Should You Lower Your Child’s Fever? What You Need to Know Before You Reach for the Tylenol

baby_poop_updatedThank you to Dr. Linda F. Palmer for sharing this excerpt of her new book, Baby PoopWhat Your Pediatrician May Not Tell You about Colic, Reflux, Constipation, Green Stools, Food Allergies, and Your Child’s Immune Health. Find more about the book at the end of this article.

“Fever does not cause brain damage. Fever is a good thing,” says pediatrician Scott W. Cohen, MD, author of Eat, Sleep, Poop. Pediatrician Jo Ann Rohyans, MD, writes for BabyCenter.com: “Most children can tolerate a temperature of slightly higher than 107°F without long-term effects from the fever itself.” She explains that this is unless the child is overdressed or trapped in a hot space.

The U.S. National Institutes of Health (NIH) post about children on their Medline Plus website: “Brain damage from a fever generally will not occur unless the fever is over 107.6°F (42°C). Untreated fevers caused by infection will seldom go over 105°F (40.5°C) unless the child is overdressed or trapped in a hot place.”

Pediatrician Barton Schmitt, MD, states in his American Academy of Pediatrics book, My Child is Sick, “Fevers with infections don’t cause brain damage. Only fevers above 108°F (42.3°C) can cause brain damage.” Need I go on?

A child stuck in a hot car can become heated to higher than 108 degrees Fahrenheit and suffer injury or death. Certain severe chemical poisonings can cause excessive, damaging temperatures. These are not infection-related fevers, rather they are unnatural overheatings. The body will not destroy itself through its own immune system process of warming up to kill infections.

Pediatrician Susan Markel, MD, in our book What Your Pediatrician Doesn’t Know Can Hurt Your Child, states,

Despite the common fear that fever can cause brain damage, this has never been confirmed by any scientific tests or investigations. Only in the rare cases of meningitis or encephalitis, conditions which themselves can cause brain damage, can the brain’s ability to control the body’s temperature be disrupted. In neurologically normal children, the brain has an internal regulatory mechanism that does not allow fever to rise out of control. Fevers produced by viral or bacterial infections will not cause brain damage or permanent physical harm, despite the myths about children being severely compromised by having a high fever.

Fever is not to be feared. Fever is useful. It’s the body’s means of getting itself better. We want baby to get well as soon as possible. Fever is one of the body’s immune system processes for killing infections. We want infections killed. There is no reason to block the body’s efforts to recover. The goal of caring for a sick child should be to keep her protected while her body tackles the infection and repairs itself. A child is not truly healthy and well just because she behaves better when her symptoms are covered up by some chemical medication—while the drug hinders her immune system—for the sake of short-term relief.

Some children experience febrile seizures. These are frightening to see, but according to the American Academy of Pediatrics, and other authorities, febrile seizures do not cause brain damage or other long-term harm. As well as having seizures, a child can experience hallucinations or suffer a “swimmy head” feeling when her fever is in higher ranges. These all come from the head being hot, when the benefits of fever are mostly needed for the rest of the body. A child’s head can be cooled by using cool cloths, bringing comfort without stopping the benefits of fever to the rest of the body.

We all get sick. It’s okay for a baby or child to feel uncomfortable sometimes. You don’t have to fix it. The best medicine for your child’s ill feelings is your warm affectionate attention and tender embraces. Your child will not only gain great comfort, but this is a special opportunity for your child to learn empathy and caring through your compassion, and have opportunity to really feel how much you care. Besides the emotional feel-good, your touch and especially skin-to-skin contact lead to oxytocin releases that invigorate the immune system. Baby’s neurological feedback systems are also designed to gain great relief and physiological normalizing through sucking. Whether on a finger, breast, bottle, or pacifier, help your sick baby or toddler achieve as much as desired.

Pain and Fever Medications

Pain and fever medications do not cure, reduce, or shorten illnesses. If anything, they may lengthen them. They stress baby’s liver and kidneys when he is already ill, and they put baby at slight potential risk for damage when we actually want him to be getting stronger. By causing a child to feel much better through the use of pain and fever reducers, his body will be prevented from telling him when to slow down and when to lie down. Unimpeded, the immune system tells the body when it needs rest in order to focus on efforts toward recovery. Masking of symptoms with drugs can also cover up important signs of worsening, which could possibly delay the pursuit of important medical attention.

Accidental medication overdoses are risky, of course, but each kind of fever and pain medication has its own health risks even at recommended doses, which is what I discuss here. NSAID is common lingo for a non-steroidal anti-inflammatory drug, which includes aspirin, ibuprofen (Motrin), and naproxen. Acetaminophen is another common, non-prescription pain medicine.

Also known as paracetamol, or Tylenol, this medication is not classified as an NSAID. All of these pain-reducing medications are also fever reducers. There are other drugs in these same categories with similar actions and side effects, but I will focus on these.

Aspirin is known to cause non-permanent liver damage in half of all who use it regularly. In a small number of children, more severe complications can occur. All of the above meds are known to pose slight and—on rare occasion—severe liver risks, even at recommended dosages. Ibuprofen and aspirin are known to occasionally cause gastrointestinal (GI) discomfort or bleeding in children. Acetaminophen can do the same but less often. Acetaminophen is labeled as safer overall than ibuprofen in some studies, although other studies claim it has worse side effects. NSAIDs and acetaminophen are also implicated in occasionally causing an autoimmune blood disease, thrombocytopenia, from which recovery is generally good.

Exposure to acetaminophen before the age of 15 months has been associated with an increased risk of later developing allergies or asthma.

Acetaminophen and other medications rarely can cause severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis. These can be fatal. If a medication ever causes a skin reaction, it should be stopped and never used again. In addition to these threatening skin reactions, there is also a risk of severe or fatal skin staph or strep infections when NSAIDs are used with chicken pox or shingles infections. A risk in using these medications for a child with diarrhea and vomiting of unknown origin is that they could be exhibiting early symptoms of chicken pox or shingles, though the chance of a child actually having chicken pox or shingles is low today in vaccinated young children. Shingles rates are higher in children over 10 years of age than before the era of chicken pox vaccination.

Further safety studies for these meds are sorely needed. Studies have been performed in animals with influenza and with pneumonia, finding increased death rates when fever reducers are used. In animal studies, fever reducers were found to lengthen the time of illness in diarrheal infections from Shigella. Small studies of humans with influenza have found prolonged illness with the use of fever reducers. Only three different microbes were included in this study so this finding doesn’t exclude such an effect with other infections.

Parents continue to be warned about the risk of Reye syndrome when giving aspirin to young children with chicken pox or other viruses. There are many dangers from giving medications to sick children, but this actually is not one of them. It’ll likely take another decade for this information to trickle its way into mainstream medical education. The whole aspirin and Reye syndrome connection has been fully debunked in the medical research literature since the year 2000 and, even a decade before that, it was strongly suspected that anti-vomiting drugs have been responsible for most of the serious effects in children who showed symptoms that were associated with Reye syndrome. Still, aspirin, like all of these medications, may rarely be linked to serious skin, organ, or neurological disorders, especially when combined with bacterial or viral infections.

Some parents may understandably have concern about seizures after witnessing one in their child, but a large review of studies found that fever reducers actually do not prevent the return of febrile seizures. These results also imply that they do not prevent a first febrile seizure. An even larger review looked at the use of all kinds of anti-seizure medications as well as fever reducers and found that no drugs reduced the return of febrile seizures or provided any benefits, yet a full 30% of children suffered adverse effects from such drugs. Although a very small percentage of children who experience febrile seizures go on to be diagnosed with epilepsy, there is no evidence that this occurrence can be prevented with drugs.

Cooling of the whole feverish body through cool bathing has also not been proven beneficial; if anything, it slightly increases complications.

Your affection, attention, close observation, avoidance of unnecessary drugs, and provision of good hydration and nourishment will see baby through her illness with healthy success.

Endnotes for this article can be found here.

About Baby Poop

What Your Pediatrician May Not Tell You about Colic, Reflux, Constipation, Green Stools, Food Allergies, and Your Child’s Immune Health by Linda F. Palmer, DC; Edited by pediatrician Susan Markel, MD

Eat, sleep, and poop. That’s what babies do. Every parent has challenges and questions about these activities and there is an abundance of information on eating and sleeping, but poop? The appearance and behavior of a child’s stools can give more information about the child’s health than any other factor, but we just don’t seem to like to talk about it.

From an award-winning, three-time author—and a mother—Baby Poop brings the hard-to-find facts that equip parents to help their babies be happier and healthier, head off the occasional dire situation, and to optimize their child’s lifelong health.

Yes—poop. Parents spend inordinate amounts of time worrying about what goes into their babies. All the while, what shows up in baby’s diapers provides tremendous clues about baby’s digestion, immune functioning, and overall wellness. We don’t get explanations or even pointing fingers from babies: We get smiles or tears, and we get poop.

Baby Poop is about child health dilemmas faced in industrialized nations. These are distinctly different from the challenges in less developed countries, as most of these challenges are caused directly by modernization. Infectious disease rates are high in many less developed parts of the world, with high infant and child mortality rates—but industrialization, medicine, and money are not the end-all answers to optimal child survival. Baby Poop illuminates how a much larger portion of children in developed nations suffer from colic, reflux, food allergies, asthma, autism, and diabetes than those in the developing world—and how modern practices are encouraging these.

Baby Poop presents evidence from science and medical studies—accented by the collective wisdoms of mothers, midwives, lactation consultants, and other infant care specialists—and provides options that are shown to optimize children’s health. Written with new parents in mind, even the most experienced lactation, birthing, or pediatric professional will find many new pearls of information throughout the text.

It’s clear that Palmer has had plenty of experience with baby poop physiology and has researched the literature thoroughly, for our benefit. Palmer also fully recognizes that every family has its own unique needs, desires, and challenges, so she does not promote a one-size-fits-all agenda. Never judgmental, Baby Poop expands the evidence-based options, so parents have more resources from which to make decisions that work best for their family.

When is runny poop actually a sign of constipation?

Is it normal for a baby to go 10 days without pooping?

My baby’s poop is white! Am I seeing things?

Fifteen to twenty-five percent of U.S. babies suffer from colic and/or reflux. Contrary to common medical lore, a large portion of babies don’t just “grow out” of colic and reflux; rather, they “grow in” to new symptoms that can haunt them into adulthood when not addressed early.

Baby Poop encourages parents to take charge of their own child’s health while keeping healthcare professionals in the loop.

You think of a baby as one organism, but actually trillions of organisms, chiefly bacteria, have powerful influences over a child’s immune protection and nutrient absorption. Strongly measurable differences in long-term disease risks have been correlated to a child’s floral beginnings. Early diet, and even place and mode of birth, have been shown to have great impacts on a child’s long-term microbiome. Antibiotic drug treatments create the greatest assault on baby’s flora. When out of balance, the flora plays a role in generating syndromes such as inflammatory bowel disease, celiac disease, allergies, autism, diabetes, and even obesity. The stage for all of these can be set during infancy.

In case of a preterm birth, it is highly valuable for expectant parents to learn about issues over which they may have some influence. High rates of gastrointestinal maladies are reported in autistic children. Whether such symptoms are the cause or the result, these children still need help.

Because the majority of pediatricians find many stooling symptoms unimportant or simply are not enlightened as to how easily they can be resolved, many chances to relieve a child’s uncomfortable conditions are lost. A large portion of troublesome intestinal conditions in infants are quickly written off by doctors as “common” complaints that will go away with time. Many extra hours of crying and discomfort in babies, and of worry and lost sleep in parents, take place because of the taboo of poo. A great number of these health challenges carry on or return as the child becomes an adult, and entire lives are hampered by missed diagnoses and opportunities to heal.

Food allergies and intolerances join the ranks of other rapidly growing disorders in children and are often the first signs of future GI ailments and autoimmune diseases. Food reactions are largely the cause of early colic, reflux, constipation, diarrhea, sleeplessness, rashes, and many more symptoms. Challenges to infant gut health are at the root of such food reactions.

The healthcare provider needs to be involved when baby is sick with diarrhea, but it’s still the parents’ job to continue baby’s care at home. Baby Poop provides evidence-based recommendations that can greatly benefit baby’s recovery. Constipation can quickly turn into a serious problem—or can become a chronic problem for years. Baby Poop expounds upon early healing efforts that can reduce lifelong stool challenges.

To help prevent your child from joining the growing statistics of chronic health problems, early gut healing and continued gut health efforts are worthwhile, especially if your child expresses any of the symptoms of concern discussed in this book, has been exposed early to antibiotic drugs, has had early exposure to formula feeding, or has experienced multiple GI infections.

Baby poop is a window to the health of a child. Baby Poop lets parents in.

Dr. Linda Folden Palmer left her 11-year nutrition-oriented chiropractic practice after the health challenges of her newborn son overwhelmed her. Perplexed by the lack of appropriate advice from pediatric sources, her extensive literature research led to her first book, Baby Matters, What Your Doctor May Not Tell You About Caring for Your Baby.


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