Wednesday, October 22, 2008

A Fever for Kids is Not Bad

If you have been the parent of a small child, no doubt there have been sleepless nights worrying about your child having a fever. All kinds of old wives tales and misinformation have led to unfounded fears about fevers. We feel that we have to “bring the fever down” using all kinds of over the counter medicines, poultices, incantations and prayers. Most of these reactions are totally unnecessary, usually ineffective and sometimes even dangerous.

Fever by itself is not harmful or dangerous, and unless it is very high (over 106 or 107 F), it is unlikely to cause brain damage or other problems. Fever is not a disease, instead, it is a symptom that can accompany many illnesses, especially infections. In general, you should call your pediatrician if your infant under three months of age has a rectal temperature above 100.4 F, if your infant aged 3-6 months has a temperature above 101 F, or if an infant above 6 months has a temperature above 103 F.

For most older children, it is not so much the number, but rather how your child is acting that is concerning. If your older child is alert, active and playful, is not having difficulty breathing, and is eating and sleeping well, or if the temperature comes down quickly with home treatments (and he is feeling well), then you don't necessarily need to call your doctor immediately

Kitty’s Indian Sweat Bath

When Kitty lived with the Mescal Indian tribe near the Peyote Mountains of New Mexico, she popped a fever one night after an especially trying day of ritualistic activities. The Indians decided to treat her with a sweat bath.

Although the sweat bath has ceremonial functions, sort of like a modern day hot tub party, it also is used in the treatment of rheumatism and fever. Usually the sweat lodge is a small domed structure with a framework of arched poles and a cover of hides or bark. Rocks are heated and rolled into the lodge. Water containing plant medicinals is then sprinkled on the rocks to form steam.

The sweat bath was usually followed by a plunge into cold water. This was NOT Kitty’s favorite part of the treatment.

For little ones, the medicine can be worse than the fever and the illness behind it.

Parents have long relied on fruit-flavored cold medicines to relieve the sniffles and fever. But concerns about the over-the-counter medications marketed for children have led the Food and Drug Administration to study the safety and effectiveness of these products. (In fact many of these medicines are behind the counter now…due to their use in the manufacturing of Crystal Meth…definitely not a children’s medicine).
Pediatricians and others want the government to require labeling that says these medications should not be given to children under 6.

The Centers for Disease Control and Prevention reported in January that over two years, 1,519 children under 2 were treated in emergency rooms for adverse effects and overdoses associated with cough and cold medicines. The medications were also the cause of death for infants who were found dead in their homes. The babies, all less than 6 months old, had levels of the decongestant pseudoephedrine that were 9 to 14 times the dosage for children 2 to 12. (The babies were essentially on a high dose of speed)

Drugstores said to be confusing

Parents sometimes don't read labels and then become confused by all the products on drugstore shelves. (Remember: Apply directly to the forehead…and repeat 30 times). Many of the most popular cold medicines contain up to four active ingredients, any of which can cause side effects.
Decongestants, for example, are stimulants that can raise the heart rate and cause insomnia, loss of appetite or irritability, said Dr. Joel Steinberg, professor of pediatrics at UT Southwestern Medical Center.

"I see a lot of small kids who are really fussy," he said. "The parents think it's the illness but it's actually the medication they're taking." (and you wonder why the kid can’t sleep)

Antihistamines, often found in cold medicines, can cause drowsiness, but children can also have a paradoxical reaction and become hyper, said Dr. Maria Fisher, an Arlington, Texas, pediatrician. Multi-symptom cold medications often contain acetaminophen, but some parents don't realize that and unknowingly give their children more of the drug for a fever, she said.

Too much acetaminophen has been associated with liver toxicity. (These are the same parents who quaff a handful of Tylenol Extra Strength capsules to kill a hangover…the absolute worse thing you can do to your liver. Take an Advil or Aleve instead…better to risk your stomach than have your liver fail.)

No proof of effectiveness

Not only do these drugs have side effects, there's little evidence that they work, Steinberg said.

"The standard cough syrup has no effect on coughs," he said. "And you shouldn't take medicine that has no effect." (Duh)

Physicians say the safest approach is to skip the medications and use saline drops, a cool mist humidifier and nasal suctioning to help with congestion.

If a parent feels they must use OTC medications, doctors recommend giving the smallest dosage possible. It's better to give the medication during the day before administering it at night, so any side effects can be observed, Fisher said.

"Usually a cold or virus lasts a couple days and runs its route," she said. "But if it lasts, we go to the doctor."

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