Fever Phobia: The Pediatrician's Contribution

Fever phobia, the exaggerated fear of fever, is found among parents of all socioeconomic classes. Pediatricians may inadvertently contribute to fever phobia if their practice and educational message are incongruent. To determine how pediatricians treat fever in their practice, the authors sent a self-administered questionnaire to a sample of members of the American Academy of Pediatrics who lived in Massachusetts. Pediatricians were asked (1) how dangerous they believed fever to be, (2) how they treated fever in their practice, and (3) what types of educational information they gave families regarding fever. One-hundred seventy-two of the 234 (74%) eligible pediatricians returned the survey; 151 were completed. Sixty percent of the respondents were male, and 75% practiced some form of primary or episodic care. Ninety-eight (65%) believed that fever itself could be dangerous to a child, with 58 (60%) of the original 98 citing that a temperature of 104°F or greater could lead to complications such as seizures, brain damage, or death. In practice, 108 (72%) always or often recommended treatment to reduce fever and 96 (89%) of the 108 did so at temperatures between 101° and 102°F. One hundred thirty-one (88%) respondents agreed that a sleeping child with fever should be left undisturbed. One hundred twenty-one (80%) pediatricians always or often tried to educate families about fever during sick-child visits, yet only 38% addressed the dangers of fever. It is concluded that (1) many pediatricians believe that fever (with no underlying treatable cause) greater than 104°F could lead to serious complications and (2) most pediatricians educate families about fever predominately during sickchild visits. Pediatricians may be contributing to fever phobia by presenting mixed messages to parents about fever—for example, by prescribing antipyretics for children with temperatures between 101° and 102°F while recommending that a sleeping child with fever be left undisturbed and by failing to address parental concerns about fever during all types of pediatric visits.