Many Parents are Afraid of Fever. Don’t Be.

Written by: Kerry Frommer Fierstein, MD, FAAP

In a recent article the American Academy of Pediatrics reviews the facts and fiction that surround fever in children and reminds nurses and pediatricians to better educate parents about fever.

Important fever facts:

The following information does not apply to infants under three months of age for whom you should contact your pediatrician urgently for any temperature of 100.4oF (38oC) or higher.

• There is no “normal” temperature. 98.6 is an average and many children will normally run a little higher or a little lower. In addition, throughout the day, a given child’s temperature will vary by as much as a full degree.
• Fever can be helpful in fighting infections. Fever slows down the growth of viruses and bacteria while activating our immune system.
• Higher fever does not necessarily mean a more seriously ill child. Most fevers, no matter how high, are brief and not dangerous. However, if your child has a fever greater than 101 degrees Fahrenheit for more than 48 hours you should see the doctor to discover the cause of the fever.

Fevers do not cause brain damage or death. Children with fevers above 104 degrees are not at increased risk of problems because of their temperature (the one exception is heat stroke, which usually occurs from over activity in warm weather.) Fevers can cause “febrile seizures” but these types of seizures, though scary to watch, do not cause any permanent effects. Furthermore, there is no evidence that Tylenol (acetaminophen) or Motrin (ibuprofen) use will reduce the risk of fever seizures.

Parents should remember:

• The #1 reason to bring down your child’s fever is to make him/her more comfortable.
• It is not necessary to wake your child to give him/her fever medicine.
• Look at your child, not the thermometer. If your child is drinking, quietly playing, or sleeping, do not worry about fever. If your child looks poorly and is too weak to drink, he/she should be seen by the doctor regardless of the temperature.

Dr. Fierstein is a practicing pediatrician. Born in the Bronx and raised in Queens, Dr. Kerry Frommer Fierstein is a New Yorker all the way. She works atPediatric Health Associates, PC, a division of Allied Pediatrics of New York.

Why Do We Need A Doctor’s Note to Apply Sunscreen?

Written by: Kerry Frommer Fierstein, MD, FAAP

Parents make decisions for their children all the time. It is part of the job. Breast or bottle? Cloth or plastic? And that is just the beginning. By the time a child enters school the decisions a parent has made number well into the thousands.

Medical decisions are just part of the job description as well. Is my child sick? Does she need to go to the doctor? Should I put ointment on his cut?

Yet as soon as that child walks into a New York school, that same parent can’t approve the use of sunscreen on a school trip unless a physician signs off on it.

This upsets me on so many levels.

As a parent, I don’t understand why I can’t ask the school nurse to give my child a simple over-the-counter medication – the same medication I bought without a prescription and gave my daughter before she got on the school bus.

As a pediatrician, I can’t imagine a circumstance where sunscreen or bacitracin would be bad for a child, unless there is an allergy, which I depend on the parent to give me this kind of history anyway.

In my busy home life, I don’t need the unnecessary procedures involved with getting the doctor to sign off on over-the-counter medications.

In my busy practice life, I don’t need yet one more unnecessary piece of paper demanding my attention.

As a parent and a physician, I would like the schools and the government to remember that parents make health decisions every day, decisions much more important than sunscreen, bug spray and Tylenol.

Dr. Fierstein is a practicing pediatrician. Born in the Bronx and raised in Queens, Dr. Kerry Frommer Fierstein is a New Yorker all the way. She works at Pediatric Health Associates, PC, a division of Allied Pediatrics of New York.