It’s OK to let fevers run their course

A fever can be a scary thing, especially in children. For parents of young children, the first impulse is to treat a child’s fever with an over-the-counter medication, and get the child’s temperature back down to normal — around 98.6 degrees.

The American Academy of Pediatrics’ guidance to pediatricians and other health care providers who look after children cautions against “fever phobia.” The AAP emphasizes that fever itself is not an illness but rather a beneficial reaction to infections. However, any newborn or infant aged 3 months or younger with a fever should be evaluated by their pediatrician or health care provider.

Through their advertising campaigns, pharmaceutical companies who make fever-reducing and pain-relieving medications have convinced most Americans that a fever is a serious problem that must be promptly and thoroughly treated.

But, the reality is that a fever isn’t a problem in and of itself. Fevers are the body’s natural reaction to an illness or infection. They are a sign the body’s immune system has recognized a problem and is actively fighting it off.

There is a growing amount of research showing that fever helps slow the reproduction of viruses and bacteria, and stimulates the production and effectiveness of infection-fighting cells in the body. Leaving fevers untreated has been shown to shorten the duration of an illness. In the case of chicken pox, children whose fevers were allowed to run their course recovered one day faster than children whose fevers were treated with medication.

These days, parents are likely to get this advice: “treat the child, not the fever.” If a normally healthy child has a fever but isn’t uncomfortable, it is not necessary to give fever-reducing medication. The goal should be the comfort of the child during an illness. There is no reason to wake a sleeping child to give him or her this type of medication — rest will likely do the child more good.

Over-the-counter medications such as acetaminophen and ibuprofen have dual action: they lower fevers and are pain relievers, too. Viral illnesses, such as the flu, often cause headache and body aches — so these medications are helpful for this type of pain.

For many years, parents have been counseled to give acetaminophen or ibuprofen or both to children with fevers. Although these are generally safe medications, calculating the dose according to the weight of the child and giving them at the correct time intervals can be complicated, especially if multiple caregivers are involved. Overdosing children on these medications can harm the liver and kidneys.

A common misconception is that treating high fevers in children prevents seizures — and that seizures can cause brain damage or epilepsy. The AAP studied this topic and found that giving children fever-reducing medication does not reduce the risk of a febrile seizure. Also, febrile seizures in children — though very disturbing to witness — cause no long-term effects and do not cause epilepsy.

So, the next time you or your child has a fever, it’s OK to not to rush to treat it. Pay attention to other symptoms and get medical advice if needed. Rest and fluids are always a good idea. If a fever is due to a cold or the flu, give medication if needed for comfort — but don’t focus too much on the number on a thermometer.