[logicchains]

>I wonder what I should give my kids when they have fevers though

You don't have to give them anything. Ibuprofen doesn't make the underlying infection causing the fever go away any quicker, it just alleviates the symptoms. It's a trade off between reducing short-term suffering and risking long-term defects. Personally my parents never gave me painkillers for fever and I'm grateful for it: fever pain is just a temporary feeling, but some of the uncommon side effects of painkillers are much longer-lasting.

*Edit: To whomever downvoted, I'm curious what part of what I said you disagree with.

[babuskov]

I didn't downvote you, but you seem to lack experience/knowledge on the topic if you think it's only a painkiller.

Ibuprofen's main use is to help to keep the body temperature in check. When your body temperature goes too high you can lose consciousness and even die. I had a very high fever once and didn't want to take any medicine until I started to lose consciousness and I almost fell while waiting in a line in pharmacy. I was able to go through it only because I was adult. Children are more fragile. Fever is the reason people died so much before discovery of antibiotics.

You are right that it alleviates the symptoms, and it's actually better not to use it when the temperature is moderate because high temp kills some germs. But if it goes too high, you have to stop it before it's too late.

[logicchains]

>Fever is the reason people died so much before discovery of antibiotics.

I thought bacterial infections were the response were the reason people died before antibiotics. Fever is the body's response to infection, a primitive means of fighting it. If somebody has a serious infection and you give them anti-fever medication but no antibiotics, they're still at serious risk of death even if their fever goes away.

According to the first article I found while Googling: https://www.google.com/amp/s/www.nytimes.com/2018/05/11/well... :

"The best evidence suggests that there is neither harm nor benefit to treating a fever with fever-reducing medications like acetaminophen or ibuprofen."

"In 1997, these data led to a large, randomized, placebo-controlled trial of ibuprofen in 455 patients with sepsis, a life-threatening infectious condition. In this study, ibuprofen failed to prevent the worsening of sepsis and failed to decrease the risk of death."

So there's no evidence that such drugs actually stop fever "before it gets too late" in adults, as they don't reduce risk of death. I had wrongly assumed the same applies to children.

[raverbashing]

An NSAID failing to help with a bacterial infection is not surprising

[logicchains]

Yep, but if death was due to the combined effects of both bacterial infection and fever, we'd expect to see a reduction in mortality when fever was treated compared to when it was untreated, which the linked study didn't find.

[komali2]

But how is it better than an ice bath given the side effects of ibuprofen are potentially worse than an ice bath?

[babuskov]

Ice bath has really short-term effect. If your body temp is really high, ice bath can take it down for 30-40 minutes and then it's back up. Ibuprofen takes it down for 6 hours.

[distant_hat]

True, but children are not that fragile. High (above 103/104) should be brought down, febrile seizures are bad but lots of parents hit ibuprofen/paracetamol when the kid is showing 99F.

[14]

My guess is the down vote comes from someone thinking your comment sounds like you don't have any children or know what you are talking about. You don't give ibuprofen for pain during a fever, though doctors will say it can help because often times the source of the fever will cause pain like an ear infection or strep throat, you give it to reduce the temperature. There is a serious risk of seizure in children if you let fevers run high. So to say you don't have to give them anything is certainly not true in many cases and in fact could be life threatening to just ignore. That would be my guess to the down vote. I have multiple kids and never has the thought in my mind been I will give them analgesic for the pain of their illness. It is about the temp 100% of the time. I do not like to take drugs nor give them to my children if avoided but certain things you must treat. Fever is one.

[logicchains]

According to the first article I found while Googling, https://www.google.com/amp/s/www.nytimes.com/2018/05/11/well... :

"The best evidence suggests that there is neither harm nor benefit to treating a fever with fever-reducing medications like acetaminophen or ibuprofen."

"In 1997, these data led to a large, randomized, placebo-controlled trial of ibuprofen in 455 patients with sepsis, a life-threatening infectious condition. In this study, ibuprofen failed to prevent the worsening of sepsis and failed to decrease the risk of death."

The science doesn't seem to support the notion that reducing fever will reduce the risk of fatality in the general case. I had assumed the same thing also applied to children, as before this thread I'd never heard of children getting seizures from fever (at least not from any of the children/parents I knew growing up in rural Australia).

[stolsvik]

Why do you not help your kids when they are in pain?! This is truly shocking to me, it is definitely a cruel and inhumane sentiment.

[coldtea]

Why do you pose a ridiculous question, implying the parent commenter is a bad person who doesn't love their children or whatever?

Do you give your children general anesthesia when they are in pain? E.g. they've fallen and bummed their knee or something?

Why not, since it would be the ultimate pain-killer? Because it's both dangerous and unnecessary.

The parent has the same reasoning for other unneeded and dangerous drugs.

Why can discuss whether they're really as unneeded and dangerous as the author implies, but that's another question, not loaded with "why don't you love your children" implications...

[logicchains]

Painkillers are not side effect free; if the pain is something minor, like a bruised knee or normal headache, it's not unreasonable to decide that experiencing the pain is a better choice than risking the side effects of a drug, which in uncommon cases can be much more severe and long term. It's not as clear cut as "helping" vs not helping, as unfortunately we don't yet have any side effect free painkillers.

[distant_hat]

Also, the pain sometimes keep activity low which may help with healing. If I give my kid something pain relieving he'll be up and bouncing around and could hurt himself more.

[ada1981]

You could also teach your kids meditation techniques to be deployed when in pain.

[coldtea]

"Dad always thought laughter was the best medicine, which I guess is why several of us died of tuberculosis" (Jack Handey)

[ada1981]

Unsure why this got downvoted, meditation has been show to reduce pain up to 90%.

Seems like teaching kids to meditate would have all sorts of benefits, including drug free pain management.

https://www.psychologytoday.com/us/blog/mindfulness-in-frant...

[ada1981]

Can someone please explain the downvotes? Do you not like the idea that meditation can mitigate pain? Don’t think it’s true? Find it wrong to teach kids? What?

[14]

I meant in the sense I don't give pain killer for pain during a fever but I give it during a fever to help with the temperature. It is not to take away the pain of a fever but the temperature but often times there is something painful causing the fever so it helps. Now as for giving my kids analgesic I do give them Acetaminophen and Ibuprofen occasionally when they really need it. I encourage things like rest in a dark room and more fluids first but you get to know as a parent when they are really not well and when they just need to take a break from screen time or activity or take something like tylenol. Medicine is not my go to but I use it accordingly.

[kristiandupont]

I am sure there are nuances to your statement that get lost in the short text so I assume that you don't mean it quite as hyperbolic as it comes across but my immediate reaction to that sentence is: you can't protect your child from pain forever -- physical or emotional. How will they learn to handle it if they aren't exposed to it gradually?

[frostburg]

Your parents probably aren't doctors. The issue isn't cut and clean... To a point a moderate fever usually helps your immune system (the response exists for a reason), but anything other than a moderate fever can be a lot more dangerous than long term issues stemming from sporadic usage of antipyretics.

[logicchains]

Replying to my own comment as it's too late to edit, I was basing my assumptions on studies showing fever reducing drugs have no positive effect on mortality in adults, like described in https://www.google.com/amp/s/www.nytimes.com/2018/05/11/well..., but was unaware that children face separate risks from high fever that can make such drugs more vital. So my comment is bad advice.

[A1phab3t]

I appreciate that you followed up.

[danjayh]

Rapid rise in temperature in infants, toddlers, and young children can cause febrile seizure. Given the trade-offs, we generally choose to medicate our child when his temperature passes ~102 and it's on a rapid uptrend.

[sgt101]

Has this happened often? Also, how often do you measure the child's temperature and how do you establish the rapid uptrend?

[coldtea]

>how often do you measure the child's temperature

As often as you need when they have a fever. Modern thermometers can give you the temperature in a minute or so.

[sgt101]

yes, but is this sampling a good idea? Have you tried measuring temperatures periodically when the child appears well? What is the variation then? How do you know that the device is telling you something meaningful? Is the child getting flustered and hotter because of the attention?

[danjayh]

You have to measure rectally for good results. Forhead thermometers, ear thermometers, under the tongue thermometers -- all crap. If you have an infant or small toddler, use a rectal thermometer. Measuring this way, results are both precise and accurate (and therefore, repeatable).

[coldtea]

>yes, but is this sampling a good idea? Have you tried measuring temperatures periodically when the child appears well? What is the variation then?

There should be no major variation then. On the other hand, if the child reaches 38+ or so, you need to be on the lookout...

[ReptileMan]

39C - seems about right as decision.

[distant_hat]

Exactly this. It just works on the symptoms and children tolerate fevers fine as long as it is not too high (above 103F). But you have to endure a lot of crap from everyone breathing down your neck about how you are ignoring the child and are a cruel parent.

[stolsvik]

These kind of sentiments really scare and provokes me. Telling anyone that they shouldn't alleviate kids fever and/or pain is absolutely revolting to me.

[logicchains]

I didn't say that, I said it's a trade-off. Taking them reduces pain and the risk of certain complications, but increases the risk of other complications (side effects). According to https://www.consumerreports.org/prescription-drugs/too-many-..., "The amount of harm stemming from inappropriate prescription medication is staggering. Almost 1.3 million people went to U.S. emergency rooms due to adverse drug effects in 2014, and about 124,000 died from those events." So even if a medicine is side effect free when used as prescribed, there are still risks if it's accidentally misused, and painkillers are not side-effect free even when used as prescribed.

Thought effect: if you had the option to eliminate a kid's pain with an 0.01% chance of causing a lasting defect, would you do it? Not everybody would; different people have different time preferences.

[stolsvik]

"...prescription medication..."

[logicchains]

Ah, good catch, I didn't notice that part. Here's a more relevant link, evidence for the trade-offs of OTC painkillers: https://www.sciencedirect.com/science/article/pii/S014067360... . Seems there's evidence of a link between use of paracetamol in early childhood and developing asthma.

[kristiandupont]

Fever is likely a mechanism that the body exercises to fight infections, just the way diarrhea is probably a way for the body to flush out vira and bacteria quickly. In both cases, excess can be dangerous but that doesn't mean they should be stopped per default.

Would you also give your kid anti-diarrhea and let the disease spread in order to stop the immediate unpleasantness?

[jtc331]

What if the fever is actually the body’s way of killing the infection? You’re saying it’s scary that someone would want to prioritize recovery from the root cause rather than prolonging the root cause in favor of relief of mild symptoms?

That’s the more shocking belief from my perspective.

[coldtea]

Is the idea that you can kill your child or severely damage it because of what you did to "alleviate their fever/pain" equally revolting to you?

Or are you OK with hurting your kids, as long as they don't feel the pain?

(I'm putting the questions in the same tone you put yours)