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Alternating Fever Reducers

Fever is a word that most parents dread.  Just the first hint of a fever sends the worried parent to the medicine cabinet to find the fever and pain reliever. In many cases this is an appropriate response, but not for the reasons parents think. 

Fever in and of itself is not dangerous to the vast majority of children. Fever actually has the beneficial effect of fighting infection.  A pediatrician’s goal in recommending treating a child with acetaminophen or ibuprofen is actually to simply improve the child’s overall comfort and be in a better position to assess the child’s wellbeing.

It also surprises many parents to learn that pediatricians only define a fever as anything over 100.4° F for a rectal temperature.  In recent years, many pediatricians have been recommending alternating acetaminophen and ibuprofen as a treatment for fever as it has been shown that they may work better to lower fever when used together.  But this is not a practice that parents should regularly employ without a visit or call to a pediatrician.  The reason is simple; errors in dosing are very common and you may be accidentally over-medicating your child.

So, what is a parent to do?  The best thing to do if your child has fever is to give them a dose of acetaminophen or ibuprofen to make them more comfortable and monitor their intake, activity level, and for resolution of the fever.  The exact temperature really doesn’t matter or tell you anything about the illness, but monitoring temperature shows the response (or lack of response) to acetaminophen/ibuprofen and presence or absence of a temperature is helpful to know when deciding it an illness is resolving.  It does not matter whether you choose acetaminophen or ibuprofen because they have both been proven equally effective in treating fever in children.

Never wake a child from a slumber to give them a dose of fever/pain reliever.  Since the primary reason for the medicine is to improve overall comfort, by definition if they are sleeping then they are comfortable.

Always consult your primary care physician if your child is less than two months old (because we always evaluate every infant less than 2 months old if they have a fever), if the fever persists for more than several days, your child has trouble feeding, seems exceptionally lethargic, has a febrile seizure, or if you have specific concerns or questions.  It is also important to note, that although very scary for the parent, a febrile seizure is not in and of itself dangerous, but by all means if you feel your child is having an emergency, never hesitate to bring your child to an emergency department.

Dr. Betty Witman is a WakeMed pediatrician and Medical Director of the SAFEchild Advocacy Center.

WakeMed Children’s is dedicated to providing answers to common questions parents have about children’s health and wellbeing.   Learn more by subscribing to WakeMed’s Families First newsletter.  Have a specific question you would like answered?  Post a comment or email us directly.