I guess it was somewhere around thirty years ago that doctor’s started to report about aspirin, when given to children with viral infections, causing “Reye’s Syndrome.” Not that it was overly publicized, to this day many parents likely have never heard of this often deadly complication from aspirin use in children.
About on the expected time frame, after mass marketing aspirin, tylenol and other antipyretics to children and adults for decades The American Academy of Pediatricians is issuing a report that maybe trying to lower a mild fever isn’t always the best course of action.
and according to Google some 328 articles and blogs on the same theme over the past week. According to Dr. Janice Sullivan, lead author of the report, per the above linked Reuters article, fever is not always a bad thing,
That’s because fever can be help (sic) fight illness, by slowing down the reproduction of bacteria and viruses or stimulating the body’s immune response.
“That’s a benefit of fever,” Sullivan said, “and may shorten the time that your child remains ill.”
Fever is not a danger itself; it usually is a benefit,” Henry Bernstein, MD, chief of general pediatrics at the Cohen Children’s Medical Center of New York, says in an email.
Experts stress that a fever isn’t an illness, it’s a response, probably an evolutionary adaptation to help fight infection. Setting the body’s thermostat (the hypothalamus gland in the brain) a few degrees higher slows the reproduction of bacteria and viruses and boosts white blood cells.
Well up to this point I don’t have too much difficulty with the report. Isn’t this, by the way, a very common point brought up by those critical of many conventional medicine approaches, that they only treat symptoms and often make the underlying disease worse. Well, I guess the American Academy of Pediatrics is admitting that at least in this case they were absolutely right.
“I disagree with this post. My 13 month old had a fever with no other symptoms … in the car on the way home from Urgent Care, he started having seizures. We ended up on PICU for 4 days and was advised to keep his fevers controlled to prevent future febrile seizures. Neurologist and other doctors informed us, it was the fevers that caused the seizures.”
Febrile seizures are not remarkably uncommon. However, where things take a turn for the worse is when we find the report looking to shift blame. Again from WSJ, “The report, aimed at calming what it calls “fever phobia … ” or from Reuters, “A lot of families have fever phobia,” Claire McCarthy, a pediatrician at Children’s Hospital Boston, told Reuters Health. “What’s really important is making the child feel comfortable.” Ahhh, “fever phobia” that’s it is it? It’s not the physicians fault, its mentally ill parents. Now I’m waiting for “fever phobia” to be classed as a mental disorder in the next release of the DSM, just in time for the release of “Once Daily Febrilia(Tm) – For Life.” Stupid mentally ill parents, its amazing they ever figured out how to have kids in the first place.
“Parents frequently give too much or not enough medication, Sullivan said. Her report stresses that dosing should be measured by weight, not age or height.” Or this gem from WSJ, “Yet many beliefs about them (fevers) are based more on culture, tradition and playground chatter than scientific evidence. Ads showing parents fretting over thermometers confuse things further.“ Playground chatter? Playground chatter, Really?? The kids or the parents? Going with the kids who are being treated by the parents not vice versa, I know me and my buddies were always up for a good discussion of “fever lore and culture” down at the sandbox. Ads showing parents fretting over thermometers?? first of all, I can’t recall one, secondly, uhhhhh who made that add?
I don’t want to be too overly critical of this recent report, it is certainly a step in the right direction and acknowledges the concerns that many critical of the medical industry have voiced for years. Where I take issue with it is in the both the condescending tone and the unnecessary oversimplification. The cynic in me wonders if there would be any official push-back against these drugs if they were still on patent or expensive. In any event let me try and rewrite what I think the recent report may be trying to get across.
“We in the medical community and pharmaceutical industry over the past hundred years or so have created, developed and vigorously marketed a wide variety of antipyretics, aspirin, acetaminophen, ibuprofen etc. We held and promoted the position that it was beneficial to take these drugs for any number of indications, even to the point that, “take two aspirin and call me in the morning” became the cliche response of physicians to any illness. Well, it now has become clear that we went too far and in many cases our advice was just plain wrong, sorry. We do epidemiological studies on all manner of medical minutae, there’s likely no point at this time in trying to go back and estimate the number of children we harmed or killed with our bad advice, suffice it to say we were in error.
Any parent obviously knows that a fever is a worrying sign of illness, and any fever should be paid close attention to, while additionally all efforts are made to heal the child’s underlying illness. While we previously marketed antipyretics to reduce fever in children it is now clear that, if the fever is not overly high, such an approach may interfere with the bodies natural healing process. Such reasoning of course does not apply only to children.
A very high fever is itself however, a long accepted and scientifically well documented sign of more serious illness, and may also by itself cause harm and interfere with healing. Fevers may elevate rapidly which is again why we note that you are correct to keep a close eye on your child’s fever. Another reason why one should be wary of attempting to lower a mild fever is that the drugs we have developed, advertised and prescribed for this purpose are far more dangerous then we first realized, again we are sorry, we believed we were doing good. First we found the clear association of aspirin with Reye’s syndrome (a syndrome which is fatal in up to 30% of cases despite our best efforts), now we find that the largest percentage of pediatric toxic ingestion emergency room visits are caused by acetaminophen ingestion. These drugs are powerful albeit dangerous medicines. We realize that this is a great change from our previous position on such matters, though we felt it only necessary to prevent further possible harm. Feel free to contact us if you have any level of concern over your precious child’s health, no matter how small.”