Fever Phobia

According to an article in the Journal of Clinical Pediatric Emergency Medicine, “fever phobia causes both health care providers and parents to over treat fevers. This places children at risk of medication toxicity, needless repeat temperature readings and parental panic”. 

This is a quote from a handout I received from Naturopathic Doctor, Mary Choi. I took the girls to see her for a wellness check up recently. 

Over the last few months, as babies start getting their first fevers and illnesses, I've noticed that the words, "Tylenol", "Advil" and "Motrin" get thrown around very nonchalantly. I'm not against using these medications. The girls have had them once or twice when no amount of comforting would soothe their teething pain. No one likes to see their baby in pain. While I'm not against using them, I do feel that they should be used sparingly and as a last resort.

When it comes to a fever, I do not think of it as a bad thing that need to be suppressed immediately. Dr. Choi gave me a great handout that includes lots of valuable information on dealing with fevers in young children. With her permission, I wanted to share some of that info. 

Fever -- A Natural Defence

Fevers are one of the most important defenses our body has against disease. The intention of a fever is to raise the temperature of the body to create uncomfortable living conditions for bacteria and viruses (i.e. “to cook the bugs”). 

In order to build a healthy and strong immune system, it is extremely important to support the body’s natural immune defenses – fevers should be encouraged, not suppressed. 

The most common problems associated with fever include discomfort and mild dehydration. Only fevers above 41.7 C (107.6 F) can cause serious complications such as altered states of consciousness, swelling of the brain or even death. In general, the body is able to prevent temperature from reaching these alarming levels.  

There is no evidence to suggest that brain damage occurs in fevers of less than 41.7 C (107.6 F).  Febrile seizures only occur in approximately 4% of patients with fever and are not associated with any long-term complications. Febrile seizures are more often associated with dehydration than elevation of temperature. 

How to Manage a Fever

• First: Do nothing. Observe closely. Can your child drink fluids well? Urinate every 3-4 hours? Does your touch console them? Are they playing normally? If the answer to these questions is yes, your child is not seriously ill.
• A wet fever is better than dry fever. Try to get your get your child to sweat.
• Keep food to a minimum, so that your child’s energy is not used to digest food, but is free to fight the infection. Fever can be considerably prolonged by giving too much to eat, especially rich and sugary food. Even when the fever comes down and the appetite returns, it may be advisable for your child to avoid food for anther 12 hours, unless there are signs of great weakness.
• Encourage fluids, especially nutritious fluids.
• Herbal teas that include lemon balm, peppermint, elder flowers/berries, oat straw and chamomile.
• If your child craves cold drinks, you can make herbal tea into iced tea or into ice cubes with half herbal tea and half fruit juice.
• Cold cotton socks: brings down the temperature, sedates them and is also good for teething.
• To bring down a temperature, bathe with water temperature 1 degree below body temp or sponge with water of this temperature.
• Dress lightly or bundle depending on your child’s perception of temperature.  If your child looks pale, shivers, or complains of feeling chilled (early stage of fever) à bundle her in breathable fabrics (cotton, wool) so that sweat will evaporate.  If she is comfortable and her fever is low, dress her snugly and give warm liquid ¾ cup 3 times per day for a 40 pound child to assist the body’s  fever production.  If she sweats and complains of heat, dress her lightly and let her throw off the covers (do not over cool, to avoid chill).
• Herbal water spray: can help send a feverish youngster off to sleep. Add 2 drops of essential oil of chamomile, lavender, thyme, ylang ylang, or rose with 4 oz of water in a spray bottle.  These oils provide some anti-bacterial action along with a sense of tranquility.  Spray liberally on arms, legs, back and chest, but keep this spray away from eyes and out of the reach of small children.  Best to use in a warm, steamy bathroom so that your child doesn’t get chilled. 
• Contact your doctor for additional treatments for managing fever, colds and flu.

Warning Signs

• Fever in infants under 3 moth old (esp. if over 101 F or 39 C – could possibly be meningitis, requiring immediate emergency room treatment)
• Fever gets very high, more than 105F or 40.5C. 
• Child becomes confused, or loses consciousness.
• Seems hot on one side of the body yet cold on the other
• Starts to twitch. Or has a history of febrile seizures
• Child refuses fluids
• Child cries inconsolably or otherwise acts extremely irritable
• Complains stiff neck or is unable to touch his chin to his chest.
• Your child breaks out in a purple rash that resembles tiny bruises.  This could be a sign of a rare but serious infection.
• Child seems to be in severe pain.
• Child becomes dehydrated (dry skin and lips, crying without tears, no urination within 8 hours, listlessness)
• Child has signs of respiratory distress (rapid breathing, sucking of the skin between the ribs and above the breastbone when breathing in, bluish tinge around the mouth, wheezing or crackling sound with breathing).
• Constant low grade fever can indicate a bladder infection.

In the case of a febrile seizure 

• Try to stay calm: stimulate a pressure point between the upper lip and nose. 
• Look at your watch – time the length of the seizure.  If exceeds 5 minutes, call 911.
• Turn your child on his side – reduce the risk of gagging or inhaling secretions.
• Make sure the immediate environment is safe. – remove objects your child might hit.
• Do not restrain your child or put anything in the mouth
• After the seizure is over, comfort and reassure your child, then call your doctor for an immediate appointment.