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Fight Fever Fear With Knowledge

High temperatures are normal for kids

Fever is a sure sign that the body’s natural defenses are helping to fight an infection. But when your child is red-faced and burning up, how many parents say to themselves “Oh good, little Suzie’s body is working just the way it should!” No, we get out the thermometer, give it a few vicious shakes and call the doctor before the mercury hits 102.

The medical journals have a name for this syndrome: It’s called fever phobia and according to the textbooks it accounts for more phone calls and visits to pediatricians’ offices than almost any other symptom. But parents aren’t the only ones who have this near-visceral reaction. Over the last decade, numerous studies have found that doctors actually perpetuate fever phobia by fixating on a child’s temperature when inquiring about symptoms. The result is a lot of unnecessary medication.

Additional Problem

One of the latest such studies, published in the May 2000 issue of Pediatrics, suggests an additional problem. Half of the 161 pediatricians surveyed about fever management reported that they regularly advise parents to alternate between acetaminophen (Tylenol) and ibuprofen (Advil or Motrin). This is alarming news, as the authors of the study – a team of doctors at Winthrop University Hospital in Mineola, N.Y. – make clear: There is presently no scientific evidence that this is safe or achieves faster resolution than either agent alone,” they wrote. “There is evidence that the improper use of these agents may cause harm.”

The potential risk for over-dosing and double-dosing is not only serious but well documented. A 1998 study in the same medical journal showed that parents perceived acetaminophen as a safe drug and are unaware of its potential consequences when given incorrectly. Those consequences include allergic reactions and serious liver damage.

Other studies have consistently identified control of fever to be a major issue for both doctors and caregivers. For example, a 1992 study showed that 65 percent of Massachusetts pediatricians said they believed that fever itself could be dangerous to a child. Seventy-two percent reported that they “always” or “often” recommend treatment to reduce fever, while 89 percent did so at a temperature between 101 and 102 degrees. Many of the doctors cited death and brain damage as potential complications of untreated fever.

It ain’t necessarily so

The truth is that fever of less than 107 degrees is not responsible for such complications. Children can have high temperatures (that would make an adult feel very ill) and still have nothing very much wrong with them, according to “The Philadelphia Children’s Hospital Book of Pregnancy and Child Care,” edited by Dr. Patrick S. Pasquariello. The height of the temperature doesn’t necessarily reflect the severity of the illness. More important is the child’s appearance and behavior. Does he seem sick? Is he lethargic? Is he responsive? Is he in pain?

Many parents are concerned, justifiably about meningitis. Signs of this life-threatening illness, stiffness of the neck, listlessness, poor appetite, vomiting, inconsolable crying or irritability or headache. Certainly if you suspect meningitis, seek medical help immediately. If a baby under 3 months of age has a fever, that is also reason promptly to see a doctor. Babies typically don’t come down with fevers.

But for the rest of us, a little fever can do a lot of good. It kills many germs, including strep. Pneumonia, the bacteria responsible for many ear infections and pneumonia. To let the body heal itself – without unnecessary medications consider these alternatives:

  • Encourage the child to rest by reading her a book and sponging her wrists and the back of her neck with lukewarm water.

  • Bring her plenty of liquids, broths, teas and fruit juice or Popsicles.

  • Offer light foods.

  • Squirt half a dropper of echinacea in her fruit juice, and give vitamin C and garlic.

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