Fever is not Your Child’s Enemy but His Friend

It can be scary when your child’s forehead feels abnormally warm to the touch. So it’s only natural for parents to stress over how to treat a fever in their child. But your impulse to bring that fever down immediately with ibuprofen or acetaminophen may not be the best move, according to a new American Academy of Pediatrics clinical report, published in the journal Pediatrics. The reason: Your child’s fever is a physiologic mechanism that has beneficial effects in fighting infection, so reducing the fever may actually hamper healing.

The details: Even when a child has a mild fever, many parents want to administer antipyretics such as acetaminophen and ibuprofen, according to the report. That’s natural; we all want to be reassured by that “normal” 98.6 reading on the thermometer. But according to the AAP researchers, there is no evidence that fever itself worsens the course of an illness, or causes any long-term neurologic complications. “Thus, the primary goal…should be to improve the child’s overall comfort rather than focus on the normalization of body temperature,” the report says.

What it means: So how should you treat a fever when your child’s sick? “The report’s main takeaway is to treat your child’s discomfort, not the fever,” says lead author Janice Sullivan, MD, principal investigator of the University of Louisville Pediatric Pharmacology Research Unit. “For example, if your 1-year-old is pulling at her ears, looks uncomfortable, and has a temperature of 103, you’ll want to give her medication to make her feel better. If her temperature comes down to 101 but she’s comfortable, that’s fine. Don’t worry about getting it to 98.6.”

“In the end, fever is your friend,” says Dr. Sullivan. “It’s a normal, positive response. It decreases the ability of viruses and bacteria to reproduce in the body, and it stimulates the body to manufacture more white blood cells, which help fight infection.”

Dr. Sullivan offers the following advice:

Don’t focus only on fever.

Even in the absence of fever or obvious discomfort, is your child active? Is he playing or is she lethargic? Is he having difficulty breathing? Is she experiencing pain? Does he have a skin rash? These are all signs of sickness, and warrant treatment.

Beware of dehydration.

“A high temperature speeds dehydration, which becomes a problem all by itself,” says Dr. Sullivan. “Look for a dry mouth or less-frequent urination.” For infants, you can give Pedialyte, says Dr. Sullivan. If a child is vomiting, clear liquids like 7-Up or Sprite are best. If there’s no vomiting, anything the child wants is fine, including soft drinks, water, or juice.”

Have a game plan.

During wellness visits with your pediatrician, ask him or her what steps to take if your child gets sick and how to handle a fever. And once your child does get sick, always feel free to call your pediatrician with any concerns.

Act fast if your child has a chronic disease.

“Fever is a more serious factor in this case,” says Dr. Sullivan. “For example, a fever can make the heart work harder in children with cardiomyopathy. In these sorts of cases, it’s important to devise a game plan during your well-child visits.”

Look out for the littlest ones.

An infant less than 3 months old who gets a temperature of 100.4 or higher needs to be seen by the ER or your pediatrician right away. “At this age they’re too young for medications, and their temperature may be the sign of a serious illness,” says Dr. Sullivan.

Stock the right stuff.

Only use pediatric versions of ibuprofen or acetaminophen, and use an appropriate measuring device. “Research has shown that a large percentage of parents give their children either too much or too little medication—often because they’re not measuring properly,” says Dr. Sullivan.

Let them sleep.

Don’t waken a child to give him or her medication, advises Dr. Sullivan. If she’s sleeping, it means she’s comfortable. She likely needs the rest.

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