Tag Archives: fever-induced delirium

Don’t fear the fever

Fever in a child can be nerve-racking for parents.

When one of my own children felt warm and the thermometer measured over, say, 101, my thoughts would always turn to the story about the monkeys.

I was about 5, long before there were MMR vaccines. I got the measles.

In the days when kids got the measles.

I remember feeling so sick. My throat was sore. I was red and rashy and so tired I couldn’t play. My fever hit 105 degrees.

In my delirium, I imagined that monkeys were dancing on the walls and told my mother so. The doctor actually made a house call, not unheard of in those days, but uncommon.

According to the American Academy of Pediatrics (AAP), fever is one of the most common reasons parents seek a pediatrician’s care.

Surely, it was a night of worry for my parents in the days before Tylenol, with a dangerous (and now, thank goodness, preventable) disease that left some children disabled or worse.

But unless they climb to very high levels, says the AAP, fevers are not dangerous in and of themselves.

Many infants and children develop high fevers with minor viral illnesses. According to the National Institutes of Health (NIH), brain damage from a fever generally will not occur unless the fever is over 107.6 °F (42 °C). Untreated fevers caused by infection will seldom go over 105 °F unless the child is overdressed or trapped in a hot place.

Fever is a physiological mechanism that has beneficial effects in fighting infection. Most bacteria and viruses that cause infections in people flourish at the normal body temperature of 98.6 °F. A fever signals that a battle might be going on in the body. But the fever is battling for the sick child, not against.

In the interest of helping pediatricians educate parents and families about fever and “fever phobia,” the American Academy of Pediatrics has issued a clinical report, “Fever and Antipyretic Use in Children,” published in the March 2011 print issue of Pediatrics (available online Feb. 28).

The primary goal of giving a child antipyretics (medications to reduce a fever), such as acetaminophen or ibuprofen, should be to help a sick child feel more comfortable, not simply to maintain a “normal” temperature.

The AAP recommends the following to parents when a child develops a fever:

  • Focus on the general well-being of the child and his/her activity. Watch for signs of serious illness and maintain appropriate fluid intake.
  • Do not wake up a sleeping child to administer a fever-reducer.
  • Store fever reducers and all medications safely to avoid accidental ingestion.
  • The correct dosage for fever reducers should be based on the child’s weight. Always use an accurate measuring device to insure proper dosage.
  • While there is some evidence that combination therapy (alternating doses of ibuprofen and acetaminophen) may be more effective at lowering body temperature, questions remain about whether it is safe and whether it helps children feel more comfortable. Combination therapy also increases the risk of inaccurate dosing, so check with your pediatrician to see if this method is right for your child.