Do not give ibuprofen (Advil®, Motrin®) to infants less
than 6 months old.
• Acetaminophen (Tylenol®, Tempra®) is effective for
fever and pain control. It is available in several forms
such as drops, syrup, tablets/chews or rectal
suppositories. .
•
•
•
•
•
Carefully read and follow all labels on the
medicine bottle and package.
Always check your child’s weight so that they
receive the right dosage of medication.
Doses may be repeated every 4-6 hours until the
fever drops. Do not give your child more than 5
doses in a 24 hour period.
Acetaminophen may be present in other overthe-counter medications. Overdoses of
acetaminophen have been known to cause
permanent liver damage and/or death in children
and adults.
Do not alternate giving acetaminophen and
ibuprofen as this does not control a fever or pain
any better than just giving acetaminophen and
may cause accidental drug overdoses.
For more information, contact HealthLine at 811 (24
hours a day), your local public health office, or your
physician or nurse practitioner.
Resources: http://healthlineonline.ca/; Canadian
Pediatric Society www.cps.ca; The Hospital for Sick
Children (2010) www.sickkids.ca; www.tylenol.ca
(2014); http://www.metricconversions.org/temperature/celsius-tofahrenheit.htm
Dosages for Various Forms of Acetaminophen for Children
Weight
(kg)
Weight
(lbs.)
Single dose
(mg)
Infant drops
80 mg per
1mL
Children’s syrup
160 mg per 5mL
Children’s
meltable or
chewable tablets
80 mg per tablet
Junior
meltable or
chewable tablets
160 mg per tablet
Suppository
120 mg
2.5-5.4
6-11
40 mg
0.5 mL
-
-
-
-
5.5-7.9
12-17
80 mg
1 mL
-
-
-
-
8-10.9
18-23
120 mg
1.5 mL
-
1.5 tablets
-
1
suppository
11-15.9
24-35
160 mg
2 mL
1 tsp.
(5 mL)
2 tablets
1 tablet
-
16-21.9
36-47
240 mg
-
1.5 tsp. (7.5 mL)
3 tablets
1.5 tablets
2
suppositories
Rev. April 7