Fever in Children - A Blessing in Disguise

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December 17, 2000 | 119,278 views

ByLinda B. White and Sunny Mavor
Originally printed in MotheringMagazine

Excerpted from Kids, Herbs, and Health: A Parents'Guide to Natural Remedies by Linda B. White, MD, and Sunny Mavor,AHG, $21.95, with permission from Interweave Press, 1999. CLICKHERE to view on Amazon.com.

Fever is not a disease butrather a symptom of an illness.

It may help parents to remember that fever is only one part ofthe picture of an illness. In fact, for children under eight yearsof age, and especially for infants, the severity of a fever isan unreliable indicator of the severity of the child's illness.

For example, infants and toddlers can be very sick with a low oreven subnormal temperature. Conversely, children three to eightyears old can be running about quite cheerfully with a fairly impressivefever. The important thing is how your child is acting, not thethermometer reading.

Defining Fever

First, let's define normal body temperature. Most people say 98.6ºF(37ºC) is normal, but this doesn't account for individual variationsor the fact that kids tend to run slightly hotter than adults. Youcan think of anything between 97º and 99.4ºF (36ºand 37.4ºC) as normal.

Consumption of hot food, recent exercise, overbundling, hot weather,or an overheated room can drive body temperature up a degree ortwo. Body temperature also varies during the course of the day,and, with teenaged girls, the menstrual cycle.

Fevers usually hit their highest point in the late afternoon.

Conversely, kids often have their lowest temperature of the dayearly in the morning. So don't panic at 4 p.m. when your child'sfever rises slightly; this does not necessarily forebode a ragingfever. On the other hand, if your child has a low-grade fever uponawakening, you may want to keep him home.

How Fever Happens

Infections most commonly launch fever, especially in children.Other triggers include transfusion reactions, juvenile rheumatoidarthritis, tumors, inflammatory reactions caused by trauma, medications(including some antihistamines, antibiotics, or an overdose of aspirin),immunizations, and dehydration.

Most physicians do not believe that teething directly causes significantfever, but we have seen it happen.

When infectious "bugs" stimulate white blood cells ina specific way, they release a substance called endogenous pyrogen,which signals the brain's hypothalamus to raise the body's thermostatsetting. In turn, the body heats up by increasing its metabolicrate, shivering, or seeking warm environments.

It also minimizes heat loss by restricting blood flow to the skin,giving it a pale appearance. Once body temperature rises, the skinflushes and sweats. A fever sufferer may lose appetite and feellethargic, achy, and sleepy. When these phenomena happen to ourchildren, we just tuck them into bed and let them sleep.

A basic fever, onedue to minor bacterial or viral illness, can be an expression ofthe immune system working at its best. Given thatmost animals (vertebrates anyway) mount a fever in response to illness,it's likely that humans have preserved this evolutionary responsebecause it improves survival. Some research supports this theory;animal studies show when fever is blocked, survival rates from infectiondecline.

Fever increases the amount of interferon(a natural antiviral and anticancer substance) in theblood. A mild fever also increases the white blood cells thatkill cells infected with viruses, fungi, and cancer, and improvesthe ability of certain white blood cells to destroy bacteria andinfected cells. Fever also impairs the replication of many bacteriaand viruses.

Bottom line: A moderate feveris a friend, but not one you want to spend a lot of time with. Soit makes sense to avoid suppressing moderate fevers with drugs,while continuing to monitor your child for dramatic increases intemperature and worsening of any other of his symptoms.

Can Fever Do Harm?

Any time body temperature increases, salt and water are lost viasweating, and stores of energy and vitamins, especially the water-solubleones, are burned up. During moderate fevers, we can compensate forthese losses by drinking appropriate fluids, ingesting nutritiousfoods, or taking vitamin supplements.

Replacing water-soluble vitamins (chiefly C and Bs) makes sense.However, during fevers, the body makes some minerals unavailablefor a good reason - bacteria need them to thrive. In terms of energystores, our bodies switch from burning glucose (the favorite mealof bacteria) to burning protein and fat.

This means a fewdays of poor appetite is probably adaptive. In other words, don'tcajole or coerce your children into eating during fevers if theydon't feel hungry; they will likely regain anylost weight quickly after the illness ends. You do, however, needto encourage fluids, because dehydration alone can drive up fever.

Very high fevers - those above 106°F(41°C) - can harm the heart and brain. Some authorities,however, say that fever is unlikely to cause brain damage in a previouslyhealthy child. During most infections, the brain keeps body temperatureat or below 104°F (40°C). So in most - not all - cases,you don't need to be afraid that your child's temperature is goingto continue to rise above that point.

What About Febrile Seizures?

First, let's define them. These abnormal jerking movements occurin children between the ages of three months and five years in associationwith a fever, but without evidence of infection of the nervous system.The seizure lasts no longer than 15 minutes (usually five minutesor less) and causes twitching all over. About 3 percent of kidsget febrile seizures.

The reason some children have this susceptibility isn't well understood.Of those kids who have a first-time febrile seizure, about one-thirdhave a recurrence. Risks for recurrence go up with younger age atthe first seizure (16 months old or less) and a family history offebrile seizures.

Frightening as theseseizures are for parents, they're benign; oncethey pass, the child continues to develop normally. Often pediatricianscan help parents learn to block high temperatures by giving ibuprofenor acetaminophen when fevers start. For the few children who haverecurrent febrile seizures, anticonvulsants or sedatives may beused.

What to Do If Your Child Has a FebrileSeizure

Try to stay calm. That's a tall order, but your child needs youto be collected. Take a deep breath. Let it out. Tell yourself thatthe seizure will not last long (although it may seem like forever)and that your child will likely be fine afterward.

Look at your watch to time the length of the seizure. This soundslike a big demand, given the anxiety a parent naturally feels. However,you will otherwise overestimate the time, and the duration of theseizure is important information for the doctor. If it exceeds fiveminutes, call 911.

After the seizure is over, comfort and reassure your child, thencall your doctor for an immediate appointment. He or she will wantto evaluate your child for any abnormalities (other than fever)that may have triggered the seizure. If the seizure lasted longerthan five minutes and/or your child seems to be very sick, yourphysician may tell you to go to the emergency room right away.

Over-the-Counter Medications for Fevers

It makes sense to us that if fever helpsdefend against infection, giving fever-reducing medications maymake things worse. In addition, some fever medicationscan have undesirable side effects. On the other hand, no one likesto watch a child suffer. And fever can deplete a child's energy.Here's a profile of over-the-counter medicines for reducing feverand discomfort.

Acetaminophen reduces fever and pain but not inflammation. Followthe package instructions. Because of the risk of liver damage, donot dose more frequently than every four to six hours or for morethan five consecutive days. There is no need to awaken your childto give her a dose; sleep will do far more good.

Ibuprofen (Children's Motrin, Pediaprofen, Advil) reduces fever,pain, and inflammation. Follow the package instructions. Do notgive more often than every six hours unless your physician advisesotherwise. This medicine can cause stomach upset.

Aspirin reduces fever, pain, and inflammation, but pediatriciansrarely recommend it.

Use of aspirin in children during viralillness has been linked to Reye's syndrome, a diseasecharacterized by severe liver dysfunction and brain swelling. Symptomsinclude effortless and repeated vomiting, then a change in the levelof consciousness (lethargy, stupor, combative behavior, delirium,seizures, coma).

No one knows what the cause of Reye's is, but it seems to be linkedwith aspirin use during viral illnesses. For this reason, authoritieshave recommended that children under 21 years with symptoms of viralrespiratory illness or chickenpox do not take aspirin. Sometimesherpes outbreaks and viral gastroenteritis (marked by vomiting and/ordiarrhea) are included in the list of illnesses during which aspirinmust be avoided.

Unfortunately, it is often difficult to be certain of the causeof an illness when it starts. Aspirin is a component of many coldand flu over-the-counter medications, so avoiding it requires carefullabel reading on your part.

Medications for fever can act as a screen. Here are some pros andcons to giving your child over-the-counter medication to ease afever.

Medication such as acetaminophen can help sort out whether yourchild feels miserable because of a fever or because of an infection.Some physicians use a trial of acetaminophen as a screen. If, afterthe drug kicks in, the child looks and acts better, it is less likelythat he has a fever or that his infection is a serious one.

Fever medications can make your child feel better. He may be morelikely to drink fluids, nibble food, and sleep. All can help himrecover.

Fever medicationscan mask symptoms. In other words, your child acts as though hishealth has improved, but it really hasn't.

Fever medications may actually prolong the illness. This opinionof some practitioners is backed by a few studies. Assuming the responseof the body to illness (fever, inflammation, sleepiness) is adaptive,it seems reasonable to assume that interfering with the processmay do more harm than good. The following are some examples thatsupport this theory.

The bottom line.Use these medicines sparingly when your childis in pain or suffers discomfort from a fever over 102°F (38.8°C).Ask yourself whether you are administering the fever-reducing medicineto make your child more comfortable or to decrease your own anxiety.

Nondrug approaches can go a long way toward helping your childfeel better. If the situation does not seem urgent, you might wantto consider a trial of herbal treatment before you pull out theacetaminophen.

Home Management of Fevers

Do give your child lots to drink.Fever increases fluid loss, and dehydration can drive up your child'stemperature. Kids with fever often do not feel thirsty, or by thetime they do, they're already dehydrated. So keep offering fluids.

Small, frequent sips are often best,especially if the child feels nauseated. If necessary, use a plasticmedicine dropper to gently insert water into your child's mouth.The type that holds several ounces is best to use.

Dress lightly or bundle? Theanswer depends on your children's perception of temperature - followher cues. If your child looks pale, shivers, or complains of feelingchilled (things that tend to happen in the early stages of fever),bundle her in breathable fabrics so that sweat will evaporate, butmake sure she can easily remove the layers. If she is comfortableand her fever is low, dress her snuggly and give warm liquids toassist the body's fever production. If she sweats and complainsof heat, dress her lightly and let her throw off the covers. Olderkids will take care of these needs themselves.

Don't push food. People withfevers generally don't have much appetite. Let your child determinewhen and what she eats. Just bear in mind that consumption of sugaryfoods could delay the natural immune response.

Herbal Remedies for Fevers

A rule of thumb that herbalists like to use during minor illnesswith fever is: "First, do nothing,"meaning that a short period of observation ought to precedeany action against the illness. Follow our guidelines above forseeking medical assistance for feverish children under the age oftwo, and encourage fluids. For older children, give liquids, makethem comfortable, and observe closely.

Is your child drinking fluids well? Urinating at least onceevery eight hours (ideally, every three to four hours, or wettingeight to ten diapers per day)? Does your touch console her? Is sheplaying normally? If the answer to these questions is yes, she isprobably not seriously ill.

This observation time can also help you figure out which of thefollowing herbs are most indicated and effective.

Boneset. We cannot find much current research on this herb, butfolklore, historical medical texts, and personal experience tellus it works. Consider the opinion of Drs. John Uri Lloyd and HarveyFelter from 1898, two of the most respected herb doctors in Americanhistory: "In influenza, it relieves the pain in the limbs andback. Its popular name, 'boneset,' is derived from its well-knownproperty of relieving the deep-seated pains in the limbs which accompanythis disorder."

For more information about herbal remedies for children, see thefollowing articles in past issues of Mothering: "TheScent That Soothes," no. 80; "Natural Remedies for ChildhoodDiseases," no. 77; "Natural Immune Boosters," no.73; "Natural Remedies for Winter Illnesses," no. 69, and"Childhood Fevers," no. 51.

Linda B. White, MD, is the mother of two and the author of TheGrandparent Book. She is a national natural health writer.

Sunny Mavor, AHG, is a professional member of the American HerbalistsGuild and lectures nationally on botanical medicine. She is themother of two and the founder of Herbs for Kids.

This is one of the most comprehensive articles to date thatI have reviewed on this important topic. Many families with youngchildren will want to print this article out or book mark it soyou can have it to refer to in the future.

However, it is absolutely amazing how infrequently your childrenwill get sick when they are following the dietprogram. We all know that it is far easier to prevent an illnessthan to treat it.

A fever is a backup mechanism when our primary ones fail. Goodfood, adequate rest and the ability to handle stresses are the primaryones.

I would also advise avoiding most all of the anti-fever medicationsunless your child is absolutely miserable or the fever is over 105.

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