Fevers in children is one of the primary concerns driving parents to seek medical guidance. Witnessing a fever in a child frequently triggers worry regarding its severity and appropriate management, often culminating in late-night visits to the Emergency Department. Exhausted parents contend with restless children and enduring wait times. However, when the doctor finally arrives, the child miraculously appears revitalized, darting around the room in seeming normalcy. This confusing situation can leave parents frustrated and dissatisfied upon discharge. Particularly as young children seem to fall ill in succession, perpetuating a cycle that turns the Emergency Room into a revolving door—a costly feedback loop.
The other extreme is when parents succumb to “fever phobia,” a term coined by Dr. Barton Schmitt in 1980. Where a misconception to the definition of a fever, and over concern about rare fever side effects, leads to an over-aggressive treatment of fevers (Schmitt 1980). Treatment, referring to use of an antipyretic such as Acetaminophen (Tylenol) or Ibuprofen (Advil). This “fever phobia” continues to be observed. Polat et al. (2014) sought to investigate knowledge and attitudes surrounding febrile children. Of the 1,032 surveyed, about a third considered a fever to be under 37.8°C (100°F), where 13% of caregivers would treat a fever under 37.8°C. They also note 10.5% thought a fever had benefit, noting this mindset was correlated with higher levels of education, and less emergency room visits (Polat et al. 2014). This study suggests parental education as a main factor in reducing fever phobia.
So what is a fever? According to the Mayo Clinic, a fever is an elevated body temperature of 37.8°C (100°F) or higher (2022). It is vital to infant and toddler age children to closely monitor fevers, as they are more susceptible to serious complications. The Mayo Clinic lists as follows:
Younger than 3 months old and has a rectal temperature of 100.4 F (38 C) or higher.
Between 3 and 6 months old and has a rectal temperature higher than 102 F (38.9 C) or has a lower temperature but seems unusually irritable, sluggish or uncomfortable.
Between 7 and 24 months old and has a rectal temperature higher than 102 F (38.9 C).
As for older children, they recommend seeking medical advice if your child experiences lethargy, confusion, excessive vomiting, severe headache, or had a seizure (Mayo Clinic 2022). The general consensus is to treat the fever with medication only if the child is tolerating it poorly. Otherwise, it is fine to let it ride.
References:
Mayo Clinic [Internet]. 2022. Fever. Mayo Clinic. [cited 2024 Feb 29]. Available from:https://www.mayoclinic.org/diseases-conditions/fever/symptoms-causes/syc-20352759
Polat M, Kara S, Tezer H, Tapısız A, Derinöz O, Dolgun A. 2014. A current analysis of caregivers’ approaches to fever and antipyretic usage. J Infect Dev Ctries. 8(3):365–371. doi:10.3855/jidc.3904.
Schmitt BD. 1980. Fever phobia: misconceptions of parents about fevers. Am J Dis Child. 134(2):176–181. Assessed and Endorsed by the MedReport Medical Review Board