Fever remains the leading reason for pediatric office and ER visits, and it is a common cause of parental anxiety. We and others have tried to educate our parents for years that fever itself is not harmful (but the cause of the fever may be), and that fever helps the body to fight off infection. The only reason to treat fever is if the child is uncomfortable or is not drinking or sleeping well. Treating the fever also helps sometimes in evaluating how ill the child really is. (Fever can make a child appear ill and lethargic. If the child is not seriously ill, reducing the fever will result in the child being more active and playful. If the child’s fever comes down and she is still lethargic and ill appearing, this is a more serious illness). Fever should be treated to make the child feel better, not because the fever is harmful. Numerous other websites, books, and articles have been written to educate parents about fever. But it still seems to cause a great deal of anxiety.
This new report is aimed at educating pediatric health care providers about fever, and particularly about the use of fever medications. There has been increasing concern about harmful effects of fever medicines in both children and adults in recent years. The report clearly states what we already know:
- Fever is harmless and actually beneficial and that parents need to be educated about “fever phobia.”
- Fever medicines should be used only for the child’s comfort.
- The degree of fever does not correlate with the seriousness of the illness.
- Acetaminophen and ibuprofen appear safe at recommended doses for short periods of time.
- Using the correct dose for the child’s weight is absolutely critical.
- Alternating acetaminophen and ibuprofen is not necessary (since fever is not harmful) and may not be safe. It also increases the risk of dosing errors.
- Use of these drugs over a day or several days (the total dose in a day or series of days) may have harmful effects that are not clear at this time. Little research has been done on the safety or long-term effects of these medicines in children.
Parents should continue to use these medications when necessary but only when necessary. And they should keep reminding themselves (as I have to when my kids are sick) that the fever itself will not harm them, but you need to be sure you know the cause of the fever, such as a cold, flu, stomach virus, strep throat, ear infection, or other causes.