Fever is one of the most feared and misunderstood symptoms of childhood. Every child gets a fever at some point in their lives, and most will get a fever multiple times in their lifetime. Time after time, parents see that their children are okay after they recover from the illness causing the fever, yet fever continues to be feared so much. Parents desperately want to get the temperature into the normal range because they fear that fever causes brain damage.
Once parents understand fever better, I hope they won’t fear it much.
Fever is an elevation of temperature out of the normal range. An average temperature is 98.6 degrees Fahrenheit, but a normal range can be from 97 degrees Fahrenheit to 100.5 degrees Fahrenheit. Is a temperature of 100.3 degrees a fever? That’s debatable, but as you’ll see, it doesn’t matter.
Fever is the body’s response to infection, inflammation, or injury. We most commonly see a fever with some kind of infection. The body will elevate its temperature to combat the infection. A higher temperature allows the body’s immune system to fight the illness. Nothing is better than our own immune system. All the antibiotics in the world won’t cure an illness if our immune system is not functioning. Which is why people with immune deficiency disorders do so poorly. So if a fever is helping the immune system and the immune system is the best way to combat infection, why do we try to stop the fever? It is essential to understand the history of fever to answer this question.
Until the middle 1800s, the medical field did not know about the organisms that caused illness. No one knew about viruses or bacteria. So when a child got sick and got a fever, there was no way to know exactly what was causing the fever. A doctor would look at the symptoms and name the illness, but no one knew that the underlying cause was a microscopic organism. The child got a fever, and the illness would just run its course. There were no antibiotics to fight the bacteria. Almost every child, as is the same today, would recover without problems. The fever would break, the illness would pass, and the child would feel better. However, an extremely low number of children would have long-term complications. Was this because of the fever? Of course not. But the fever was the only thing these people were sure of, so the damage was blamed on the fever. The fact is that the complications came from the underlying illness that caused the fever. The child may have had a severe bacterial infection, such as bacterial meningitis or bacteremia, which means that bacteria was in the bloodstream. The illness, and not the fever, would cause complications. Because fever was to blame, this fear of fever became entrenched in society.
So why do we stop the fever? There is no good reason other than to make the child comfortable. If a child is comfortable, looks well, is eating and drinking, and has normal activity, then the best choice is to leave the fever alone and let it do its job. The only reason to bring a fever down is if the fever is causing discomfort in the child.
Fever in itself is not dangerous. It does not cause brain damage. It is not something to be feared. When a child is ill, fever is not the most important symptom. It’s not as simple as defining a child with a 98.6 temperature as healthy, one with a 100.1 temperature as worse, a child with 102 degrees fever as sicker, and one with a 104 temperature as dangerously ill. It just doesn’t work that way. A child with a 98.6 temperature could be seriously ill, and a child with a 104 temperature could have a mild virus. The best way to determine how sick a child is is to look at how they act. If a child is vigorous, full of activity, eating, drinking, and even actively fussy, they are healthy but may have a minor illness. If the child is lethargic, not responding well, not able to show good eye contact, has a stiff unmovable neck, or is floppy, then you have an ill child. The height of the fever doesn’t matter.
The worse thing a fever can do is cause a febrile seizure. A febrile seizure is a short seizure induced by a fever. Some children are prone to this, and a slight elevation of temperature can initiate it in these children. Most will never get a febrile seizure, no matter how high their temperature gets. A febrile seizure is not dangerous and does not cause brain damage. A febrile seizure occurs, it is over quickly, and there are no sequelae. It’s scary to see, but it is only a dangerous event if it repeatedly happens in a short amount of time. In this case, you would need to seek emergency medical care. It is rare, and there are under 200,000 cases a year.
In conclusion, we should not look at fever as the enemy. We should look at fever as our friend. Fever helps our bodies combat infections. It is best to find the cause of the infection and treat it but leave the fever alone.
Written by Dr. Michael Bornstein, who has 30 years of experience as a pediatrician.
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
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