A fever in a child can be worrying to parents, and is one of the most common reasons parents seek a pediatrician’s care. To help pediatricians educate parents and families about fever and “fever phobia,” the American Academy of Pediatrics has issued a clinical report, “Fever and Antipyretic Use in Children,” published in the March 2011 print issue of Pediatrics (published online Feb. 28). Fever is a physiological mechanism that has beneficial effects in fighting infection. Although many parents administer antipyretics (medications to reduce a fever) such as acetaminophen or ibuprofen to a child to reduce a fever, the report emphasizes that the primary goal should be to help the child feel more comfortable, rather than to maintain a “normal” temperature. Parents should focus on the general well-being of the child, his/her activity, observing the child for signs of serious illness and maintaining appropriate fluid intake. Parents should not wake up a sleeping child to administer a fever-reducer. Antipyretics must be stored safely to avoid accidental ingestions. Parents should be aware that the correct dosage is based on the child’s weight, and that an accurate measuring device should always be used. While there is some evidence that combination therapy (alternating doses of ibuprofen and acetaminophen) may be more effective at lowering body temperature, questions remain about whether it is safe and whether it helps children feel more comfortable. Combination therapy also increases the risk of inaccurate dosing.
