Cold and flu season is just around the corner, even though it doesn't seem like it this year in Central Texas. For youngsters, exposure to other children through school and day care increases the chances that a child will have one or more illnesses that cause a fever. We asked pediatrician Anna Bell, MD of Children's Medical Group for advice on dosing a fever.

'It's okay to have a fever and okay to have a cold,' she says. 'Fever is an indication that the body is fighting off an infection - either a virus or a bacteria. It's the body's defense mechanism and we need it to fight off germs. It can be scary, but it's not necessarily dangerous.'

'Parents fear that a high fever could lead to a febrile seizure or possible brain damage, but that is rarely the case. Although a seizure can be troubling, few children experience one and usually it has no lasting effects. The usual fever of 100 degrees to 104 is normal. Temperature must be as high as 107 degrees before it can be harmful.'

According to Dr. Bell, fever is a symptom, not a disease. She advises observing the child and treating the symptoms if necessary. A youngster who has fever but is still smiling and playing probably doesn't need medication. 'You should only treat children to make them feel better,' she advises. 'If the child is feeling bad and looks sick, medication can help reduce the symptoms.'

Dosing a Fever

'Dose a child's fever by weight,' continues Dr. Bell. 'Weigh the child, then consult a medication chart. You need to know the strength and type of medication you are using.'

She recommends using Children's Motrin or Children's Tylenol. 'Remember that you give different amounts of the two medications - 10 mg per kilogram of weight for Motrin, 15 mg of Tylenol per kilogram of weight.' Here's her easy-to-use dosing chart.

Dr. Bell's Medication Dosing Chart

6-11 lbs 12-17 lbs 18-23 lbs 24-35 lbs Infant's Tylenol Drops (80 mg/ 0.8 mL) dropper = 0.8 mL 1/2 dropper (0.4 mL) 1 dropper (0.8 mL) 1 1/2 droppers (0.8 0.4 mL) 2 droppers (0.8 0.8 mL) Children's Tylenol (160 mg / 5 mL) - 1/2 tsp (2.5 mL) 3/4 tsp (3.75 mL) 1 tsp (5 mL) Infant's Motrin Drops (50 mg / 1.25 mL) dropper = 1.25 mL - 1 dropper (1.25 mL) 1 1/2 droppers (1.25 0.625 mL) - Children's Motrin (100 mg / 5 mL) - 1/2 tsp (2.5 mL) 3/4 tsp (3.75 mL) 1 tsp (5 mL) 36-47 lbs 48-59 lbs > 60 lbs Children's Tylenol (160 mg / 5 mL) 1 1/2 tsp (7.5 mL) 2 tsp (10 mL) 2 1/2 tsp (12.5 mL) Children's Motrin (100 mg / 5 mL) 1 1/2 tsp (7.5 mL) 2 tsp (10 mL) 2 1/2 tsp (12.5 mL)

Comfort Care

Decongestants and antihistamines for young children have been taken off the market because they have not been proven to work and have been shown to have adverse effects if used incorrectly. But there are plenty of other things you can do to improve your child's comfort. Dr. Bell recommends the following.

Fever:

• Follow dosing instructions, every 4 hours for Tylenol and every 6 hours for Motrin. Pick one medication and stick with it to avoid overdosing. Avoid alternating medications routinely. It is okay to give a dose of the other medication if the fever does not respond or recurs prior to the time for the next dose.
• Giving medications does not interfere with the healing process. Temperature may fluctuate throughout the day and is not necessarily bad.
• Dress lightly.
• Other cool things such as Popsicles and cold drinks may be helpful.
• Fever can cause dehydration, so give extra fluids.
• A tepid bath (room temperature, not hot or cold) may help.

Coughs & Colds:

• Use a humidifier or vaporizer in the child's room while sleeping. The effect of both is the same. A vaporizer is cool mist and a humidifier is steam. If you don't have one, pick the vaporizer as there are fewer safety concerns because it does not use hot steam.
• A stopped-up nose can be treated with nasal saline and bulb suction.
• Have your child gargle with salt water to relieve sore throat.
• Give a teaspoon of honey at bedtime for a cough if your child is one year or older.
• Lozenges are good for older children.
• To help relieve drainage, prop up the head of the child's bed or use extra pillows.

When to Call Your Doctor

Your child's doctor should be notified when:

• Your infant (newborn to 2 months) has any fever greater than 100.4 degrees rectally. Fever in a small baby can be a sign of serious infection. Do not treat yourself. Follow your physician's instructions.
• Your baby (2 months to 6 months) has temperature above 100.4 degrees.
• Your baby (older than 6 months) has temperature greater than 101 degrees for more than two days.
• Your child of any age has temperature greater than 103 degrees.
• Your child of any age has fever and a rash.
• Your child of any age looks really ill and is lethargic.

Anna Bell - M.D., F.A.A.P.
Children's Medical Group
711 W. 38th Street, Ste G-2
Austin, TX 78705
Phone: (512) 451-5161

Dr. Bell graduated from the University of Mississippi Pharmacy School in 2000 and received her medical degree from the University of Mississippi Medical Center. She completed her Pediatric Residency training at the Children's Hospital of Austin and is a Board Certified Pediatrician. She was awarded 'Intern of the Year' after her first year of training and was recognized as 'Overall Resident of the Year' at the completion of her training. As a UTMB Clinical Assistant Professor she maintains current medical knowledge and serves as a Pediatric Resident preceptor. She is also credentialed with Pediatrix Medical Group and occasionally fills in as the nursery attending physician for healthy newborns at Seton Medical Center Austin.