Child coughing while mom take temp

Fever Phobia

Jan 10, 2023, 09:40 AM by Dr. Sally Robinson

Child coughing while mom take temp

Recently there have been frequent reports of fever reducers for children being sold out—pictures of empty shelves of medications that are unavailable.  Mostly the reporting is related to problems with supply chains but also to emphasize the increased infection rate of three important and dangerous viruses affecting children, COVID, Flu, and RSV.  Interestingly enough the dangerous three are not cured by fever reducers nor is the usual course of the disease shortened or lessened.

So what is fever and why are we so afraid of it?  Fever is the result of inflammatory processes of the body’s immune system.  This process may be caused by infection or autoimmune diseases such as rheumatoid arthritis.  Fever is one of the main reasons that children are brought to the clinic or the ER.

In 1980 Dr. Barton Schmitt coined the term “fever phobia” to help us understand the unrealistic concerns about fever and how it hurts children.  He found that 52% of parents bringing their children to clinic with a fever of 104 degrees or less thought that fever caused serious neurologic consequences such as brain damage or death.  Twenty years later Dr. Michael Crocetti found that fever phobia still existed with 21% of parents thinking brain damage was the primary harmful effect of fever.  This fear has caused parents to overdose their children.

Why do we have fever?  According to Sylwia Wrotek et al in an article called Let Fever Do Its Job the heat of fever helps the immune cells perform, stresses the invading pathogen and infected cells and combines with other stressors to provide an immune defense.  Lowering body temperature has not improved survival in laboratory animals or in patients with infections.  Blocking fever can be harmful because fever, along with other sickness symptoms, evolved as a defense against infection.  Fever works by causing more damage to pathogens and infected cells than it does to healthy cells.

It is the cause of the fever, whether infection or an autoimmune disease, that hurts the child NOT the degree of fever.  It is the degree of illness not the degree of fever.  Times that parents should seek medical help are as follows: is the child hard to awake, is the child younger than 90 days, has the child had a seizure, is there a tender spot or is the child limping, has the fever lasted longer than a week, is the child having bloody diarrhea or persistent vomiting and, most important, does the child look and act sick?

Fever itself is not a danger and is actually a benefit in fighting the infection.  If the decision is made to treat the fever to make the child more comfortable, it is important to follow the direction for doses carefully.  There is no evidence that using more than one fever reducer helps.  Aspirin is never recommended for children. If your child looks and acts sick, seek medical help.

by Sally Robinson, MD Clinical Professor

Keeping Kids Healthy

Published 01/2023


References:

The American Lung Association, "Children and Air Pollution," Oct. 15, 2020

 

Also See:  

UTMB Pediatrics - Pediatric Primary Care

 


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