This seems like an appropriate time to spend a few minutes focusing on the subject of fever, in part because it’s one that effects (and therefore interests) just about every parent I know, and also because we happen to be right in the middle of cold and flu season – a time of year during which children inevitably experience far more than their fair share of fevers. It’s also because fever phobia amongst parents is usually far more pervasive than it is warranted. That’s not to say that fever is inconsequential, but rather that we should all take the time to brush up on exactly what fever is, what it represents, when it does (or doesn’t) need to be treated, and how to do so appropriately. Fortunately, the American Academy of Pediatrics just pulled together all of the latest expert thinking on the management of fever in children and released it in a clinical report entitled Fever and Antipyretic Use in Children.
Given the importance of the subject, I figured it would be particularly helpful to review just what these latest fever recommendations tell us about fever.
A healthy respect for fever. It’s important to understand that fever is not an illness, but rather a common and normal response to infection. While fevers can in some instances signify a more serious underlying infection, they are unlikely to endanger generally healthy children.
It’s a matter of degree – or is it? According to the AAP’s report, the use of fever-reducing medications should be focused on making children more comfortable, rather than getting rid of fevers altogether. It’s certainly useful to own a thermometer and to know how to accurately measure your child’s temperature. But all too often, parents unnecessarily focus on using fever-reducing medications to fight their child’s temperature back down to normal and keep it there.
The benefits of fever. While I know it may be hard to recognize any benefits when you’re home caring for a sick child, the report reinforces that fever is actually thought to have a beneficial effect when it comes to the body’s efforts to fight infection.
Fighting fever phobia. The most common fear that parents, caregivers and even health care providers often share is that high fevers, if left untreated, will result in seizures, brain damage, or worse. In fact there is no evidence to support this fever phobia, as there is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications.
Treat with care. Acetaminophen products (like Tylenol) and ibuprofen products (such as Motrin or Advil) are considered equally safe and effective for use in the treatment of fever for children 6 months of age and older. That said, it is especially important for these fever-reducing medications to be dosed accurately and given no more often than necessary or recommended (every 4-6 hours for acetaminophen and 6-8 hours for ibuprofen). As for giving them in combination or alternating them, as is often discussed, it may be effective but shouldn’t be done unless absolutely necessary since it increases the risk of making dosing errors.
Originally posted on Omaha World Herald’s Live Well Nebraska