Key points
- Counseling priorities: comfort, hydration and warning signs of serious illness.
- Treat fever for comfort; this may also help the child drink and avoid dehydration.
- Fever from infection, even near 41°C (105.8°F), does not damage the brain.
- Scheduled acetaminophen or ibuprofen does not prevent a recurrent febrile seizure.
- Acetaminophen 15 mg/kg every 4–6 hours (no more than 5 doses in 24 hours).
- Ibuprofen 10 mg/kg every 6–8 hours, only from 6 months of age.
- Any fever of 100.4°F (38°C) or higher in an infant under 3 months needs prompt medical review.
What to tell families
Focus the visit on three things: keep the child comfortable, keep the child drinking, and know the signs that mean the child needs to be seen.
How the child looks and acts matters more than the height of the fever. A child who plays and drinks after a dose of fever medicine is reassuring.
- Offer fluids often; count wet diapers or trips to the toilet.
- Dress the child lightly; no cold baths, ice or alcohol rubs.
- Seek care for: age under 3 months with fever, trouble breathing, a stiff neck, a rash that does not fade on pressure, signs of dehydration, a child who is hard to wake or will not stop crying, or fever lasting more than a few days.
Fever phobia: what fever does not do
- Fever caused by infection, even close to 41°C (105.8°F), does not harm the brain.
- The height of the fever alone does not tell you how serious the infection is.
- Fever does not need to be treated if the child is comfortable.
- Waking a sleeping child to give fever medicine is not needed.
Using acetaminophen and ibuprofen
- Dose by weight, with the syringe or cup that comes with the medicine.
- Both medicines work about equally for comfort. Routinely alternating or combining them is not advised, because it raises the risk of dosing errors.
| Medicine | Dose | Notes |
|---|---|---|
| Acetaminophen | 15 mg/kg every 4–6 hours; no more than 5 doses in 24 hours | Any age, but call before use under 3 months |
| Ibuprofen | 10 mg/kg every 6–8 hours | Only from 6 months; avoid in dehydration |
| Aspirin | Do not use | Reye syndrome risk with viral illness |
Fever and febrile seizures
Parents of a child who has had a febrile seizure often want to give fever medicine around the clock. Scheduled acetaminophen or ibuprofen does not lower the chance of another febrile seizure, so it is given only for comfort.
Teach seizure first aid instead: lay the child on the side, nothing in the mouth, time the seizure and call 911 if it lasts more than 5 minutes.
Common questions
Can a high fever cause brain damage in a child?
No. Fever caused by infection, even close to 41°C (105.8°F), does not damage the brain. Very high body temperature from heatstroke is a different problem.
Does giving Tylenol or Motrin prevent febrile seizures?
No. Scheduled acetaminophen or ibuprofen does not prevent a febrile seizure from coming back. Use them only to make the child comfortable.
Should I alternate acetaminophen and ibuprofen?
Routine alternating is not recommended. It does not make children more comfortable in a meaningful way and raises the risk of dosing mistakes.
Study this topic
Sources
- AAP 2011: Fever and antipyretic use in children (Pediatrics)
- AAP 2008: Febrile seizures, long-term management (Pediatrics)
- AAP HealthyChildren: Fever without fear
Written for Pedemy in our own words from the sources above; checked November 2026. For education only, not medical advice; check doses and local protocols before treating a patient. Pedemy is independent and not affiliated with or endorsed by the organizations cited.