Don't Fear Fever.

Embrace the heat.

I still remember as a child, my mom’s face, full of loving concern as she apologetically carried me to a cool bath when my fever was “too high”. The fear of a fever getting so high it could cause brain damage or seizures is quite pervasive. I hear over and over stories of concerned parents or sick adults using acetaminophen or ibuprofen simply to “break the fever”. My training has taught me a different perspective on fever.

Fever is a normal natural response of the body during the process of fighting infection and “breaking” the fever isn’t always necessary. Some posit that the fever helps the immune system succeed in conquering a viral illness. One study showed that giving children paracetamol (similar to Tylenol) prior to giving vaccinations meant fewer kids with fevers but this also suppressed their immune response to the vaccines. Another recent study showed that in mice, the immune response to the rhinovirus (the common cold) was more robust at warm temperatures.

In a normal healthy person with a fever related to an infection, the fever itself does no damage to the brain or body. Brain damage occurs at temperatures in the range of over 110 degrees Fahrenheit and a person with a normal neurological system will very rarely develop a fever beyond 105. The concern about brain damage with high temperatures is more realistic with heat stroke or hyperthermia.

Febrile seizures are not associated with the severity of the fever, and some even argue that the seizures are more related to the underlying illness rather than the fever itself. Generally they happen within the first few hours of a fever, often before anyone knows the child has a fever. Therefore, treating a fever with a goal of preventing a seizure isn’t necessary. See this article in the New York Times.

Historically, physicians used to try to induce a fever thinking it might help heal people. Over twenty three hundred years ago Hippocrates (known as the father of western medicine) said, “Give me the power to produce fever and I will cure all disease."The healing properties of saunas and spas have historically been attributed to the increase in body temperature that they induce. It wasn’t until much later, at the start of the 19th century, after the thermometer was developed and the relationship between infection and fever was established, that people started to try to lower fevers with cooling measures and medications. The History of Fever Therapy in the Treatment of Disease

For myself, when I have a fever, I try to avoid taking ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). Instead, I give myself a chance to rest (which is not always easy). When my kids (ages 3 and 5) feel warm I will focus on their behavior rather than measuring their temperature. If they seem uncomfortable or are having difficulty resting, I will treat them, but I don’t ever treat based on them having a fever alone.

For more information on treating fevers in kids, here’s a link to the American Academy of Pediatrics guidelines.

I hope you stay warm!