The time of year is coming when many children will have stuffy noses, coughs, and a number of them will have fevers to accompany their discomfort. Often parents panic when their children get fevers and they rush to do whatever they can to bring the fever down. Is it always a good idea to bring a fever down? Are there benefits to leaving an elevated temperature elevated?
These questions were also on the mind of Dr. Michael Crocetti, director of pediatrics at the Johns Hopkins Bayview Medical Center in Baltimore, Maryland, who authored a study to investigate problems associated with bringing down fevers prematurely. The study questioned 340 healthcare providers, including parents and grandparents, about their practices when their children had fevers. The study indicated that 14 percent of parents gave acetaminophen (Tylenol) and 44 percent gave ibuprofen (Advil) at rates that were too frequent. If the bottle suggested that the medication be administered every 4 hours, most parents gave it every 3 hours. Ibuprofen is supposed to be administered no more frequently than every 6 hours, but parents often gave it every 4 or 5 hours. It seems that caregivers panic when children’s fevers go up even slightly, and they rush to medicate them to bring their temperatures down to a more acceptable (to the parents) range. The problem with the too-frequent dosing of children is that the children then are potentially at risk of toxicity from the medication. Parents’ tendency to overreact to fevers most likely results from the fact that in the past fevers accompanied illnesses that were life-threatening, but today that is no longer necessarily true, according to Dr. Crocetti. He says that parental practices need to catch up to medical science.
There are benefits to elevated body temperature, as strange as that might sound. It was hard for me to break the thought patterns of my own upbringing when I went to chiropractic school, but when I actually started to study the body and how it works to preserve its own health, my interest piqued. The body was designed to be a self-healing, self-regulating organism, and raising temperature is one of the body’s mechanisms for doing that. Normal body temperature is the optimum temperature for the survival of some microbial invaders, so when they are detected by the body in any form, the body’s core will heat up to just a few degrees above normal and sustain that temperature for a long enough period of time to kill its enemy. If the temperature is brought down prematurely, the infection might even be allowed to thrive in the body rather than die as it would have if it were left to be handled naturally by the body. The body also uses fever to turn on the immune system. It stimulates the inflammatory response which sends a myriad of antibodies all through the system to help protect the area of invasion from microbes and viruses. In fact, according to Paula Elbert, M.D., assistant professor of pediatrics at Mount Sinai Medical Center, “taking away a fever might even hamper the induction of the immune system to do its job…the fever can have a positive function.”
Rather than being a sign of sickness, having a fever is actually a sign that the body is working properly. The problem with fever for most is that having one causes body aches and general discomfort. Some guidelines suggested by pediatric researchers for the appropriate points at which to be concerned about fever are: 1) If a child is younger than 8 weeks old and has a temperature above 100.4 degrees, 2) If a skin rash accompanies the fever, and 3) If the child’s core temperature is above 102.2 degrees. Otherwise, it is all right to let the fever do its job and fight infection naturally. Lowering a fever will not make the process of healing the infection happen any faster. As I stated earlier, it might even prolong the illness. The only real effect of decreasing the body temperature will be that of easing the discomfort of body aches and generally feeling cruddy that come with fever. If you can just ride out the unpleasant feelings, the body will usually regulate fever and kill any invaders without medicating faster than it will if the temperature is brought down.
“It is going to take a real concerted effort on behalf of pediatricians and other healthcare providers to help parents understand what fever is and how to handle it,” according to Dr. Crocetti. This week’s column is my share of the effort to let parents know that rushing to lower fever is not always such a great idea. Use these guidelines, pay attention to the body’s signals, and be much healthier in the process. Treat your body and those of your children well.