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Confessions of a Fever-Phobic

jonaylorUntil this week, I was shockingly misinformed about fever. Despite being generally well educated and pretty savvy about medical stuff, I had some serious misconceptions. Misconceptions that may have led to unneeded treatment of my child, and definitely led to a lot of unnecessary anxiety for me!

My poor kid has had some UTIs lately, and one involved a fever up to 104° (40° C) for several days. My husband and I had to threaten, coerce, and manipulate her to get her to take some ibuprofen to get the fever down. I was terrified she’d get brain damage, start hallucinating, or seizing, or . . . I dunno, other unspecified awful stuff. I slept next to her, my clothes arranged like a firefighter’s, so I could jump up and run her to the emergency room if the fever went over the magic number (101° while on ibuprofen) one of the doctors specified.

During our next visit with a different doctor, he mentioned that fever is not a problem, and doesn’t need to be treated. But it was a brief comment amongst a lot of other critical information about kidney involvement, ID and sensitivities, and the right antibiotic. I felt like I’d gotten some mixed messages, but I didn’t think about it much at the time.

Two weeks later, my lucky kiddo came down with Fifth Disease. And her temperature went up. When it rose to 103.7°, and her skin felt as hot as a baked potato fresh from the oven, I woke her up and tried to get her to take some medicine. Despite (or because of?) her evident misery and restless sleep, she refused, so I pushed fluids, kept the covers off her, and stroked her with a wet cloth.

Now, we had called the advice nurse that evening, and she told me, “A fever between 100 and 104 is therapeutic.” In Worried Mom mode, I didn’t reflect on it much. My baby was frighteningly hot! Everything in my guts said, “Fix it! Cool her off! NOW!”

But later, with a little distance and a lot more sleep, I decided to investigate just what the deal is with fever. Turns out, fevers in response to illnesses are relatively harmless. (Heat stroke is a separate issue.) They might even help get you better faster. They don’t cause brain damage or any other lasting harm, and are self-limiting to 107° or less. Pediatricians do not recommend taking a child’s temperature frequently, or waking them up to take “antipyretics” (that’s acetaminophen or ibuprofen) to bring fevers down. Many parents dose antipyretics wrong, which is a much greater risk to a child’s health than a fever is. Even febrile seizures are not likely to cause harm, and using antipyretics doesn’t seem to prevent them. Oh, and if it’s lower than 100°, it’s not a fever, it’s a normal fluctuation in body temperature that happens every day for all of us.

TL:DR version – even high fevers in children are harmless. (NB: Fever in young babies is more complex.) You can give your kid medicine if they are suffering, but the fever itself isn’t anything to worry about.

This still feels wrong to me. But I checked. And checked. And checked. And checked. And checked. I think part of the reason fever phobia is so stubborn in our culture is that pediatricians focus on fevers. Every office visit starts with taking the child’s temperature. Any fever is focused on and investigated – how high? How long has the child had the fever? Presumably they’re trying to find out what is causing the fever, and to eliminate possible serious underlying conditions. Which is sensible, but gives us parents the impression that fever is scary. Plus clearly different doctors have different attitudes and give conflicting advice about fever management. Add in the historical use of “fever” in the names of many scary childhood illnesses, and it’s a great recipe for continued fear in parents!

Fever itself isn’t dangerous, and in the future I’m going to attempt to stow my anxiety and deal with it more rationally. Of course, my child tends to feel quite miserable, has trouble sleeping, and won’t eat or drink much when her fever goes over 101°, so I might still give her medicine, but at least I know now that the risk I’m battling is her discomfort, and I don’t have to worry that she’s cooking her own brain.

For reference by worried parents, here is a nice rundown of the common worries and the facts about fever.