What To Do For A Fever

Of all the concerns that parents have contacted my office about over the years, one of the most common ones has been what to do with a child's fever.

In addressing this concern, it's vital to understand that a fever serves to protect your body against infection and trauma in three major ways:

1. A fever stimulates your immune system into producing more white blood cells, antibodies, and a protein called interferon, all of which work to protect your body against harmful microorganisms.

2. By raising your body's temperature a few degrees, a fever makes it harder for invading bacteria and viruses to survive and flourish. The higher your core body temperature is, the harder it is for harmful microorganisms to survive in your body.

3. A fever helps to shuttle iron to your liver so that it is not readily available to fuel the growth of invading bacteria.

During a talk that I gave several years ago on the health benefits of fevers, a biology teacher in the audience mentioned that cold blooded animals like lizards will intentionally seek out warmer spots to lie on and rest to give themselves a fever when they are ill. He went on to explain that all living creatures in the animal kingdom use fevers to strengthen their immune systems when they are ill.

The most common cause of a fever is a bacterial or viral infection, the vast majority of which your body's self-healing mechanisms can conquer with proper rest and nutritional support. Heat stroke and poisoning can also cause fevers, more often in children than in adults. If you suspect that a fever is due to heatstroke or poisoning, I recommend that you go to the emergency room of your local hospital immediately.

A fever cannot cause brain damage unless it reaches 107.6 degrees Farenheit (42 degrees Celsius) and stays there for an extended period of time. Since your brain has a built-in thermostat that does not allow your core temperature to rise above 106 degrees Farenheit (41.1 C) during an infectious process, it's virtually impossible to experience brain damage from a fever caused by a bacterial or viral infection. The majority of fevers don't reach 105 (40.5 C) degrees. The highest temperature that I have encountered thus far has been 104.5 degrees Farenheit (40 C) in a 6-year old boy who had suffered a heat stroke.

A small percentage of children can sometimes experience short-lived seizures when they have a fever, called a febrile seizure. These seizures are caused by a rapid increase in body temperature, not by a specific temperature. There's no need to worry if your child experiences a febrile seizure, as they end quickly and do not leave after-effects.

Although it is usually best to allow a fever to run its course and to rely on your own self-healing mechanisms to get you well, I recommend that you seek medical attention for fevers that are accompanied by:

• Difficulty breathing
• Vomiting
• A stiff neck
• A persistent cough that lasts more than a week
• Unexplained heaviness or weakness in your legs or arms
• Unexplained irritability, confusion, listlessness, and any other behaviour that is out of character for you or your child

If none of the above symptoms are present, a fever is best treated by getting plenty of rest, drinking healthy liquids, eating lightly, and making sure that you are not increasing your core temperature by wearing too much clothing or using too many blankets. If a fever is preventing you from getting restful sleep, a minimal dose of acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) can help reduce the fever slightly, which can help you get enough rest to possibly justify temporary use of these pain killers. If you take a dose that completely eliminates your fever, you might feel better in the moment, but you should expect to experience a longer recovery period than if you take a minimal dose or none at all. And please be aware that though the risk is very slight, there are potential negative effects to taking these medications, especially in little ones, so heed all warnings on labels and stay vigilant with symptoms.

For more information on managing fevers in children, I recommend reading How to Raise a Healthy Child in Spite of Your Doctor, by Dr. Robert Mendelsohn.