Harmless Fevers in Kids
NEW YORK (Reuters Health) - A survey comparing attitudes of doctors,
nurses and parents towards treating fevers in children reveals
that parents tend to treat high temperatures much more aggressively
than health professionals do.
A low fever can actually benefit a sick child, and the researchers
attributed parental tendencies to "fever phobia"--a fear that fever
is harmful--which they say originated after the introduction of
anti-fever drugs like Tylenol.
A group of Israeli researchers obtained their results from a
questionnaire sent to more than 2,000 parents, doctors and nurses
regarding fevers in children older than 3 months. The researchers
defined fever as 1.8 degrees Fahrenheit above normal body temperature,
which is around 98.6 degrees. The survey included questions on
risks of fever, dosages of anti-fever drugs and when children
should be treated.
Dr. Michael Sarrell and colleagues from the IPROS Network of
the Israel Ambulatory Pediatric Association in Tel Aviv published
their survey results in the January issue of Patient Education
The investigators found that only 43% of parents knew that a
fever below 100.4 degrees can be beneficial to a child, in contrast
to 86% of the doctors and 64% of the nurses who responded to the
survey. The majority of parents also said they would treat a fever
below 100.4 even if the child has no other symptoms, something
with which only 11% of doctors agreed.
Dr. Donna D'Alessandro from the department of pediatrics at
the University of Iowa Hospitals and Clinics, who reviewed the
paper for Reuters Health, said these results are consistent with
what she sees in her practice. "It seems to me there is a general
feeling that many, many parents are worried about fevers," she
A fever can actually help sick children, she explained. "The
body, basically, is trying to do the right thing," she said. "Bugs
like to live at body temperature. So if you raise the temperature,
you kill them off." And contrary to what parents may believe,
she pointed out, the body can function very efficiently at temperatures
as high as 100.5 degrees.
D'Alessandro added that some parents may overtreat fever because
they mistake it for a problem, and not just a symptom.
Twenty percent of parents responding to the study questionnaire
reported the only reason they treat their child's fever is to
reduce the risk of seizure associated with high temperatures,
called febrile seizure. D'Alessandro agreed that febrile seizures
are possible, but only in children with temperatures around 108
degrees. And at that point, she said, parents should be concerned
about more than just the child's fever.
"Well, what's really causing the fever? It's not the fever itself,
it's the underlying cause that's the problem," she said.
As a general rule, D'Alessandro said she tends to treat fevers
when the high temperature makes the child uncomfortable and thus
less likely to drink often and eat.
In their report, Sarrell and colleagues included a series of
recommendations on how to improve fever management in children,
which included educating parents and the public, and adopting
standardized guidelines for when and how to treat fevers. D'Alessandro
agreed with this idea, but was unsure whether these initiatives
"The question is, who's going to spend the money for all of
this? Is this significant enough a problem to go after spending
a large amount of money?" she asked.
SOURCE: Patient Education and Counseling 2002;46:61-65.
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