New Advice for Fighting Fever in Children

Feb. 28, 2011 -- Fever may be beneficial when it comes to fighting infection, according to new advice from pediatricians.

New guidelines from the American Academy of Pediatrics urge parents to recognize fever as a sign that the body is working to fight infection and not something to be feared.

Instead, they say the main goal of treating fever in children should be to keep them comfortable while watching for any signs of serious illness rather than focusing on keeping their temperature within a "normal" range.

"Fever makes many parents do whatever they can to bring their child’s fever down into a normal range. Fever is not a danger itself; it usually is a benefit," Henry Bernstein, MD, chief of general pediatrics at the Cohen Children's Medical Center of New York, says in an email.

"Parents need to know that fever is not something to fear, but more of a?friend that shows the body is fighting the infection."?

Which Fever Reducers Work

Researchers say evidence suggests there is no substantial difference in safety and effectiveness between the fever reducers acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) in treating fever in healthy children between 6 months and 12 years old.

Although some studies suggest that alternating doses of ibuprofen and acetaminophen may be more effective at lowering temperature, researchers say questions remain regarding the safety of this practice as well as the effectiveness in improving discomfort.

"The possibility that parents will either not receive or not understand dosing instructions, combined with the wide array of formulations that contain these drugs, increases the potential for inaccurate dosing or overdosing," researcher Janice E. Sullivan, MD, of the American Academy of Pediatrics' section on clinical pharmacology and therapeutics, and colleagues write in Pediatrics.

Researchers say acetaminophen is the most common single ingredient involved in emergency room visits for medication overdoses in children. More than 80% of these overdoses are the result of unsupervised ingestion.

Therefore, proper storage, handling, and dosing of fever-reducing medications is critical.

"They must be given in the correct dose at the right times based on a child’s weight, age, and overall health," Bernstein says.

How to Treat Fever in Children

When a child has a fever, researchers say parents and caregivers should focus on the overall well-being of the child and carefully monitor their behavior for any changes in activity or temperament that may be a sign of a serious illness.

Additionally, the report offers this advice for treating fever in children:

• Encourage the child to drink appropriate fluids (breast milk, formula, water, etc.) to prevent dehydration.
• Acetaminophen or ibuprofen, when used in appropriate doses based on the child's weight, are generally safe and effective to manage symptoms of fever in children.
• Do not wake a sleeping child to give him or her a fever reducer.
• Cough and cold medications that contain acetaminophen or ibuprofen should not be given to children. Parents may accidentally give the child simultaneous doses of acetaminophen or ibuprofen and a cough and cold medication that contains the same fever-reducing medication.
• For children who require liquid medications, only one formulation should be used in the household.
• To prevent accidental overdose, all fever reducers should be stored out of reach of children, and an accurate measuring device should always be used when dispensing to children.

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