Eliminate the Fear, Not the Fever

Author // Susan Markel, MD

As loving and caring parents, we naturally want to help our children feel better when the inevitable fevers, colds, and illnesses arise. Many of us will reach for popular over-the-counter remedies to suppress fever and alleviate symptoms, in the belief that these products are reliable. Yet, it is important to recognize that by suppressing fever, we are suppressing a critical immune response—one that has a necessary function in fighting illness.

I can attest to the enormous fear that fever provokes in parents. By far, the greatest number of after-hours telephone calls are questions regarding the “management” of fever with drugs. Undue attention to a child’s temperature and mishandling of fevers generate a great deal of unwarranted parental anxiety, avoidable medical complications, and countless calls and costly visits to doctors and emergency rooms. As long as we remain captive to the medical myth that nature made a mistake in causing a fever during illness, our children will be put at risk.

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Yes, fever can be uncomfortable. A child with a high fever will often seem irritable, lethargic, glassy eyed, and listless. This alerts you that the body is mobilizing defense against disease and you, in turn, must care for your child in the most appropriate way: encouraging rest and fluids. On the other hand, there may be no reason to treat even a high fever if your child seems happy, active and alert.

The pervasive belief that fever is dangerous and must be suppressed disregards the scientific evidence demonstrating its beneficial role in inflammatory diseases. The immune system depends on the fever to accomplish myriad tasks when gearing up to fight infections.

“Fever phobia” is made worse by hearing myths about children being severely harmed by having a high fever. Many people know of children or adults who had a high fever and ended up with some sort of injury…brain damage or hearing loss. These problems are never caused by fever. The likely explanation is that they had a serious illness that gave them a fever, but it was the illness that caused the brain damage or other result. The fever was only the body’s attempt to fight the infection.

“Doctors do a great disservice to you and your child when they prescribe drugs to reduce fever,” writes Dr. Robert Mendelsohn, pediatrician and author of How to Raise a Healthy Child In Spite of Your Doctor. “Fever phobia is a disease of pediatricians, not parents, and to the extent that parents are victimized by it, doctors are at fault.” Parents are left to fear that their child’s temperature will keep rising unless measures are taken to control it. Yet, reducing the child’s temperature will do nothing to make the child well, and our bodies have a built-in mechanism that will prevent an infection-induced temperature from reaching dangerous levels. Mendelsohn emphasizes that “only in the case of heatstroke, poisoning, or other externally caused fevers is this body mechanism overwhelmed and inoperative.”

“Fever: Your Body’s Defense Against Disease” is the title of Chapter 7 in Dr. Mendelsohn’s book, an excellent resource for parents seeking a balanced and accurate perspective of the beneficial role of fevers in childhood. Dr. Mendelsohn condemns the useless and dangerous practice of fever suppression through drugs, and counters the myth that high fever causes seizures. “Many parents are fearful of fevers because they have witnessed a convulsive seizure and believe their child may experience one if the body temperature is allowed to rise too high. High fevers do not cause convulsions. They result when the temperature rises at an extremely rapid rate and are relatively uncommon.” Only a small percentage of children with high fever experience convulsions, and those who do suffer them do not have any aftereffects. Simple febrile seizures are self-limited and harmless, although they are one of the most frightening things that a parent can witness.

Dr. Mendelsohn continues, “Fevers produced by viral or bacterial infections will not cause brain damage or permanent physical harm. Fevers are a common symptom in children and are not an indication of serious illness unless associated with major changes in appearance and behavior or other additional symptoms such as respiratory difficulty, extreme listlessness, or loss of consciousness. The height of fever is not a measure of the severity of the illness.” A child who appears very ill with a fever of 101°F would be much more of a concern to me than a child who feels fine, is drinking and playing, but has a fever of 105°F.

Numerous studies have shown that fever enhances the immune response by disabling bacteria and viruses. Also, with a rise in temperature, iron is removed from the blood and stored in the liver, further disabling the rate at which bacteria can multiply.

As a note of caution, when a fever arises in a newborn in the first few weeks after birth, there is a heightened level of concern. “Newborn babies may suffer infections related to obstetrical interventions during delivery, ...aspiration pneumonia from amniotic fluid forced into the lungs because of overmedication of the mother during delivery...and exposure to the legion of germs that abound in the hospital itself,” writes Dr. Mendelsohn. Parents are advised to seek medical help if a baby runs a fever in the first two months after birth. As breastfeeding plays a critical role in preventing infections in infants, breastfed babies are superbly protected against a vast range of pathogens and have a lesser risk of developing fevers in the newborn phase.

Mistrust of natural processes and reliance on drug-oriented medicine has obscured parents’ understanding of the importance of childhood illnesses and the necessity of fever as a vital aspect of the immune system. When a child has a fever, it is not necessary to artificially lower the temperature. It is, however, important for the child to take in plenty of fluids, because in this time of elevated body temperature, it is easy to become dehydrated. Broth, liquid electrolytes, and fruit juices are great choices because they replace electrolytes that are used up in the fever process. Rest during times of fever will allow the body to use its energy to fight off infection.

Make a commitment to spend time with your sick child. Any time that you feel concerned about the way your child is acting, or if your instinct is that something is wrong, do not hesitate to call your doctor.

About the Author:

Susan Markel, MD, is a board certified pediatrician and a board certified lactation consultant. On her website www.Attachment, she discusses topics related to pediatrics, relationships and lifestyle issues. While there is no such thing as perfect parenting, peace of mind is not as elusive as it often seems. Dr. Markel welcomes each opportunity to help families move forward with confidence.

Pathways Issue 22 CoverThis article appeared in Pathways to Family Wellness magazine, Issue #22.

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