I had to write this one because it seems to me that there is a general misconception that all fevers, especially in children, are bad and we must treat every rise in body temperature immediately with paracetamol or our children will suffer from irreparable brain damage. So let’s just set the record straight… (by the way, all the quoted references are for those who want it from the horse’s mouth, so don’t just take my word for it).
1. Fever is the body’s defense
Firstly, fever is part of the body’s defense against infections. When you attempt to control the fever with medication, you’re actually working against the body’s defense, so you’re not really helping your child.
“Fever is part of the body’s defence mechanism against viruses or bacteria. The body creates extra heat, so that the foreign organism cannot survive. Having a temperature helps you fight illness. Fever is a good thing, most of the time.” – Netdoctor
“Fever is part of the body’s way of fighting infection. Macrophages, the “clean-up” cells of the body, are constantly on patrol. When they find something that doesn’t belong – such as a virus, bacterium or fungus – they mop up as much as they can. At the same time, they call for help, signalling to the brain to raise the body’s temperature. The heat kills some types of bacteria directly. It also seems to speed up the body’s production of white blood cells and chemicals that kill germs.” – Babycenter
There is a lovely explanation about fever and how it works on Family Doctor.
The other beneficial effect of fever I have noticed is that the boys usually don’t fight sleep when they have it – which is good because they need the rest to help their bodies recover. If I start treating their fever too eagerly, I find they end up wanting to run around and play rather than sleep so how can that be helpful?
2. Most fevers do not need to be treated.
The general recommendation I have seen for the treatment of fever is when it is 38.5 degrees celcius and above, and/or it is causing your child a lot of discomfort.
“Fevers generally do not need to be treated with medication unless your child is uncomfortable or has a history of febrile convulsions. The fever may be important in helping your child fight the infection. Even higher temperatures are not in themselves dangerous or significant unless your child has a history of seizures or a chronic disease. Even if your child has a history of a fever-related convulsion and you treat the fever with medication, they may still have this kind of seizure … If he is eating and sleeping well and has periods of playfulness, he probably doesn’t need any treatment.” – American Academy of Pediatrics
“Fevers help the body fight infection. Treating a fever is only necessary when you think your child is uncomfortable. The goal of administering antipyretic (anti-fever) medications is not to get a high temperature back to “normal.” They are simply medications to make your child feel better. Fevers can make kids feel pretty lousy. Children can have altered sleep, unusual behavior, and poor oral intake. If these symptoms are upsetting to your child, please give a fever reducing medication. Treating fever does provide comfort, and may decrease the risk of dehydration.” – MedPage Today
In fact, there is evidence to suggest that aggressive management of fever is not only unnecessary but even harmful:
- A study of adults with colds found that aspirin and acetaminophen suppressed production of antibodies and increased cold symptoms, with a trend toward longer infectiousness.
- In a study of children with chickenpox, acetaminophen prolonged itching and the time to scabbing compared to placebo treatment.
- In test-tube studies, therapeutic levels of aspirin suppressed the ability of human white blood cells to destroy bacteria.
- Another study found that a host of pain relievers, including aspirin and ibuprofen, inhibited white-cell production of antibodies by up to 50 percent.
It is also unnecessary to run to the doctor at the first sign of a fever. In the early stages of an illness, there are usually insufficient signs and symptoms for a doctor to do more than prescribe a few medications to control the existing symptoms and ask you to come back again if things aren’t getting better or if they are getting worse.
Additionally, with all the superbugs around these days, a trip to the doctor is actually putting your child at risk of picking up other infections from the other sick kids waiting to see the doctor. We all know that sick kids don’t know how to keep their germs to themselves – Hercules coughs and sneezes into my face on a regular basis so I’m often sick when he is. So far, there is only one paediatrician I have seen who has a separate waiting room for the “healthy kids” who are just coming for routine vaccinations.
3. Fever doesn’t cause brain damage.
“In a person with a normal functioning brain, and the ability to cool oneself, fever is normal response to infection. Every normal brain has a internal “thermostat” that will prevent a person’s temperature from getting high enough to cause brain damage. It is only when hyperthermia, or heat stroke, occurs when damage to the brain and other organs will occur. Hyperthermia happens in the rare instances when an individual’s brain cannot regulate temperature well (as in a rare case of brain injury) or when an individual is not able to cool oneself (as in a closed car on a summer day.) Fever due to illness in a normal child will not cause organ damage.” – MedPage Today
4. When do you need to take notice?
According to Netdoctor, you should be concerned about fevers when:
- you have a young child, less than three months old, who runs any fever
- your child cries and cries, without you being able to comfort them, and doesn’t wake up easily
- your child has a temperature over 38ºC (101.3ºF) for more than three days
- your child has just had an operation
- your child doesn’t seem to be getting better.
And, if your child experiences any of the following symptoms with a fever, you should call your doctor:
- Stiff neck.
- Affected by bright light.
- Red rash or blue or purple dots or patches.
- Trouble breathing.
- Cramps or leg pains.
- Continued vomiting or diarrhoea.
- Continued tonsillitis.
- Pain when urinating, or urinating more than usual.
- Other illnesses.
So there you go…