Child with feverFever is one of the most common childhood complaints seen by pediatricians and other healthcare providers. Fever, however, isn’t the real problem. Fever is just part of our natural, and actually quite helpful, physiological response to an infection. Rather than causing harm, fever actually benefits us by slowing the growth and reproduction of viruses and bacteria while increasing the production and circulation of white blood cells. (1,2,3) In generally healthy children (and adults too!), fever stimulates a stronger, more effective immune response. Research shows that fever actually helps the body recover faster, and may result in fewer complications with certain types of infections. (1,3)

Parents and caregivers frequently use antipyretic drugs such as acetaminophen and ibuprophen in order to reduce fever and pain, even when there is minimal or no fever. In fact, approximately 50% of parents consider a temperature of less than 38°C (100.4°F) to be a fever. Adding to the confusion, up to 50% parents administer incorrect doses. Up to 15% of caregivers administered doses which were too high. Acute and chronic overdosing has been linked to liver toxicity in the case of acetaminophen, and kidney insufficiency and gastritis in the case of ibuprophen. (1) Common misconceptions about childhood fevers, and the subsequent overuse of antipyretic drugs, has been coined “fever phobia”.

“Fever phobia” has been well studied: parents often express concern, anxiety, and fear about managing fevers at home which is grossly incongruent with research into the effects of fever and clinical practice guidelines. (2,4) Canadian surveys indicate that parents are concerned that fevers can cause harm due to seizures (68%), dehydration (76%), or brain damage (47%). (5)

In contrast, there is no evidence that fever itself causes harm, either short-term during the infection itself or long-term in the form of complications such as brain damage. Contrary to popular belief, there is no clear relationship between fever and febrile seizures. In fact, antipyretic use doesn’t prevent occurrence, or recurrence, of febrile seizures. (1,3,5)

Child drinking herbal teaAccording to the American Academy of Pediatrics (AAP), there is insufficient evidence to support giving a child antipyretics to bring their temperature back to normal. (1) In other words, there is usually no reason to lower the child’s temperature. Although an elevated temperature isn’t a good reason to give your child drugs, antipyretics are frequently recommended by MD pediatricians to relieve the discomfort associated with fevers. However, as the AAP states: “as with all drugs, they [antipyretics] should be used judiciously to minimize the risk of adverse drug effects and toxicity.” (1)

Certainly, if comforting a sick child is the solitary goal of antipyretic drug therapy, there are plenty of naturopathic therapies with fewer potential side effects and/or toxicity. Constitutional hydrotherapy treatments, homeopathy, warming socks, and herbal diaphoretic teas are great front-line treatment options that facilitate the body’s own healing processes and support the child and their caregivers when they are feeling unwell.

What to do if you child has a fever?

  • Fever is a good thing; don’t be afraid of it.
  • Remember that how your child acts and feels is more important than their temperature.
  • Keep them hydrated. Offer water frequently and check for signs of dehydration.
  • Do a warming sock treatment.
  • Give them lots of love and physical comfort.
  • Remove extra blankets and clothing so heat can leave their body and help lower their temperature. Avoid removing too many layers to prevent shivering and chills.
  • Store natural and pharmaceutical medicines safely, in a locked cabinet, out of children’s reach to prevent accidental overdosing.
  • Dose antipyretic drugs and herbal medicines according to weight, not age of the child or severity of the fever.
  • Never give a child or teenager aspirin (acetylsalicylic acid or ASA) as serious complications can occur.

When to consult?
Contact you healthcare provider if your child:

  • Is less than 6 months old
  • Has a fever lasts more than 72 hours
  • Becomes lethargic, excessively sleepy or irritable
  • Develops a rash, persistent cough, or other signs of illness

For information on how to take your child’s temperature and normal temperature ranges, visit the Caring for Kids website.

References
(1) Section on Clinical Pharmacology and Therapeutics; Committee on Drugs, Sullivan JE, Farrar HC. Fever and antipyretic use in children. Paediatrics. 2011 Mar; 127(3):580-7.
(2) Allan GM, Ivers N, Shevchuk Y. Treatment of pediatric fever: Are acetaminophen and ibuprophen equivalent? Can Fam Physician. 2010 Aug; 56(8):773.
(3) Boyle W, Saine A. Lectures in naturopathic hydrotherapy. Sandy, OR: Eclectic Medical Publications; 1988.
(4) Walsh A, Edwards H. Management of childhood fever by parents: literature review. J Adv Nurs. 2006 Apr; 54(2):217-27.
(5) Pusic MV. Clinical management of fever in children younger than three years of age. Paediatr Child Health. 2007 July; 12(6):469-72.