What to do when your Child has a Fever

April 4th, 2011 | Sources: MedPageToday, NPR, Pediatrics

Other than a prolonged tantrum perhaps, nothing upsets the normal give-and-take between parent and child more than a child who is running a fever. Mild temperature elevations are usually a benign, physiologic response to a mild viral infection. Yet many well-meaning parents give their kids medicine for no other reason than to keep the temperature down. As if treating the fever was the same thing as treating the virus.

Now, a task force from the American Academy of Pediatrics has advised physicians and parents that a fever, in and of itself, should not be a cause for concern, and that parents should not bother  treating low-grade fevers in kids unless they are demonstrably uncomfortable because of the fever.

In short, parents should try to keep kids comfortable rather than reducing their temperature to a pre-determined number.
The viruses that cause most fevers typically last just a few days and cause no harm. And although febrile seizures do occur, the group says anti-fever medicine don’t necessarily prevent them.

“There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications,” the report stated. In fact, fever is one mechanism by which the body fights viral infections. It slows growth and reproduction of the germs that typically cause fever and enhances neutrophil and T-lymphocyte production, for example.

According to the report, nearly half of all parents believe (incorrectly) that a temperature less than 100.4 degrees constitutes a fever, and nearly 25% would give antipyretics to their children for temperatures less than 100. And nearly 85% of parents would awaken a sleeping child if it was time to administer a dose of anti-fever medicine.

That’s unwise. “If they’re sleeping, let them sleep,” Henry Farrar, an emergency room pediatrician and report co-author said in an interview.

The AAP report doesn’t recommend a specific temperature that should prompt a call to the physician. Its main conclusion is that parents and physicians should look at the entire range of a kid’s symptoms (presumably to detect a more serious illness) and not just the temperature.

If it becomes necessary to reduce a high fever in kids, the report suggests that combining acetaminophen in alternating doses may be more effective than using either one alone, although this technique risks increasing the frequency of adverse effects associated with the drugs.

The report also cautions that many OTC medicines contain antipyretics, and this needs to be accounted for in properly dosing kids with anti-fever medications.

“Appropriate counseling on the management of fever begins by helping parents understand that fever, in and of itself, is not known to endanger a generally healthy child,” the report concluded.


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