Parents, do you suffer from fever phobia? Have you ever:
• Awakened a sleeping child to take his or her temperature?
• Chased down a running, giggling but slightly feverish child with a dose of Tylenol?
• Forced a whimpering, shivering, miserable child to endure a sponge bath?
If you answered yes to those questions, you may have fever phobia – a common malady, first named by exasperated physicians who care for children back in the 1980s.
USA TODAY is reporting that the cause of this scourge is the widespread but mistaken belief that fevers are dangerous — that “if you don’t treat a fever, the child will suffer brain damage or death,” says Lewis First, chief of pediatrics at Vermont Children’s Hospital in Burlington.
“Parents are afraid of fever,” says Ian Paul, director of pediatric clinical research at the Penn State College of Medicine.
That fear sells a lot of acetaminophen (Tylenol) and ibuprofen (Motrin). Those are safe and effective drugs when used at proper doses, physicians who care for children say. But, like all drugs, they can be toxic at too high a dose. And some researchers worry that routine overuse might produce unforeseen harm.
One hypothesis: Acetaminophen use might be linked to rising rates of asthma worldwide.
Children who got acetaminophen for fevers in infancy had more asthma in later childhood in a large international study published in the Lancet journal in September.
But the study did not show the drug caused asthma. A more likely explanation, says Paul: Kids who developed asthma had more illnesses as babies and got more fevers and fever medicine.
Fever medicines certainly are not under the same cloud as the antihistamines, decongestants and cough remedies in children’s cold medicines. The Food and Drug Administration says those drugs are unsafe and worthless for children under 2. The American Academy of Pediatrics says they should be banned for children up to age 6. At a hearing Thursday, FDA officials said they were not ready to take that step but promised further review.
‘Fever is our friend’
Fever medicines do reduce fevers. But, physicians who care for children agree, that’s not a good reason to use them. Untreated fevers do not kill and do not keep rising until the child combusts, the doctors say.
Fevers, they say, do not damage brains — though serious infections, which can come with fevers, sometimes do. Fevers can cause seizures in up to 5% of susceptible children, according to a recent review from the pediatrics academy. But those seizures, while scary, almost always are harmless. (Fever medicines also don’t appear to stop them.)
Some studies even suggest fevers might help the immune system defeat infections faster. “Fever really is our friend,” First says.
Studies have shown that with viral illnesses, when the fever is not treated, the child actually gets well faster.
But other studies suggest fevers stress the heart, throw off some immune responses and raise blood pressure, making them a more serious matter for some chronically ill children and adults, Paul says.
However, in the normal child, watching a fever that is not making a child uncomfortable is perfectly acceptable.
But, a fever in a baby under 3 months old always demands a call to a doctor, he says.
But for the average child with the flu, “think about comfort, not the number on the thermometer,” Paul says. If a child “feels lousy and they won’t drink very well,” it makes sense to use a medicine that treats a sore throat, aching muscles, or a throbbing head and also happens to lower fever.
Sleeping children, he notes, already are comfortable. Children with temperatures of 104 degrees almost always feel miserable, he says, but there’s no “magic temperature” at which drugs are urgent.