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Parents, don't fear all fevers, pediatricians say
February 28th, 2011
12:01 AM ET

Parents, don't fear all fevers, pediatricians say

When parents notice their child has flushed cheeks and is hot to the touch they often anxiously reach for the thermometer to check for a fever and a pain reliever to bring it down. But "fever phobia" may be getting in the way of properly treating children, according to a new study in the medical journal Pediatrics.

“Fever is the body's normal response to an illness, so it doesn't mean it's a bad thing. It's how your body fights the infection," explains study author Dr. Janice Sullivan, professor of pediatric critical care medicine at the University of Louisville in Kentucky.

About a third of all visits to the pediatrician are due to fever, usually caused by a bacterial or viral infection. Most fevers go away fairly quickly, are benign, and may actually protect the child. So pain relievers are primarily recommended to help alleviate some of the discomfort, not necessarily to bring the fever down to a certain level, according to the report.

Sullivan stresses that it's more important to monitor children for symptoms of serious illness and to make sure they don't become dehydrated instead of becoming overly concerned with how high or low a fever may be. There are certain exceptions, however.

"In infants less than 2 – 3 months of age we generally will recommend if they have a fever of 100.4 that those babies should be seen by their pediatrician because they may have a serious infection," says Sullivan.

Some experts also recommend that if children of any age have a fever greater than 103, they should go see their doctor.

As many as half of parents give their sick children the wrong dose of pain relievers, say researchers. Part of the problem may be that many don't know dosing is based on a child's weight, not age or height. Another common mistake is using a kitchen spoon instead of a proper measuring device or the one that comes with the pediatric medicine.

The two most common medicines used for treating fever in young people are acetaminophen and ibuprofen and if used as directed in healthy children are generally considered to be safe. Sometimes doctors recommend alternating between the two drugs during an illness, but this can increase the risk of inaccurate or overdosing without carefully reading instructions.

"When your child is ill, fever is a normal response to this illness. The important thing is first of all make sure your child is comfortable and secondly look for any other signs of symptoms to give you some indication of how ill your child is," explains Sullivan.

And remember, if your gut tells you something is wrong with your child, don't hesitate to call your pediatrician no matter how high or low the fever.


soundoff (213 Responses)
  1. Lou

    Unfortunately, a very simple fix like vitamin D deficiency that is widespread would have save a lot of griefs. Asthma, allergies, cold, flu, etc are highly linked to vitamin D deficiency but nearly all doctors don't test for it because it is not in the guideline. Vitamin D supplement is dirt cheap that would have saved us a lot of money in the long run.

    I started giving right amount of vitamin D (2000IU a day) to my then 4 years old and it made a huge improvement over the year before. It seemed to greatly cut down ear infection, cold, etc.

    http://www.grassrootshealth.net/media/download/2010-04-9-Wagner-115pm.pdf – hope this helps.

    February 28, 2011 at 13:28 | Report abuse | Reply
  2. Leslie

    sorry, i have to agree, i have friends who are perfect examples. Taking thier kids to the doc for antibiotics, because their child has an ear infection, that they didnt' even know about. Child's not complaining, kid's eating right, but has a wee fever, rush her to the doc, get an antibiotic, whine to all your friends about what a sickly child you have, when really, she's content as can be and her body's fighting of the infection on its own. I say the docs hire a statistician to keep track of the people who are bringing in their kids and unnecessarily trying to medicate them. Its sad really, the kids of today, being raised by germaphobes are going to be the unhealthy adults of the future with no means of fighting off any disease on their own...sad really.

    February 28, 2011 at 13:29 | Report abuse | Reply
  3. dan

    Doctors are NOTHING more than glorified mechanics. Sorry, I realize that will hit a nerve with many. But the fact remains, doctors are people who are trained to work on a working system much like a computer scientist or an auto mechanic.

    To believe they are anything else is to believe in the sun god, the wind god, and the boogie man. Having said that, when you run into a loser doctor, don't walk to the exit – RUN. If you ask a doctor a question and they give you that "look", turn right around and find yourself a new doctor. If a doctor gives you an answer that doesn't sit well with your instincts, you better darn well question it and stay on it until your comfortable. Its not their life, its yours or the person your in charge of taking care of.

    I'm only 42. I've seen my grandfather die of cancer, my grandmother of alzeihmers, aunts and uncles of cancer and heart diseases, and on and on. Both my parents are currently dying – one from cancer and one from heart disease. I can tell you from experience – doctors are glorified mechanics. To their defense, the system sets them up to fail, both from the educational side as well as the insurance side. That topic is way to long to even start discussing here.

    February 28, 2011 at 13:30 | Report abuse | Reply
    • PharmGuy11

      Dan,
      Sorry to hear about your troubles but I doubt that it was the physician's fault that the people in your life died. You're right to say that if a doctor doesn't feel instinctively right to get a new one but to classify all docs as losers and "glorified mechanics" is a bit of a stretch.

      February 28, 2011 at 14:08 | Report abuse |
    • PharmGuy11

      As a healthcare professional I try to educate parents as much as possible on the use of things like Tylenol and Motrin in cases of fever. The addage of always treating the fever is an old one, however, and it's very difficult to convince people that their kid doesn't need medicine and that treating the fever can actually prolong acute disease states. Being a parent myself, I fully admit that it's difficult to resist the urge to reach for that bottle of Tylenol when the fever comes but, as time goes by, it gets easier.
      As to the issue of high fever and febrile seizures, this is also an area where parents need to be educated. Believe it or not, high fevers aren't really associated with febrile seizures. It's actually been shown that the rate of fever induction (how fast the child's temp climbs) is what causes most cases of febrile seizure.

      February 28, 2011 at 14:16 | Report abuse |
  4. wolf

    add to that- the concern of parents w/kids on the Autism spectrum- the worry that a high fever or a fever that lasts a while, has the potential to cause long lasting behavioral changes...

    February 28, 2011 at 13:45 | Report abuse | Reply
  5. Sarah

    I didn't have time to read through all the comments but I have 4 kids. I was casual about fevers until my second one (now 5) was 17 months and started having febrile seizures. My third (now 3) also had one seizure from fever and has asthma. My youngest is only 12 months and is asthmatic, and I am sure I will be nervous when he gets to 17 months (the age most febrile seizures start). But I also know what I am dealing with and think there has only been one time I ever went to the doctor and was told, oh it is just a fever...

    February 28, 2011 at 13:57 | Report abuse | Reply
    • Lou

      Check their vitamin D blood level. It sounds like they have very low vitamin D level and should be treated ASAP. Asthma can be cured with simple vitamin D treatment and maintain optimal blood level at all times. Vitamin D deficiency in kids is very common and largely unknown.

      February 28, 2011 at 15:20 | Report abuse |
  6. Jon

    Another prime example of how we are becoming a nation of wussies. People need to use some common sense.

    February 28, 2011 at 14:16 | Report abuse | Reply
    • Timme62

      John, my friend I am afraid that common sense is not something people have much of any more. After my parents had their first they found a family doctor that could grow with the family. This man gave the best common sense advice, specially to new parents. Low and behold all three of us kids managed to grow up with a minimum of doctor or hospital visits.

      February 28, 2011 at 14:49 | Report abuse |
  7. AMARISA

    When my child gets a fever of 100 he gets a febrile seizure. This has happened everytime. Beware of fevers, because there could be an underlying issue. He ended up having a brain arachnoid cyst

    February 28, 2011 at 14:32 | Report abuse | Reply
  8. Denizen Kate

    My son is a grown man now (I'm sold old, I have to lie about HIS age!), but when he was a baby, we had a pediatrician who took the time and trouble to explain fevers and a child's developing immune system. He made sure I knew what to expect, he gave me simple layman's-terms brochurs to read, and recommended a book or two. Maybe he was exceptional? Don't pediatricians still do this? If so, why is this article even necessary?

    February 28, 2011 at 14:42 | Report abuse | Reply
  9. ksbondgirl

    As a parent of a child with autism, I do ask him how he feels and it is difficult for him to explain and communicate. I therefore take him to a clinic to get him checked out–I have to or otherwise I have no idea what is going on. I don't especially want antibiotics–I just want to make sure that nothing more serious is wrong with him after having had a cough and 102-103 for a couple of days.

    On the other hand, his twin sister (no autism) has asthma. When she has had a cough and 103-104 for a couple of days, of course I am taking her to the clinic to make sure that her lungs are functioning properly. What I don't want is the doc prescribing something that one has to call the FDA to find out what the side effects are just so he can get a kick back! This just happened to us over one week ago with Tamiflu. Watching my autistic son going through the gamut of side effects was sheer torture for me. I felt like the worst mother in the world and I wondered how people with Munchausen's can do what they do to their kids!

    I call it a gut call when I take my kids to the clinic–not the ER and not waiting on the doc to open his office in the a.m. and I have not failed on this one yet!

    February 28, 2011 at 14:56 | Report abuse | Reply
    • Lou

      Hi, your kids likely have vitamin D deficiency. Go to vitamin D council website and go to autism on the left. Read the vitamin D and autism theory and also case reports where autistic kids showed big improvement after vitamin D therapy. It's not a cure but only a treatment which seems to be pretty good.

      Asthma is also strongly linked to vitamin D deficiency. Fix that and it will be cured as long as optimal vitamin D level is maintained at all times. Very effective against cold and flu as well.

      I'm sorry but thanks to doctors and government, you ended up with very low vitamin D level which likely contributed to autism development in the womb and asthma too. Remember folic acid to prevent this birth defect? Anyway, vitamin D will be like that one day but I have no idea when it will become a standard to test your vitamin D level and making sure you take enough. Maybe 10 years? They move very slow...

      February 28, 2011 at 15:26 | Report abuse |
  10. Kathleen

    When my child was an adolescent, she developed chalky, soft areas on her molars that the dentist said were probably caused by having a high fever when her teeth were forming. I remember her having a high fever when she was a toddler that didn't come down immediately with medication. Is the chalky teeth problem a result of such a fever or just a myth?

    February 28, 2011 at 15:33 | Report abuse | Reply
  11. ksbondgirl

    Lou,

    Not so. We have a DAN doc for this and this is not in my son's case.

    February 28, 2011 at 15:56 | Report abuse | Reply
  12. kelly

    It is about time we got some common sense put back in the medical community with recommending LESS drugs and admitting that....OH....THE BODY IS DESIGNED A CERTAIN WAY FOR A REASON.....Tylenol is HORRIBLE for the liver and after YEARS of telling parents to give kids this horrible drug....(my aunt is a pediatrics nurse who dosed kids up on this garbage)....they finally admit to NOT giving it to kids under 2......in my opinion, you should avoid it at all costs.....to know if you are healthy is to check your medicine cabinet......the more drugs you take, the sicker you are.....and the drug industry is hell bent on making sure you stay SICK so they can stay PROFITABLE.......

    February 28, 2011 at 16:09 | Report abuse | Reply
    • PharmGuy11

      Kelly, you're overstating the danger just a bit there. Tylenol is not a horrible drug, but it does become dangerous when used improperly. There are a lot of Tylenol-containing products (including ped products) and it's easy to accidentally double up. This is generally when the problems occur. Tylenol is actually a very safe drug, we as healthcare providers just need to make sure that we are doing a good job of educating the patients. And you're wrong about the 2-year old cutoff. Although we don't unless we have to, we use Tylenol in children younger than 3 months. We certainly don't recommend that parents do that, but by using weight-based dosing, you can deliver a safe and effective dose in just about any age group.

      February 28, 2011 at 16:21 | Report abuse |
    • PharmGuy11

      One other thing. You can blame the drug companies if you really want to but your last statement makes absolutely no sense. If a company's product didn't work or made people sicker it would, at the least, be removed from the market once that information was confirmed. Couple that with the fact that people would no longer buy those products and your statement becomes absolutely ridiculous.

      February 28, 2011 at 16:26 | Report abuse |
  13. Julesa

    Pay attention to your kids symptoms. It rarely is necessary to take your kids in for a fever unless they have other disturbing symptoms, or it happens several days in to a cold.

    I am a nurse and a mother. I rarely even treat fevers anymore unless the kids stop drinking or have pain. If they have a fever, they are sick, and really should lay around, drink lots and eat when they are hungry. The fever really helps the immune function, and febrile seizures can happen even with low-grade fevers. They also frequently happen during significant changes in temperature, such as when the fever reducing medication wears off. I don't take my kids in for fevers unless they have other disturbing symptoms, or in situations where (as last year) they were unable to get the flu vaccine, and flu was going around. I did contact the docs at that point because they are all high risk, and they had flu and were treated per protocol.

    I have 3 kids. The first had constant ear infections. One year, he was treated for several months straight. I knew he had infections, and would NEVER ask the doctor to order antibiotics without seeing him. I spent a whole summer returning to the doctor every 2 weeks for a recheck, and was given more antibiotics while waiting to get in to an ENT. We then scheduled his third set of tubes. The ENT found his ears once again packed with a shockingly thick mess of stuff.

    My second 2 almost never get sick. One of these is recovering from a nasty cold with a fever around 104. He had lots of chicken soup, lots of time in a hot shower, lots of rest, and as much to drink as I could give him. He is doing great. I wouldn't have changed anything, or bugged my doc because it was just the cold that is going around, and everyone I know has.

    February 28, 2011 at 16:34 | Report abuse | Reply
  14. Tela

    There are alternatives to drugs when dealing with childhood ailments. A fever is the body's natural defense against illness and should run it's course! There are natural approaches that can help support the body during times of illness instead of conventional medications that often just mask the symptoms. Read More: http://babyminding.com/2008/05/20/natural-alternatives-to-childrens-medications/

    March 1, 2011 at 10:46 | Report abuse | Reply
  15. Carl

    Don't be so quick to medicate. You will only prolong the illness. Let nature do what it was intended to do, the fever means the immune system is eradicating the bacterial or viral infection. Not too mention the toxic garbage ingredients in children's tylenol is not healthy to ingest.

    March 3, 2011 at 10:35 | Report abuse | Reply
  16. CincyCat

    One of the best tips I ever read was to take a dry-erase marker & write on the bathroom mirror the time & amount of the last dose of medicine you gave your kid. My husband and I do that, and it really helps... especially when there are two of you caring for a sick kiddo.

    March 21, 2011 at 08:37 | Report abuse | Reply
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    I have a 11 month old baby and she's been teething. The thing is I've heard there can be some fever from teething but the thing is she has been having fevers up to 102.5 every 3 times a day for the past 2 weeks.she has been very weak from what she normally is as I know. Also has been some diarrhea and constipation most of the time since. Doctor says it's an ear infection and prescribed her with some medicine but hasn't really been doing the job.Can someone with some expertise give me an opinion of either what I should do to help her?

    February 11, 2016 at 02:46 | Report abuse | Reply
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    And what do you do when your pediatrician doesn’t trust your maternal instincts? My daughter has had fever over 101 for 24 hours consistently regardless of medication administered. Alternating 5ml of Advil and Tylenol has not brought the fever down. She is in pain as she is crying out in her sleep, crying when coughing, her entire body is hot to the touch including her feet which were uncovered for hours. Flu swab was negative.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.