Fever – More a Friend Than a Foe

Fever, as it accompanies many childhood illnesses, causes much concern and worry to parents and with the popularity and easy availability of many OTC fever reducing preparations for children, the tendency exists to quickly and aggressively treat fever in children. But is it the right thing and the best thing to do?

Recently the American Academy of Pediatrics (AAP) reviewed the  management and treatment of fever in children. At the onset, it’s important to remember that fever is is not a primary illness but is a natural body reaction that is beneficial to help fight infection. Fever does not worsen the course of an illness nor causes long term neurological complications in the vast majority of children.* In fact, fever is an important component to assist us in fighting infection.

Thus, the primary goal of treating fever is to help improve  the child’s comfort and well being while observing for signs of more serious illness while encouraging other supportive measures such as rest, good fluid intake, etc.

Regarding medication for fever reduction, research has shown “no substantial difference in the safety and effectiveness of acetaminophen (Tylenol) and ibuprofen (Motrin or Advil) in the care of a generally healthy child with fever”. Combining these two products may be more effective than the use of a single product alone. However, there is concern that combining treatment can lead to unsafe overusage of these products. Unfortunately, these medications come in wide array of dosages,  formulations and time administration intervals that can easily lead to improper treatment. Additionally, some preparations combine multiple medications (cold remedies) trying to treat a wide  range of symptoms which is inappropriate for small children ( less than 2) and discouraged in general for most children.

In summary, fever is a sign of illness but in itself is not dangerous in an otherwise healthy child. The goal of treatment is not to necessarily rapidly reduce or “normalize” the temperature but to improve the overall comfort and well being of the child while observing for other signs and symptoms of more serious illness.

* Seizures with fever  (aka febrile seizures) occur in approximately 5% of children who are otherwise healthy (and typically with a family history for febrile seizures) and are not associated with long term complications.

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