Family Matters

Has Your Kid Got a Fever? Don’t Rush to Dole out Drugs

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Parents, especially new ones, freak out about fevers. A third of all pediatric visits involve worried parents bringing in feverish little ones. But there’s really no reason to fret when your kiddo’s temperature starts to rise. And there’s no reason to push drugs to alleviate the fever, according to a new clinical report published online today in the journal Pediatrics.

Fever in and of itself is not harmful. Even more than that, it can actually be helpful since it prompts the body to churn out more infection-fighting white blood cells. Because fever decreases the ability of viruses and bacteria to reproduce, it can actually shorten the duration of an illness.

It’s not that you want your child to suffer in hopes that a cold will wind down sooner, but Janice Sullivan, a co-author of the study, says it’s not necessary to ply children with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) unless they’re uncomfortable.

“There’s a myth out there that if you have a fever, you could have brain damage or seizures. That causes parents to be very anxious,” says Sullivan, a professor of pediatric critical care and clinical pharmacology at the University of Louisville. “Sometimes children with a fever of 103 will sit and play and act completely normal.” (More on House Calls: A New Pediatric Model?)

The report reveals that parents aren’t always making the best decisions for their kids when it comes to fever. They’re quick to pour a shot of bubble-gum-flavored meds for any fever, even when doctors wouldn’t advise it for a temp of less than 101 degrees.

A quarter of caregivers say they’d give medicine for a fever less than 100 degrees, and 85% of parents said they’d awakened their child to give fever-reducing medication. Note to parents: don’t do this. If a child’s able to snooze, waking him serves only to disrupt his sleep and remind him how miserable he is.

There are a few exceptions to the don’t-worry-about-fever rule: infants less than three months old with a temperature greater than 100.4 degrees should go straight to the doctor, as should babies between three and six months with a fever over 101 degrees.

But after six months of age, fevers up to 103 degrees are not typically cause for concern. Higher fevers, combined with vomiting, diarrhea and no other signs or symptoms, may warrant a doctor’s visit. But if Tylenol or Advil can bring down the fever, there’s probably no reason to head to the pediatrician. (More on Dad Helping with the Kids? Moms: Expect Conflict, Not Cooperation)

Bottom line: in otherwise healthy children, there’s really no temperature at which you have to treat a fever.

If you decide to, however, make sure to go about it the right way. Dosages should be decided according to weight, not age. Sullivan says half of parents incorrectly dose their children.

Also, stay away from the kitchen teaspoon; it’s not a reliable way to dispense liquid medication. Instead, use a measuring device you can pick up at any pharmacy. Even those are not always fool-proof, according to an analysis in the Journal of the American Medical Association of 200 of the top-selling children’s cough and cold, allergy, analgesic and gastrointestinal over-the-counter liquid medications that found disturbing levels of inconsistency in medication labeling and measuring devices. (More on Dosages for Children’s Liquid Medications Confound Parents)

The Pediatrics report also weighs in on the practice of alternating between acetaminophen and ibuprofen for particularly hard-to-budge fevers, citing “evidence that combining these two products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs.”

The takeaway? As with all things relating to kids and medication, proceed with caution.