Parents Overtreat Harmless
Fevers In Kids

By Alison McCook

NEW YORK (Reuters Health) - A survey comparing attitudes of doctors, nurses and parents towards treating fevers in children reveals that parents tend to treat high temperatures much more aggressively than health professionals do.
A low fever can actually benefit a sick child, and the researchers attributed parental tendencies to "fever phobia"--a fear that fever is harmful--which they say originated after the introduction of anti-fever drugs like Tylenol.
A group of Israeli researchers obtained their results from a questionnaire sent to more than 2,000 parents, doctors and nurses regarding fevers in children older than 3 months. The researchers defined fever as 1.8 degrees Fahrenheit above normal body temperature, which is around 98.6 degrees. The survey included questions on risks of fever, dosages of anti-fever drugs and when children should be treated.
Dr. Michael Sarrell and colleagues from the IPROS Network of the Israel Ambulatory Pediatric Association in Tel Aviv published their survey results in the January issue of Patient Education and Counseling.
The investigators found that only 43% of parents knew that a fever below 100.4 degrees can be beneficial to a child, in contrast to 86% of the doctors and 64% of the nurses who responded to the survey. The majority of parents also said they would treat a fever below 100.4 even if the child has no other symptoms, something with which only 11% of doctors agreed.
Dr. Donna D'Alessandro from the department of pediatrics at the University of Iowa Hospitals and Clinics, who reviewed the paper for Reuters Health, said these results are consistent with what she sees in her practice. "It seems to me there is a general feeling that many, many parents are worried about fevers," she said.
A fever can actually help sick children, she explained. "The body, basically, is trying to do the right thing," she said. "Bugs like to live at body temperature. So if you raise the temperature, you kill them off." And contrary to what parents may believe, she pointed out, the body can function very efficiently at temperatures as high as 100.5 degrees.
D'Alessandro added that some parents may overtreat fever because they mistake it for a problem, and not just a symptom.
Twenty percent of parents responding to the study questionnaire reported the only reason they treat their child's fever is to reduce the risk of seizure associated with high temperatures, called febrile seizure. D'Alessandro agreed that febrile seizures are possible, but only in children with temperatures around 108 degrees. And at that point, she said, parents should be concerned about more than just the child's fever.
"Well, what's really causing the fever? It's not the fever itself, it's the underlying cause that's the problem," she said.
As a general rule, D'Alessandro said she tends to treat fevers when the high temperature makes the child uncomfortable and thus less likely to drink often and eat.
In their report, Sarrell and colleagues included a series of recommendations on how to improve fever management in children, which included educating parents and the public, and adopting standardized guidelines for when and how to treat fevers. D'Alessandro agreed with this idea, but was unsure whether these initiatives were possible.
"The question is, who's going to spend the money for all of this? Is this significant enough a problem to go after spending a large amount of money?" she asked.
SOURCE: Patient Education and Counseling 2002;46:61-65.
Copyright © 2002 Reuters Limited. All rights reserved.

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