Fever Phobia in the news again: When to stay cool and when to call the doc


A new study published in the journal, Pediatrics, today reminds pediatricians to ease parents' fears about fevers. Here is a Q & A about the top parental concerns on fevers:

Q. Are acetaminophen or ibuprofen supposed to take the fever away?

There is a reason why these products (ibuprofen and acetaminophen) say they are fever REDUCERS and not fever ELIMINATORS on their packaging. At best, they will bring down a fever by a couple of degrees. So a child who has a fever of 104 will only go down to 102 with medication. This freaks parents out, who are under the impression that the medication should take the fever away completely (and thus, something must seriously be wrong). So, this new study is a good reminder to healthcare providers to explain fevers and fever reducing medication to nervous parents.

Q. Should parents stop using fever reducing medicines altogether?

We are not telling parents to stop using these products. We are simply educating them about what results to expect. What I always tell families is that fever is not a problem–it's a clue–and we need to figure out WHY the fever is there. A previous study showed that 91% of parents believe fever can cause harmful effects such as death and brain damage. We've got to arm parents with accurate information so they don't stay up at night worrying about an old wives tale.

Q. So, what fevers need immediate medical attention? 

Here are my tips for immediate medical attention:
1. Age 0-4 weeks: any fever of 100.4 or higher taken rectally IS an emergency in this age group. It requires immediate evaluation done in a hospital setting. That is because they are at risk for bacterial infections due to issues surrounding birth or abnormalities a baby might be born with (e.g. kidney/bladder issues).

2. Age 4 weeks -3 months: Any fever in this age group also requires immediate medical attention to determine the source of the fever.

3. Age 3 months to 6 months:
Fever of 102 or greater needs medical evaluation or fever AND one of these:
a) lasting over 3 days in a row
b) a new fever after recent illness
c) no obvious symptoms of viral illness with the fever
d) unconsolable
e) petechiae rash (purple flat specks–see our rash-o-rama in bonus material on our website)

4. Age 6 months and up:
Fever of 104 or greater or any of those symptoms listed above with fever.

Less urgent:
-Persistent fever every day for more than 3 days straight even with obvious source of infection

After six months of age: it's not the degree of the fever, it is what the child looks like! It is hard to be seriously ill if your child is laughing, smiling, and running around your living room. However, if your child still looks like a wet noodle even after fever reducing medicine kicks in, it is time to call the doctor.