What is a Fever?

What is a Fever?

What is a Fever?

It’s no wonder so many parents panic over fevers. According to the research, a large proportion of medical practitioners are misinformed about fevers. 12345*  It’s hard to get good information when the people educating you are wrong!

Fevers Are the Body’s Weapons Against Illness

This is so important it can hardly be overstated.  A fever is not an illness.  A fever is the body’s means of fighting an illness.  If this is a new concept for you, please stop and think about that for a moment and really let it sink in.  A fever is the body’s means of fighting illness.  That means if you work to eliminate a fever, you have not done anything to get rid of the illness.  You have, rather, taken away the body’s weapons while it’s still on the front lines of battle against the illness.  You have given the illness, not the body, the advantage.  Not only is this not helpful; it is potentially quite harmful.

But Fevers Are Scary!

Many parents are fearful of fevers because we have been taught to fear fevers — by the same ill-informed professionals previously mentioned.  Fevers from illness are almost always self-limiting. They do not cause brain damage or death. Even what we tend to think of as a “high fever” is not, in and of itself, dangerous except perhaps in babies/toddlers or those with certain underlying conditions. Obviously a fever should not be ignored, because it’s signaling something else and the illness causing the fever probably needs to be addressed (and could be dangerous, depending on what it is), but a fever is not, itself, dangerous. 6

You may be surprised to learn that a temperature of 104° (F) is not a dangerous fever.  Temperatures don’t become damagingly high until beyond 107° — a temperature the body will rarely reach unless environmentally prevented from moderating itself (like being trapped in a hot car).

What About Febrile Seizures?

Febrile seizures have little to do with the maximum temperature the body has reached.  They seem to occur when the temperature rises or falls rapidly.  (So even if a higher temperature has just come down, a febrile seizure can occur.)  More importantly, although they can certainly be scary while they’re going on, brief febrile seizures are not the same as “regular” seizures, and do not cause brain damage.  No evidence indicates that fever-reducing medications will prevent them. 7  (Occasionally, other seizures can mimic febrile seizures, though, so be sure to properly rule that out, especially if you aren’t sure what’s caused the fever.)

Fighting Fevers is Bad for the Community

Not only is suppressing a fever bad for the sick person himself (by taking away his body’s tools for battling the illness); it can be bad for the community, as well.  At least one study indicated that the use of fever suppressors seemed to increase shedding of the flu virus.8  (That is, increased contagion.)

So What Do We Do?

In most cases, the best course of action with a fever is to let it run its course.  It’s doing a job; let it do the job.  (Of course, if you or your child have pre-existing medical conditions that would contraindicate this, you probably already know that, and should adjust accordingly.)  Sometimes, though, when a fever is getting pretty high, it makes parents (or healthcare providers) nervous, or it could make sleep difficult.  In that case, you might want to gently lower (not eliminate) the fever, at least for a while, to make everyone a bit more comfortable.

There are a number of ways you can do this.  Traditionally, tepid baths or cool wet cloths on the forehead have been used.  Keep in mind that you do not want to use cold water, which would shock the system.  You want it to merely be slightly cooler than the person you’re attempting to cool.  With a bath, you can put the person in with the water warm, and then allow the water to naturally cool.

We like a method I call “stinky socks” (because the silly name makes it more tolerable to kids), which consists of cider vinegar-soaked socks that are essentially cool compresses on the feet.

Some people recommend calcium lactate during a fever.  The theory is that part of the mechanism behind a fever is an attempt to draw out calcium stores, so supplementing calcium will make the fever less essential and the body will back off of it.  I’m not sure how viable this explanation is, but there does seem to be some limited evidence that febrile seizures may be related to  calcium9.  Supplementing an essential mineral in moderate amounts seems like a safe enough option to try, even if the mechanisms are poorly-understood or even questionable.  Use your judgment.

Meanwhile, keep all of this in context: we’re talking here about treating (or not treating) a fever, which is a separate question from what we should or shouldn’t be doing to treat the illness that induced the fever.

Appropriate measures to address the illness itself will vary, based on factors like what the illness is, the age of sick person, the underlying physical condition of the sick person, etc.  But as a general rule, it is good to support the body in doing its work.  That doesn’t mean “do nothing”; it means pay attention to whether what you’re doing is building up the body and its efforts or undermining it.

 

*You’ll find even more if you search the literature for “fever phobia”!

What is a Fever?

  1. https://www.ncbi.nlm.nih.gov/pubmed/26998922
  2. https://www.ncbi.nlm.nih.gov/pubmed/17637156
  3. https://www.ncbi.nlm.nih.gov/pubmed/1437424
  4. https://www.ncbi.nlm.nih.gov/pubmed/11299405
  5. https://www.ncbi.nlm.nih.gov/pubmed/30716166
  6. https://medlineplus.gov/ency/article/003090.htm
  7. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Febrile-Seizures-Fact-Sheet
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906934/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010887/