Johnny has a fever of 101°F, but he's chasing the dog around the house. You've been checking his temperature every half hour, and you're ready to dose him with Tylenol. Another degree or two higher, and you'll rinse him with a cold sponge.
Sound familiar? Many parents overreact to children's fevers, and the steps they take can be dangerous, or at least uncomfortable, for kids, says a study in the latest issue of Paediatrics. Moreover, compared with a similar study 20 years ago, we're "fever-phobic," the study says.
You need to see fever as the body's way of fighting infection, say lead study author Dr Michael Crocetti. Treat it only if your child is uncomfortable or has other, dangerous symptoms - and use appropriate remedies, he says.
"I'm not trying to say ignore fever. It's an extremely important sign for determining how sick a child is, but it's only a sign. It's not a disease," says Crocetti.
First, what is a fever? There's no easy answer, Crocetti says. Of the 340 caregivers in Baltimore who filled out a questionnaire for the study, 35 percent said a fever under 37.7°C could cause problems like a seizure or even death, compared with 4 percent in the survey 20 years ago. As a result, many parents see fevers as potentially life threatening, and they treat what's really a harmless symptom very early, Crocetti says.
"We found parents will treat temperatures of 37.7°C - or 37.2°C, " Crocetti says.
In fact, he says a fever by itself will not create serious problems; even a seizure caused by a fever will not harm the child and is common. Parents need to watch out for dehydration and other symptoms combined with fever, which he says may warrant a call or visit to the doctor.
"Most of the time, children's fevers relate to viral infection and are self-limiting," says Dr Dennis Murray, professor of paediatrics at Michigan State University. But for some reason, Murray says parents of children under two and of adolescents ages 10 to 16 panic when their kids' temperatures spike. "If they have persistent fevers or high fevers, families just sort of freak out about it."
Rather than look at the temperature alone, Crocetti says look at the whole child. Is there a rash? What's the child's energy level? Are there complaints of ear pain? A severe sore throat?
In fact, fever is helpful in returning children to health, the study says. It slows the growth and multiplying of bacterial and viral micro-organisms. "It revs up your immune system," Crocetti says.
Compared with 20 years ago, parents are super-vigilant in checking their children's temperatures. While eight percent checked at least once an hour then, 23 percent check that often now, the study says. It's uncomfortable and invasive, particularly if a rectal thermometer is used, Crocetti says.
Fever-phobia causes the serious danger of overdosing kids with anti-fever medicines, Crocetti says. Acetaminophen (Tylenol and others) should be given at most every four hours, but 14 percent of the parents questioned said they give the medicine at least every three hours. Similarly, ibuprofen (Motrin, Advil and others) should only be given every six hours, but 44 percent of the parents said they give this over-the-counter drug every five hours or more frequently.
Finally, 73 percent of the parents interviewed said they sponge their children, and of that group 68 percent used alcohol, cool water or a cool rag. Alcohol can dehydrate children, and cool water and rags create terrible shivering, Crocetti says.
In the past, fevers accompanied illnesses that often were life threatening, Crocetti says. Then, a high fever might have meant death. Today that's not true, and parental practices need to catch up to medical science, he says.
Murray says, "We need better education of families."