Health Break | Published March 28, 2011

Child's Fever: To sweat it out or not?

No one likes to see their little ones down with a fever. Still, there’s some debate about whether to treat a fever or not.The American Academy of Pediatrics reports that even high temperatures are not necessarily dangerous or significant, unless the child has a history of seizures, chronic disease, or is under two months of age. We know that a fever is a good sign that a person’s immune system is kicking in to fight off an infection. My own philosophy is that a child should be as comfortable as possible until the fever passes. Two standard treatments for fevers include the use of either acetaminophen or ibuprofen. Each over-the-counter treatment has its positives and negatives, so let’s take a look at which might be appropriate:Acetaminophen is appropriate for children as young as two months old, and can be administered every four hours. It is usually easier on the stomach than ibuprofen but also poses potential risks, particularly with very young children, due to potential long-term use, or over dosage. If a child’s illness includes some queasiness or vomiting, acetaminophen is probably a better choice. Ibuprofen, which lasts for six hours, typically does a better job of bringing down a fever. It is also an anti-inflammatory and better at alleviating the aches and pains that often accompany illness. It is, however, harder on the stomach so it wouldn’t be my first choice if a child were vomiting. Other Do’s and Don’ts for treating a fever:1) DO give the child a lukewarm bath. However, avoid rapid temperature changes. 2) Do NOT give a child aspirin, which has been associated with Reyes Syndrome, a serious condition that can lead to coma and/or death. 3) Do NOT give alcohol baths and other treatments our grandparents may have used.4) DO give clear liquids frequently and regularly. If the child is older, don’t be afraid to remind him/her to keep taking fluids. 5) DO NOT push food. Moderate amounts of food, and even some sugar, are helpful. Watered-down Gatorade (50%) is one drink I recommend from time to time. 6) DO monitor your child if she/he is running a fever, even if they’re older. 7) DO check with your pediatrician if a child runs a temperature for three days or more or if she or he had a fever that went away and then suddenly returns. 8) If a child is under two months of age, you should always contact your pediatrician if she/he has a temperature above 100.4 degrees rectally. Although some people may want to alternate between acetaminophen and ibuprofen while treating a fever, always check with your pediatrician to see if this is a good strategy. Finally, always check with your pediatrician if you’re not clear on how to best handle a sick child or if anything unusual crops up during what seems to be a normal cold. Craig H. Collison, MD, pediatrician with Mount Nittany Physician Group, is department chair of pediatrics at Mount Nittany Medical Center, State College, Pa. The pediatric offices of Mount Nittany Physician Group are located in Bellefonte and Boalsburg.