Treat the child, not the fever

Is it feed a fever and starve a cold or treat a fever and wipe their nose? This has always been confusing, so now to make it easier, the experts in infectious disease say you don't have to treat a fever.

Fever has a purpose. Don't mess with nature. A fever does not harm a child. Their brains will not sizzle. A fever is a signal to parents to be alert for the infection triggering the fever. It is not a signal to panic. Elevated temperature is a way to heat-sterilize our bodies from germs. The fire also revs up the body's defense to seek out and destroy the enemy more effectively.

The key is not the temperature, but the way the child acts with and without the fever. The child is hot, the fever comes down and starts to play again, which suggests the underlying disease is not so bad. On the other hand, if the temperature is down and the boy or girl is still listless and just seems sick, there may be cause for concern. It is also not a measure of severity if the temperature does not come down with anti-pyretics such as ibuprofen or acetaminophen. Most often what happens is the dose for the medicines is too low.

So often, the parent will say they felt warm, but there are times when a child is hot and still does not have a fever. Mothers without thermometers can identify fevers in a young child, but they also overcalled some who were warm to the touch but had no life threatening infections.

A fever in 99 out of 100 cases signifies an infection. It is the infection that can be harmful. Dismissing the urgency of fevers does not mean dismissing the risk for serious infections, particularly in the young. There are levels of concern. There is something different about an infant under 2 weeks, a baby under 2-3 months and a toddler under 2 years. At each stage, the immune system is different, with more rapid responses as the child ages and experiences different pathogens. There are also different organisms that are more common in a newborn, especially a baby born prematurely. Lastly, the younger the infant, the harder it is to detect if bugs have invaded the body, putting the new person at risk. Sometimes, a doc or parent will just look at a child and know at a gut level they are sick. That feeling or gestalt is just harder when an infant's repertoire of reactions is pretty limited.

What does a sick newborn do? They may fuss and not eat. What does a normal newborn do sometimes? They may fuss and not eat. This is where a fever of 100.4 and above would be helpful to know in order to act rapidly in case there is a serious infection in the blood, the spinal fluid or commonly in the urine.