Fever.

Sorry. I couldn't resist. I am going to be talking fever today but not Bieber Fever. Oh no! Bieber Fever is a special illness I don't quite understand and am not qualified to treat.....

So now let's talk fever for serious.

On our trip overseas we couldn't have been more proud of our little gal. She was a superstar! She travelled like a seasoned pro.....but. But, but, but.....like all children do, as all parents know, she got sick the minute we drove away from Kingston.

Everything seemed to be fine. We survived the drive to Toronto, made it through security and boarded the plane without a problem. Take off was a breeze - Winnie fell asleep cuddled up to me, and then slept the next three hours on a makeshift bed at our feet. Easy. When she woke up I thought she felt a bit warm. Warm and clingy. Jamie brushed it off, the plane was hot and it was 1:30 in the morning...quote "she's fine! Don't worry about it!". I wasn't convinced but I wasn't worried either....until she barfed all over me. Oy! {Of course I had a change of clothes for her but not for me. Live and learn!}

For the next two days we dealt with the exhaustion of jet-lag, incredible heat (the temperature was through the roof!) and a raging fever.



What is Fever?
Fever is an adaptive response to tissue trauma or infection. It is the most common symptom of childhood illness and not necessarily a dangerous condition. However, it can also indicate more serious conditions such as meningitis or pneumonia. Febrile seizures, the "big" concern for most parents, can accompany fever and be quite frightening, though not linked to negative outcomes for the child.

Definition of a fever in children under 11 years of age:
Temperatures above:
Rectal: 38C (100.4F)
Axillary: 37C (98.6F)
Oral: 37.5C (99.5F)
Tympanic: 37.9C (100.2F)

As the body combats infection it produces a number of pyrogenic (heat producing) blood cells. These cells send a message to the brain where, in simple terms, the temperature set point on the body's "thermostat" is increased. A number of bodily processes cause blood flow to be decreased near the surface of the body and redirected towards the core.

The resulting feeling of malaise causes a decrease in activity (reduces sweating) and encourages us to seek warmth, both of which increase heat production and conservation.....everything about the initial stages of a fever cause us to behave in ways that help the body's temperature increase.

When the infection is dealt with, the pyrogenic blood cells decrease in number, which changes the message to the brain and the temperature begins to drop.

Is Fever Beneficial?
In short, yup. We all know and understand the potentially life threatening nature of a high fever.....but, it has NOT be clearly established whether or not febrile temperature elevations per se can be lethal. What I mean is, it hasn't been established whether it's the fever that is life threatening or the destructive infection that accompanies the fever that lead to medical emergency. [Cooper RL, Kavlock RJ, J Endocrnol 1997; 157(2):159-166]

This has long been accepted and understood by naturopathic doctors. Fever is not the issue. Fever is simply the body's way of defending itself against foreign invaders. Fever is the signal that there is something else that needs to be dealt with.

Super Interesting: "Substantial evidence has emerged supporting the hypothesis that....fever seems to have an empirical upper limit, rarely exceding 41C (105.8F). It has now been determined that endogenous antipyretic agents control the upper temperature limit". [Stantich R, Bone K, Phytotherapy Esentials: Healthy Children, Phytotherapy Press, 2008].

Translation: the body has built in agents that, for the most part, keep fever in an acceptable and safe temperature range. A temperature that helps the body kill off microorganisms and restore balance.



Even more important regarding the body's regulation of fever, evidence exists that interrupting a fever with agents such as acetominophen is associated with complications post-infection.

A Naturopathic Approach to Fever
So, what to do? Fever is scary and when you're dealing with a young child it's easy to make decisions out of anxiety and fear.

Naturopathic advice suggests that, as long as the fever does not exceed 102F, fever reducing-medication is generally not needed. Managing the fever and allowing it to run it's course will help the child recover quickly and with fewer post-infection complications.


Naturopathic Fever Management
1. Tepid Baths: lukewarm NOT cold baths are a safe way to help bring a temperature down. Repeat as necessary.



2. Herbs: Typically we focus on antimicrobial and immune supporting herbs but peripheral vasodilators (increase blood flow to the skin, helping us "give off heat") such as yarrow, elder flower and peppermint are key to bringing down a temperature. I have a Fever Tea I give to patients. It can be consumed as a tea or mixed with juice or, even better, made into Popsicles! I find that is often the best method of administration with a sick toddler:)

3. Homeopathic combinations such as Viburcal by Heel is great to have on hand when fever strikes. Dose frequently until the fever breaks.

4. Plenty of fluids to prevent dehydration.

5. Watching the child: In adults, the severity of the fever is usually an indication of the severity of the illness. This is not necessarily true with children. A child with a mild cold may have a temperature of 105F, while a child with pneumonia may have a fever of 101F.

Regardless of the temperature, you can tell how serious things are getting by the state of the child. If your child is eating, drinking and playing...things are probably okay. Conversely, even with low temperatures, a child that is lethargic, refuses to eat or drink and seems "out of it", is more likely to be dealing with something serious.

*If in doubt as to how serious the infection is, give one dose of acetaminophen. If it is just the fever making the child feel awful, they should perk up when the fever comes down. If they continue to be lethargic and restless, achy, unwilling to sleep, etc. after the acetaminophen, there may be a more serious infection happening.

6. With that in mind, if you are ever feeling uncomfortable, using acetaminophen can help reduce the fever and gain control over the situation. While I think letting a fever do it's work is ideal, it's always best to follow your gut instinct. Parents know their kids better than any professional. Do what feels right for you and your family!

If you have any questions, or would like references for any of the information above, just contact me!

Have a great Thursday!

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