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Health Today: Cooling fever phobia - new info on treating children's fever

by Janice Sullivan, MD, Division of Pediatric Critical Care; chief & medical director, Kosair Charities Pediatric Clinical Research Unit; UofL Department of Pediatrics last modified Mar 01, 2011 11:19 AM

(Editor's Note: Health Today is a regular column from health care professionals at UofL that features information ranging from health issues to UofL faculty/staff benefits.)

Fever is one of the most common reasons parents seek a pediatrician’s care. They worry that a high fever could cause brain damage, seizures, even death, but research has shown that high fevers alone do not lead to any of these. There's no evidence to suggest that fever worsens the course of an illness. A higher fever doesn't necessarily mean a more severe illness.

In fact, using a medication like acetaminophen or ibuprofen to bring down a fever could actually mask signs of a serious illness or make you think your child is less ill. 

Fever is not an illness; it's the body's way of fighting infection. So, if a sick child has a fever, parents should focus more on keeping the child comfortable than maintaining a "normal" temperature.

Here are some guidelines to remember when your child has a fever.

  • Keep an eye on your sick child. Watch for signs of serious illness other than fever, things like changes in how alert your child is (are they listless), signs of dehydration (decreased urination, dry mouth), breathing problems, seizures, development of a rash, etc.
  • Track your child's activity level. If it doesn't change, chances are your child does not need medication to bring the fever down.
  • Make sure your child drinks plenty of liquids.
  • Sponge baths haven't been shown to improve a child's level of comfort even though a sponge bath can reduce a fever. Alcohol baths are never appropriate for children.
  • If your feverish child does need medication for comfort, remember that the correct dosage is based on the child's weight, not age.
  • Be sure to use pediatric preparations of the fever-reducer and use an accurate measuring device.
  • Be sure to dose the fever-reducer no more often than every 4 hours for acetaminophen and every 6 hours for ibuprofen.
  • Avoid cough and cold products (these are not shown to be effective in children and do have some risks) and especially those that contain acetaminophen or ibuprofen.
  • Don't wake a sleeping child to give a fever-reducer.
  • Fever-reducers, like all medications, should be stored safely to avoid accidental poisoning.
  • Ibuprofen and acetaminophen seem to be equally effective fever reducers. Alternating doses of ibuprofen and acetaminophen may be more effective at lowering body temperature, but this may not be a safe practice. It is unclear if alternating these medications helps children feel more comfortable. Plus, it's very easy to get the dosage wrong so be sure to consult your child's doctor before using combination therapy to bring down your child's fever.
  • If you have a child with a chronic illness or special needs you should discuss the management of their fever with your pediatrician during a routine visit so you are prepared when they develop a fever.

The UofL Health Care Centers for Primary Care serve is a gateway to meeting all of your health care needs. You can reach us at the UofL Health Care Outpatient Center at 401 E. Chestnut St., 813-6800, and Cardinal Station at the corner of Third Street and Central Avenue at 852-5205.

UofL Pediatrics has offices in downtown and south Louisville where children, birth to 18 years old, receive the full range of primary care services. Evening hours are available at UofL Pediatrics-C & Y, 555 S. Floyd St., and UofL Pediatrics-Broadway, 230 E. Broadway. At UofL Pediatrics-Stonestreet, doctors are available evenings and Saturday morning, 9702 Stonestreet Rd., Suite 100.

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