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Fever phobic? what doctors advise when kid's temperature rises

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Fever doesn't always need treatment, according to new report. istockphoto

(CBS/AP) CHICAGO - The American Academy of Pediatrics has some advice for parents who get all hot and bothered by a child's fever:

Chill out.

In a myth-busting new report, the academy advises against treatment every time a kid's temperature inches up.

"There's a lot of parental anxiety about fever. It's one of the most common reasons people bring their child to the doctor," said Dr. Henry Farrar, co-author of the report and an emergency room pediatrician at Arkansas Children's Hospital.

There is no proof that untreated fevers lead to seizures or brain damage. Nor is there evidence that lowering fevers reduces illness, according to the report, which focused on children older than 3 months.

Temperatures under 100.4 degrees are not considered fever. There's no harm in treating a true fever with over-the-counter acetaminophen or ibuprofen. And it makes sense to do so when the child is feeling ill. But the No. 1 reason to use fever-reducing medicine is to make a sick child feel more comfortable, the authors said.

The report - released online Monday in the journal "Pediatrics" - emphasizes that fever is not an illness but a mechanism that helps fight infection. Fevers can slow the growth of viruses and bacteria, and enhance production of immune-system cells.

"The fact is, no one has ever been able to say that a fever below a certain point is not associated with a serious infection, or that a fever above a certain point is associated with a serious infection," Farrar said.

Many experts recommend calling the doctor if a child's temperature hits 104 degrees, but Farrar said parents should pay attention to symptoms, such as whether the child is cranky, lethargic, or not drinking liquids and avoiding food. Those are often better measures of how sick a child is and whether medical attention should be sought, the authors said.

Co-author Dr. Janice Sullivan said infants younger than 3 months are an exception. Parents should get medical help when their temperatures rise above 100.4 because infants can be very sick without showing obvious signs, said Sullivan, a pediatrics and clinical pharmacology professor at the University of Louisville.

Another exception is kids with heat stroke - a medical emergency with symptoms including fever higher than 104 degrees, hot dry skin and rapid pulse caused by overexposure to heat and not enough fluids.

Children with special medical needs, including certain heart conditions, also should be seen by a doctor when their temperatures are mildly elevated, Sullivan said.

And when giving kids fever-reducing medicine, Sullivan said parents should be sure to use correct dosing devices, not kitchen teaspoons, which vary widely in size and lead to undertreatment and overtreatment.

But the biggest cause of overtreatment? Over-worried parents.

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