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No More Fever Phobia!

by Sue Hubbard, M.D.

Parental concerns about children with fever continues to be the primary reason for phone calls to pediatricians offices, visits to the doctor and late night trips to the ER.  The term “fever phobia” is not new and one of the hardest things to “teach” parents is the mantra “fever is your friend”.

What?  How can that be?  What if the thermometer reads 103.7 degrees?  Well, the latest report by the American Academy of Pediatrics reiterates that fever phobia is an unnecessary and unfounded worry, as the number on the thermometer is just that, a number, and is not indicative of degree of illness.  In other words, degrees Fahrenheit does not correlate with degree of illness.

It is hard not to think that a thermometer that reads 103.7 degrees is not indicative of a life threatening illness. But fever in and of itself is a symptom and not an illness. The body’s reaction to fighting an infection is typically a febrile response, and fever may be a protective mechanism.

I spend a lot of time with my patients and their parents discussing fever and what a fever means.  It is hard to discuss a fever in the abstract, and most parents say that they will not “fear a fever”. But, when the actual time arrives and their child has a fever, it is a whole different thing. Despite all of the education about “fever is your friend” the thermometer with 103.7 degrees flashing at you is a scary proposition.

Of course it seems reasonable to think your child is” sicker” if their temperature is higher, and I know as a mother and pediatrician, your child does “look pathetic” with a high fever. The fever makes you feel yucky, and your heart rate goes up as does your child’s respiratory rate, this is a body’s normal response to a fever. When you have a higher temperature you don’t feel a lot like eating or playing, you are often happy to just lay on the bed or a couch and watch a movie and eat a popsicle or have a glass of Gatorade. But, taking fluids and watching a movie or quietly reading a book is a good sign that your child is not “too” sick.

Young children with a fever are often whiny and pathetic, but they will have moments when they will play, or eat a cookie, and then become pathetic again soon thereafter. That up and down is a good sign.

Treating a fever with either acetaminophen or ibuprofen is recommended only to make your child feel better. Treating a fever is not always necessary and some studies show that an illness may resolve sooner if the fever is left untreated.

When and if you do decide to treat your child’s fever, make sure that you use the correct dosage of medication, which should be based on a child’s weight. I try to give each family a medication-dosing chart for acetaminophen and ibuprofen at their 2 month visit so that they may tape it inside the medicine cabinet and can refer to it when needed.

I promise you there will be many nights of fever to face during the course of parenting!  As you learn to “relax” while reading a thermometer, each illness will become a little easier.

Lastly, it is not necessary to awaken a child from a nap or during the night to take their temperature, or treat a fever. An uncomfortable child will wake up and demand your attention.  Fever does not cause “a scrambled brain” (term from a patient of mine), and you will not have caused brain damage if you let your child sleep with a fever.

Sleep is usually one of the best treatments for illness, so let a feverish child rest and wait to take their temperature and treat the number on the thermometer. Chant with me “fever is your friend”!!!

That’s your daily dose for today.  We’ll chat again tomorrow.

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