When your child is sick, you can’t help but worry. Especially if he or she has a fever.
Long been feared to cause seizures or brain damage if left untreated, a fever is one of the most common reasons parents seek a pediatrician’s care.
But pediatricians are hoping to cure parents of their “fever phobia” and educate them that high temperatures aren’t always a bad thing.
The American Academy of Pediatrics issued a clinical report, “Fever and Antipyretic Use in Children,” published Monday in the March 2011 print issue of Pediatrics in an effort to educate parents and caregivers.
The first thing they should do, the report recommends, is focus on making the feverish child comfortable – not bring the fever down with the use of antipyretics (medications to reduce a fever) like acetaminophen or ibuprofen.
Parents and caregivers should focus on the general well-being of the child: his or her activity levels, observing the child for signs of serious illness and maintaining appropriate fluid intake.
Antipyretics can be used, but they’re not as crucial as many might think -- the report recommends sleeping children should not be woken to take a fever-reducer.
Parents and caregivers giving their kids antipyretics should be aware the correct dosage is based on the child’s weight, and that an accurate measuring device should always be used.
Antipyretics should also be stored safely to avoid accidental ingestions.
Combination therapy
Combination therapy -- alternating doses of ibuprofen and acetaminophen -- should also be used with caution.
While there is some evidence that it may be more effective at lowering body temperature, questions remain about whether it is safe and whether it helps children feel more comfortable.
Combination therapy also increases the risk of inaccurate dosing.
Kidshealth.org offers these tips to help feverish kids (and their parents or caregivers) feel more comfortable:
- A lukewarm sponge bath can help cool the body down. Use only lukewarm water; cool water may cause shivering, which actually raises body temperature. Never use alcohol (it can cause poisoning when absorbed through the skin) or ice packs (they can cause chills that may raise body temperature).
- Dress your child in lightweight clothing and cover with a light sheet or blanket. Overdressing and overbundling can prevent body heat from escaping and can cause a temperature to rise.
- Make sure your child's bedroom is a comfortable temperature -- not too hot or too cold.
- Offer plenty of fluids to avoid dehydration -- a fever will cause a child to lose fluids more rapidly. Water, soup, ice pops, and flavored gelatin are all good choices. Avoid drinks containing caffeine, including colas and tea, because they can cause increased urination.
- If your child also is vomiting and/or has diarrhea, ask the doctor if you should give an electrolyte (rehydration) solution made especially for kids. You can find these solutions at drugstores and supermarkets. Don't offer sports drinks -- they're not designed for younger children, and the added sugars may make diarrhea worse. Also, limit your child's intake of fruits and apple juice.
- In general, let your child eat what he or she wants (in reasonable amounts) but don't force eating if your child doesn't feel like it.
- Make sure your child gets plenty of rest. Staying in bed all day isn't necessary, but a sick child should take it easy.
- It's best to keep a child with a fever home from school or childcare. Most doctors feel that it's safe to return when the temperature has been normal for 24 hours.
- If your child is fussy or appears uncomfortable, you can give acetaminophen or ibuprofen based on the package recommendations for age or weight. Unless instructed by a doctor, never give aspirin to a child due to its association with Reye syndrome, a rare but potentially fatal disease. If you don't know the recommended dose or your child is younger than 2 years old, call the doctor to find out how much to give.
- Infants under 2 months old should not be given any medication for fever without being evaluated by a doctor. If your child has any medical problems, check with the doctor to see which medication is best to use. Remember that fever medication will usually temporarily bring a temperature down, but won't return it to normal -- and it won't treat the underlying reason for the fever.
