Doctors: Parents shouldn't fret over kids' fevers

Fever phobia is rampant among parents of young children, according to a myth-busting American Academy of Pediatrics report that advises against treatment every time a kid's temperature inches up.

"There's a lot of parental anxiety about fever. It's one of the most common reasons people bring their child to the doctor," said Dr. Henry Farrar, co-author of the report and an emergency room pediatrician at Arkansas Children's Hospital.

Most often, kids' fevers are caused by viruses and they will go away without medicine and without causing any damage.

Parents tend to overtreat fevers, even waking up sleeping kids to give them fever-reducing medicine, Farrar said.

"If they're sleeping, let them sleep," he said.

There is no hard proof that untreated fevers lead to seizures or brain damage; there's also no evidence that lowering fevers reduces illness, according to the report which focused on children older than 3 months.

Temperatures lower than 100.4 degrees are not considered a fever. There's no harm in treating a true fever with over-the-counter acetaminophen or ibuprofen. And it makes sense to do so when the child is obviously feeling ill. But the No. 1 reason to use fever-reducing medicine is to make a sick child feel more comfortable, the authors said.

The report was released online Monday in the journal Pediatrics.

It emphasizes that a fever is not an illness but rather a mechanism that helps fight infection. Fevers can slow the growth of viruses and bacteria, and enhance production of important immune-system cells.

The report doesn't recommend any temperature cutoffs for when to treat or call the doctor.

"The fact is, no one has ever been able to say that a fever below a certain point is not associated with a serious infection, or that a fever above a certain point is associated with a serious infection," Farrar said.

Many physicians recommend calling the doctor if a child's temperature hits 104 or 105 degrees, but Farrar said it's just as important to assess the child's behavior.

"What we're trying to do is get people to look at the whole picture."

Parents should pay attention to other symptoms of illness, such as whether the child is unusually cranky, lethargic, or not drinking liquids and avoiding food. Those are often better measures of how sick a child is and whether medical attention should be sought, the authors said.

Co-author Dr. Janice Sullivan, leader of an academy panel on medication treatment, said infants younger than 3 months are an exception. Parents should get medical help when their temperatures rise above 100.4 because young infants can be very sick without showing obvious signs, said Sullivan, a pediatrics and clinical pharmacology professor at the University of Louisville.

Another exception is children with heat stroke - a medical emergency with symptoms including fever higher than 104 degrees, hot dry skin and rapid pulse caused by overexposure to heat and not enough fluids.

Children with special medical needs, including certain heart conditions, also should be seen by a doctor when their temperatures are mildly elevated, Sullivan said.

Sullivan stressed that when giving kids fever-reducing medicine, parents should be sure to use correct dosing devices, not kitchen teaspoons, which can vary widely in size and lead to overtreatment and undertreatment.

Tracy Richter of Campton Hills, Ill., west of Chicago, has two young boys and mostly follows the advice not to be fever-phobic, and not to grab the medicine bottle every time her kids feel a little warm. But Richter, 34, said the report is reassuring just the same.

"It's nice to hear something that says it OK to be a little less helicopter mom," Richter said.

Dr. Margaret Scotellaro, a pediatrician at Rush University Medical Center in Chicago, said the report "is right on."

She said she and her staff spend lots of time handling calls from parents anxious about their kids' fevers.

"Some feel that an illness changes from being something insignificant to something serious as soon as the temperature rises, which is really not true," Scotellaro said.

She said the report will help her relay that message.