New advice on treating kids' fevers


by Jean Enersen

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Posted on March 5, 2011 at 11:00 AM

Updated Saturday, Mar 5 at 1:27 PM

When sisters Lucinda and Greta get fevers their parents don't panic. Lucinda is three. Greta, the youngest, is just over a year old.

"If she seems to be handling it well, and she's able to eat and drink well, then a lot of times we don't treat it at all," said their father Greg Lewis, recalling  Greta's recent fevers.

But what about when a child's fever spikes?

"It's scary, yeah. It's definitely scary," said Carmen Albert, little Rosemary's mother.

So how should parents react to a fever?

New advice from the American Academy of Pediatrics says the goal of giving fever reducing medicine should not be to keep a child's temperature at normal, but to make the child comfortable instead. The advice came in a clinical report which appeared in the March issue of the journal Pediatrics.

"Remember that fever is a natural and normal response to infection, that babies and children that have fever, their body is instinctively and protectively increasing the level of temperature to boost their immune system and possibly improve recovery," said pediatrician Dr. Wendy Sue Swanson.

Dr. Swanson is the author of the Mama Doc blog for Seattle Children's. She said a fever under 104 degrees can usually be managed with home care such as rest and rehydration.

"The number is much less relevant to pediatricians. What's more relevant is how a child is feeding, how they're responding, what they're behavior is like, how long have they had the fever? Is this out of the usual or atypical for this child?," said Dr. Swanson.

The biggest exception to treating a fever only for the comfort of the child involves infants under three months of age. If they get a fever it's time to call the doctor, or to take the infant to the emergency department.
The new report said acetaminophen and ibuprofen can both bring a fever down. But treating a child by alternating them can be confusing and might lead to overdose. Knowing the correct dose is important.

"Medications are best dosed based on weight in children, not on age, but actually on weight. So when you're in the pediatrician's office at your regular check up ask them what dose is appropriate, both for something like tylenol, and for Morton or Advil," said Dr. Swanson.

Another local father had some perspective on parents' fever phobia. For his son, little Brazos, like most children, springing back from a fever just took time.

"He had a tough night. But other than that, the next day he was fine." said Jayson Owens.
In maybe the most welcome advice of all to parents, Dr. Swanson advised, don't wake a sleeping child just to give him or her a fever reducer.

The new clinical report emphasized fever reducing medicine won't prevent a febrile seizure. If a sick child has a seizure, parents are advised to call 9-1-1.