Parental Fever Phobia: Separating Fact from Fear

In the same way that parents know the sun will rise tomorrow, they also know that their child's temperature will sometimes also rise. This temperature elevation sends signals of fear and concern into the hearts of most parents. Why is this so? Why is it that the myths about elevated temperatures can cause a parent's anxiety to reach a fever pitch? This article aims to dispel some of the myths and fears by educating parents about normal and abnormal temperatures.

Myth 1: Fever is bad for you.

Fact: Fever is just one of our body's actions in response to chemical signals indicating inflammation. Most often, the inflammation is due to an infection from a virus or bacteria; sometimes, it has another less common cause. Just as most infections are not serious, most fevers are not serious, either. In fact, we know that fever helps our bodies to rid themselves of infections more quickly by increasing the metabolic activity of the white blood cells that fight infection. In one recent study, people with the flu (influenza) who did not treat their fevers recovered more quickly than those who took medications to reduce their elevated temperature.

Myth 2: A temperature of 1000 Fahrenheit (F) is a fever.

Fact: While 98.6 degrees F is the mean or average oral temperature, physicians do not consider a temperature to be a fever until 100.6 degrees F is reached. Temperatures naturally vary throughout the day by about one to two degrees, with the lowest temperature occurring in the early morning hours, and they vary according to the measurement site. Axillary (underarm) temperature is approximately one degree lower and rectal temperature one degree higher than the measured oral temperature. Tympanic (ear) temperature is near rectal temperature.

Myth 3: All fevers need to be treated.

Fact: Most fevers do not need to be treated. Fever treatment is primarily for patient comfort and usually recommended to begin at temperatures of 101.50 F. However, there is no need to treat a low grade or moderate fever if the person is comfortable and there are no other compelling reasons to do so. In either circumstance, plenty of clear fluids are important for maintaining adequate hydration. Tepid baths or showers are used also, both to lower the temperature and to provide symptomatic relief.

Some fevers do require medical treatment. A number of research studies over the years have identified four groups of children with fever who require special attention:

1. Infants younger than 2 months of age with any fever (temperature of 100.6 degrees F);

2. Children between 6 months and two years of age whose temperature is greater than 1020 F and whose white blood cell count is greater than 15,000;

3. Children of any age whose temperature is 104.50 F or higher

4. Children without spleens, with immunodeficiencies, or sickle cell disease.

Myth: Febrile seizures cause brain damage and epilepsy.

Fact: Febrile seizures (seizures caused by fever) are common, occurring in two to five percent of children between six months and six years of age. There is often a family history of febrile seizures and thirty percent of children have recurrent febrile seizures. While frightening and dramatic for parents to witness, typical febrile seizures do not cause damage to the brain in and of themselves. Additionally, they are not a cause of other seizure disorders or epilepsy. Despite this, the diagnosis of febrile seizures should be made by qualified health care professionals who can rule out other serious illnesses that may also cause seizures and fever.

Febrile seizures typically occur in children with minor infectious diseases. The seizure occurs not when the child already has a fever; rather, the seizure occurs when the child's body is rapidly raising the temperature above normal to generate a response to the infection. In other words, it seems to be the rapid rate of rise, rather than the actual degree of fever, that is related to the onset of a febrile seizure.

Hence, children with known febrile seizures are generally medicated with antipyretic drugs around the clock at the first sign of a cold or other minor infection. This is intended to prevent the fever spikes that are triggers for a seizure in this population of otherwise normal children. Both ibuprofen (Motrin®) and acetaminophen (Tylenol®) in standard doses have been shown to be effective in lowering temperatures.

It is important to know the effective dose of each medication for your growing child. Ask your pediatrician at each well child visit what the proper does is for your child's current weight; keep that information readily available for when your child needs treatment.

Myth: Feed a cold, starve a fever.

Fact: Many of us grew up hearing this adage from our mothers and grandmothers. The basis for it is obscure, but probably has its origins in the fact that sick people often feel better after eating some warm soup, toast or other "comfort" foods. On the other hand, eating with a high fever is associated with vomiting. Current thinking would be to offer plenty of clear fluids and light foods as desired for both situations. The aim is to keep the child well hydrated and provide easy to digest and comforting foods. Should vomiting persist, your physician should be called.

As in all situations, if you have a question or are concerned about your child, call your health care provider's office and tell them. They may be able to help you via the telephone or ask you to bring your child to their office or an emergency care center. Heed their advice.

Like each day's rising of the sun in the eastern morning sky, fever is a certainty for children. However, separating the fever facts from the fever myths means that every parent can keep a cool head when fever strikes.

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