Several years ago, we shared an excerpt from Dr. Linda F. Palmer's book Baby Poop: What Your Pediatrician May Not Tell You about Colic, Reflux, Constipation, Green Stools, Food Allergies, and Your Child's Immune Health. We thought as we approach cold and flu season, it might be a good time to remember a few things about our children's bodies and what they're capable of doing.
From 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:
"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.
Our editing team wanted to interject some tips for keeping your child comfortable when they have a fever.
Before you reach for the acetaminophen or the ibuprofen, here are some ways you can make your child a little more comfortable while their body uses their natural immune system to fight off the infection:
6 Ways to Make Your Child More Comfortable When They Have a Fever
It is important to remember that the goal your child's fever is to heat the body in order to fight the infection inside of them. Therefore, you don't want to necessarily decrease the temperature of the fever but rather simply make your child more comfortable as their body fights the infection.
A high temperature isn't actually categorized as a fever until it reaches 100.4. If your child is eating and drinking normally and is generally happy (except when you give them the blue cup when they CLEARLY wanted the yellow one, of course), then you don't have to worry about their fever except ensuring that they are drinking plenty of fluids. If their fever is inching above 103-104, or they are acting extremely lethargic, refusing to eat or drink, or inconsolable, then you will want to monitor them very closely or bring them to your local emergency room where they can be given intravenous liquids and monitored closely. Otherwise, here are a few things you can do to keep your child comfortable while their body works hard to get rid of their infection- naturally.
- Give them plenty of liquids- Their bodies are fighting an infection which means it is using more of their electrolytes in their body than normal. Replenish those with Pedialyte or something similar to ensure their bodies are hydrated enough to fight the infection. You can even make your own Pedialyte at home if you do not want to use store-bought.
- Give them an icy treat- Popsicles are a great way to get some liquids into your child as well as soothe scratchy throats. Make your own with organic orange juice for an extra boost of Vitamin C.
- Give them Elderberry- Elderberry helps to boost your child's immune system. If you aren't giving this daily already, you can give them a dose of elderberry (they come in gummy form, too) to boost their immune system.
- Spend the day snuggling- You may limit screen time but sick days are meant for lying on the couch and watching their favorite shows or movies. Their body needs to rest and the only thing they should be doing is spending the day with mom or dad.
- Apply a cool compress- If your child is so feverish that he or she is shaking or uncomfortable, you can apply a cold compress to their forehead to bring the fever down slightly, especially if it's over 103 degrees.
- Take a LUKEWARM bath- Not a cold bath or a warm bath (which is what they may beg for because they are feeling cold). A lukewarm bath will do something similar as a cold compress- it will help bring the fever down slightly without eliminating it like medication would, and allows your child to be more comfortable.
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 acetaminophen, 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.