According to a new report from the American Academy of Pediatrics (AAP), fevers alone are not a cause for intervention in children. Dr. Janice Sullivan, the lead author of the report says, “The focus should be on comfort and not on absolute temperature.” That’s because fever can be help fight illness, by slowing down the reproduction of bacteria and viruses or stimulating the body’s immune response she explains. “That’s a benefit of fever…and may shorten the time that your child remains ill,” she adds.
The AAP has released guidelines on treating fever with over-the-counter medications in the latest issue of the journal Pediatrics. The authors reviewed studies on the safety and efficacy of acetaminophen, marketed as Tylenol, and ibuprofen, marketed as Motrin and Advil.
Sullivan, a professor at the University of Louisville and head of the AAP’s section on clinical pharmacology and therapeutics, said parents should recognize that fever is a sign that a child is ill. This should alert them to other symptoms - such as lethargy, pain or dehydration - to see if a call to the doctor is warranted. Sullivan said, “We discourage parents from waking their children to give them antipyretics (fever-reducing medications), because if their child is sleeping, there’s no sign of discomfort.” Parents frequently give too much or not enough medication, Sullivan said. Her report stresses that dosing should be measured according to weight, not age or height.
It is seen from studies that the vast majority of parents will wake their children to give them fever reducing medicine. Claire McCarthy, a pediatrician at Children's Hospital Boston said, “A lot of families have fever phobia…What’s really important is making the child feel comfortable.” McCarthy said the guidelines are useful in reiterating what pediatricians have been practicing for years. She is a member of the AAP, but was not involved in developing the guidelines. “I think that a lot of people don’t realize how possibly dangerous acetaminophen can be,” McCarthy said. Overdoses can cause harm to the liver.
The guidelines also encourage parents not to give their children cough or cold medicine that includes acetaminophen or ibuprofen. Sullivan said parents often do not notice that these drugs are included in cough syrups, and end up giving their kids a double dose of fever reducer.
Dr. John Rodarte, a pediatrician in La Canada Flintridge also said, “Fever phobia would be the fear of the actual number - if you didn’t know what your child’s temperature was, you wouldn’t necessarily be afraid of it but parents are.” “The biggest piece of advice I always give is not so much what’s the fever, but how is your child. I don’t really care what the number is, it’s more how is your child doing…If your child has been having a fever but also has been not drinking or eating all day and they might be dehydrated, that would be something I’d want to know about,” said Dr. Rodarte. Also, Dr. Rodarte says febrile seizures, or seizures that happen with fevers, may be a huge concern for parents, but they are usually harmless and children often grow out of them.
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