‘Fever phobia’ and the role of the GP

Fever is very common in children. In the three months leading up to Melbourne’s Royal Childrens Hospital’s Nationwide Child Health Poll, parents reported that more than half of children aged under five had experienced a fever.
 
The poll explored parents’ understanding and beliefs relating to fevers in children and found that many parents have misconceptions, including that fevers are a sign of serious illness and can be harmful or even fatal if left untreated.
 
The poll also showed that many parents try to lower their child’s body temperature by using outdated practices such as cold sponges, cooling patches or even cold showers.
 
The nationally representative survey included responses from more than 2000 households, with parents providing information on 3324 children between the ages of one month and 17 years.
 
‘Fevers are extremely common and most children with fever can be safely cared for at home,’ Dr Anthea Rhodes, a paediatrician and director of the child health poll, said.
 
‘However, our latest report shows that there is a misunderstanding among Australian parents that if left untreated, fever can cause severe illness, seizures or fits, brain damage, coma or even death.’
 
Two thirds of parents gave medication, such as paracetamol, to treat a fever with one quarter waking their child from sleep to do so. When parents identified a fever, one in three reported they would take their child to the GP, while one in 10 would take their child to the emergency department.
 
Dr James Best, GP and Chair of RACGP Specific Interests Child and Young Person’s Health, told newsGP he is unsurprised by the results and says GPs play a key role in dispelling myths when parents and carers seek advice on caring for unwell children.
 
‘Fever phobia or fever fear is a perennial problem that parents need guidance and reassurance on,’ he said.
 
‘There can be a whole range of fears relating to fever, parents or carers might think that fever causes damage to the brain or can increase risk of seizures, and lots of other concerns, especially new parents or parents with lower health literacy.’
 
Dr Best says that GPs can re-educate parents around these misconceptions to help allay fears and improve their understanding when it comes to childhood illness.
 
‘[Fever] is really just suggesting that your immune system is turned on and it’s reacting to something, and that something doesn’t necessarily mean a serious thing,’ he said.
 
‘Especially as they get towards that virus age group, usually starting between six and 12 months and going up to 2–3 years old, where they’re just getting recurrent viral infections.
 
‘When they’re on the first one rather than the 10th one, or a child gets a fever for the very first time and [the parents or carers] don’t really understand the context of it, it can require quite a bit of reassurance and also quite a bit of health education.’
 
The poll results have also sparked concerns around over-medicating children and using potentially harmful and unnecessary methods to treat a fever.
 
‘It’s important to try and keep your child comfortable while they have a fever, but trying to cool them down is not recommended,’ Dr Rhodes said.
 
‘We don’t advise that parents remove clothing or put children in a cool bath or shower to try and lower their temperature.
 
‘It’s important for parents to remember that a fever alone does not need treatment if the child is comfortable and otherwise well. In some instances, fever is a sign of more serious underlying illness requiring medical review and treatment.’
 
Dr Best says that GPs can assist parents in identifying the signs and symptoms in children that should prompt early medical review.
 
‘Other signs when assessing the unwell child that are more significantly of concern, such as decreased oral intake, decreased urine output, increased work breathing or respiratory distress or drowsiness or lower arousal and activity, these signs are what we should be advising parents about and the sort of things to watch out for when your child is unwell,’ he said.
 
However, Dr Rhodes reminds parents that children under three months of age with a fever need to be seen by a doctor, regardless of whether there are other signs or symptoms present.
 
The Royal Children’s Hospital has freely available health information for parents, including resources for those caring for a child with a fever.
 
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child health febrile illness health literacy