Interesting Advice From Pediatrician

[AprilM]

So I brought DS to the pedi today because he had a high fever last night following complaints of a sore throat this morning. We wanted to rule out strep. I saw the nurse practicioner (sp) who ripped me a new one because I only gave DS one dose of tylenol, instead of giving it every 4 hours to keep the fever down. I have always been of the mindset of letting a fever run its course and not to interfere unless it spikes fast and high. I always thought that fevers helped your body to heal and suppressing them would only make the sickness last longer. Maybe I'm wrong about that.

She told me that they always recommend to keep the fever down, as to keep the child comfortable, and ensure they will continue to drink liquids. I get her line of thinking, to keep the child hydrated, but to give tylenol ALWAYS?  When I questioned her on this, she said, it doesn't matter if you give the tylenol or not, the body will still have the fever and the fever will still be doing its job. Is this true?

She also told me that I should be giving DS anything to keep him hydrated and consuming calories, including ice cream, sherbert, cool aid, junk etc. DS wasn't anywhere near being dehydrated today, he was just having a hard time getting water down because his throat hurt. He's drinking like a fish now, but I can't bring myself to give feel OK with giving his sick little body all that junk. Doesn't nutrition play a role in helping the body to get better? And doesn't sickness feed off of sugar?

I was blown away at the reeming I got, and here I thought I was doing the best thing for my child. 

Edited by AprilM - 9/22/11 at 5:02pm

[sunnygir1]

I think you're right about all the things you "thought" before being "re-educated" by a misinformed practitioner.

My family doc says let the fever run its course, and treat the child rather than the temperature.  He says if my lo is really miserable and can't sleep I can give Tylenol to help her rest.  If she's tolerating the discomfort okay, skip the medications.  If I'm really worried that she's not okay based on how she's acting, take her in to see a doctor.  I agree with that.

I don't know for sure if holding the fever down will prolong the sickness, but she is definitely wrong that the fever can still do its job if you bring it down with drugs.  The fever's function is to deter the organism causing the illness by creating an inhospitable environment.  A lower temperature is more hospitable.

I would consider giving my kid some kind of crap if I was worried about dehydration, but it would be something without dairy, corn syrup, food coloring, artificial flavors, or preservatives.  I really think those things are all detrimental to healing.  But like you, I would only consider sugary beverages or popsicles if I was getting worried about dehydration.  As long as the kid's drinking and peeing, I don't worry about it.

[Caitlin0919]

Every time I've called about making an appointment based on a fever after telling the nurse what DD's temp was, every single nurse has always told me exactly what you said, that a fever is the body's way of killing an infection and unless it's extremely high or persists for over a week, there's no reason to mess with it. Give Tylenol to keep the kid comfortable(I only gave it to her before bed so she could sleep a little better) and keep them hydrated. Let them eat when/if they're hungry but don't force it and try to give them healthy options. I've never had someone yell at me for NOT giving DD Tylenol for a fever, they've just said, "You can give her Tylenol to keep her comfortable" but never that I HAD to give it to her. Trust your original instincts.

[CrunchyMama19]

It's people like this that make me lose faith in the medical community as a whole. You WERE doing what was best. Follow your instincts. A fever is a body's way of defeating the virus. No the child does NOT still have a fever that does it's job if you give him or her tylenol and the temp returns to normal. 

I will give Motrin or something if my babe has an exceedingly high fever or if she is really miserable but more often than not, I just do fluids, rest, extra love, and let it run it's course. Unless it really spikes high or goes on for more than a few days, I don't do much more than that. 

And also, I would not be ok giving kool-aid or other super sugary drinks unless that was the ONLY thing she would take but that is never the case since we don't ever have that stuff in the house anyway. Apple juice or some other 100% juice blend but that's it. Homemade juice popsicles are great for soothing a sore throat too.

[organicviolin]

wow whomever you spoke with is really clueless!  No offense!  Personally, if I was given that information at a Dr's office, I would be out of there and finding a new practitioner asap.

I don't even have baby tylenol or motrin in the house!!!  That tells you my stance right there.  What pp said is true, the fever is taking care of it and lowering meds should only be given if the temp is over 105 or lasts for more than a week (in that case, a trip to the Dr is in order regardless).

If you give your kid garbage, especially when ill, it makes healing much much slower.  Sugar and grains are inflammatory to the body!  If my DS had what you are describing this is what I would do....he's only 2.5 btw

Bone broth as much as he'd take, even if it was by the spoonful only.  Coconut water (a natural pedialyte that is way better!  Has loads of electrolytes etc), water, maybe watered down juice like 3/4 water to 1/4 juice, tea (chammomile, mint, whatever tea he wants) with raw honey.  Manuka honey umf 16+ taken orally 2x a day, extra fermented cod liver butter oil, elderberry syrup and of course loads of love and hugs from mama.  Foods I would offer are raw yogurt, kefir, any chicken, maybe some noodles, maybe not - depending on how sick he is.  Attempt some veggies and def fruit.  Fruit is extremely hydrating....also any homemade juice/creamsicles (I use barely any sweetener).

HTH and hope your LO is feeling better!

[motherhendoula]

My first two kids couldnt tolerate OTC medicine AT ALL - my son was known for projectile vomitting any and all medicine back at me .... i have always heard that the high temp of the fever is supposed to kill the germs causing the illness - i have to say im very wimpy when it comes to fever and would always want to give my kids 'something to bring  it down'...of course, they would throw it up....so...no help there.  And i always lived by the addage 'starve a fever feed a cold'  - no foods during a fever - not that they ever asked for any!  No dairy products either ...but i could be persuaded to buy some junk food in order to hydrate - but mostly just water and herbal teas....the junk food was mostly for me

I actually started using Belladonna alternating with Nux Vomica - typically two days of that homeopathic regimen and the fever was down.  I think you stumbled upon a cranky, ill-informed nurse!

[foreverinbluejeans]

I disagree that mothers should follow their instinctics. Mothers should be well informed and follow evidence based practice.

Medications do not need to be given for fevers until they reach a certain level. That depends on the age of your child. For children 6-24 months according to Children's Hosital Colorado you don't need to call your child's doctor until the child's temp has been over 104 repeatedly. Many people are under the false impression that brain damage occurs at 104. If you have given your child medications that reduce the fever then you don't know what the child's temp would be without the fever. You could mask the symptoms of dangerous dieases like meningitis.

How quickly a child gets dehydrated depends on their age, if they are breastfed, and if they have diarrhea. You can make oral rehydration fluid for your child to drink if your child has dehydration symptoms. Water, sports drinks, sugar drinks, and everyting else can cause problems. If you think your child is clinically dehydrated (the disease state not jus lost some fluids) it would be important to have him evaluated to see if he needs IV hydration. I know that sounds like overkill but it has happened to my children several times. We have a genetic disease that involves getting diarrhea easily.

[Alisse]

I think the sugary advice is likely being misinterpreted.

Perhaps the nurse was trying to express that because dehydration, which can occur so much quicker in a child, is so bad, if the child is having difficulty taking anything in, then the sugary stuff is better than nothing.  

[sunnygir1]

Well, in this case, both posters who used the term "instincts" were telling the mother to continue to trust that her information was correct, and the nurse was wrong.  I'm not sure anyone is advocating being uninformed as a parent.

I do think that mother's should follow their instincts in the sense that they know their child(ren) better than any health care provider.  I can tell better than my family doctor how "off" my child's behavior is, how sunken her eyes look compared to normal, etc.  Our doctor depends on us as parents to help him determine the severity of our children's symptoms.  If a mother instinctively feels that her child is okay (yes, taking into consideration the available information on the ailment) then she should trust that, and even more importantly, if she instinctively feels that her child is NOT okay, then she should take all necessary measures to be sure that her child is receiving the very best care possible.
 

Originally Posted by foreverinbluejeans 

I disagree that mothers should follow their instinctics. Mothers should be well informed and follow evidence based practice.

Medications do not need to be given for fevers until they reach a certain level. That depends on the age of your child. For children 6-24 months according to Children's Hosital Colorado you don't need to call your child's doctor until the child's temp has been over 104 repeatedly. Many people are under the false impression that brain damage occurs at 104. If you have given your child medications that reduce the fever then you don't know what the child's temp would be without the fever. You could mask the symptoms of dangerous dieases like meningitis.

How quickly a child gets dehydrated depends on their age, if they are breastfed, and if they have diarrhea. You can make oral rehydration fluid for your child to drink if your child has dehydration symptoms. Water, sports drinks, sugar drinks, and everyting else can cause problems. If you think your child is clinically dehydrated (the disease state not jus lost some fluids) it would be important to have him evaluated to see if he needs IV hydration. I know that sounds like overkill but it has happened to my children several times. We have a genetic disease that involves getting diarrhea easily.