New Advice on Fevers: Wait and Watch

Mar. 02, 2011 - When a child runs a fever, most parents run to the medicine cabinet to offer relief.

But here's the latest word from the American Academy of Pediatrics (AAP): Wait.

"Sometimes, parents think that if they treat a fever that their child will get better faster, but fever is a sign of illness, and it's the body's way of slowing the germs down to help get rid of them," says Janice Sullivan, M.D., at the University of Louisville.

Observe behavior

The AAP, in a report published in this month's Pediatrics, now recommends that parents only treat a fever if it's making their child feel uncomfortable. Instead of focusing on the thermometer reading, parents should monitor their child's behavior.

If your child is eating and drinking well, and playing, you probably don't need to offer any fever-reducing medication, the AAP says.

"Fever is one of the triggers that your body uses to produce more white cells," says Dr. Sullivan. "If you bring a fever down, your child may not produce as many white cells to fight the infection."

Use only as directed

On the other hand, if your child seems lethargic and is generally uncomfortable, fever-reducing medications such as acetaminophen or ibuprofen may make your child feel a little better. Give these medications only as directed by the package or your child's health care provider, based on your child's age and weight.

Dr. Sullivan says it's important to not give your children adult formulations of anti-fever drugs, even if you attempt to break tablets up to provide the correct dose.

And NEVER give aspirin to children, because of its association with Reye syndrome, a potentially life-threatening condition.

In addition

Here is other fever advice from the AAP:

• Store any fever-reducing medication safely away from young children.
• Always use an accurate measuring device for each dose.
• Don't wake a sleeping child to give fever-reducing medication.

When should you call the doctor about a fever? Dr. Sullivan offers these general guidelines:

• An infant under 3 months of age with a fever of 100.4 degrees or more
• An infant between 3 and 6 months of age with a fever of 101.5 degrees or more
• An older child with a fever of 103 degrees or more
• Any child with a fever plus lethargy, headache, skin rash, difficulty breathing, or dehydration

When your little one is ill and you need to check his temperature, follow these steps:

• Use a lubricating jelly to lubricate the tip of the thermometer. (A water-soluble jelly such as K-Y is preferred. You may also use a disposable plastic cover on the thermometer. Check with your child's health care provider to see what he or she recommends.)
• Place the child across your lap, making sure to support his head. You can also lay him on the changing table or other firm surface.
• Hold the baby still by pressing the palm of one hand on his lower back.
• With the other hand, insert the thermometer one-half inch to one inch into the rectum. Stop immediately if the thermometer meets resistance.
• Hold the thermometer between your second and third fingers and cup your hand around the child's rear. As you hold the thermometer in place, calm the child by speaking softly to him.
• Keep the thermometer in place until you hear the signal or beep that it is ready. Write down the temperature, the date and time of day.

Always talk with your health care provider to find out more information.