Should you treat a kid’s fever? What doctors say as Trump Tylenol comments spark flu season debate

Treating childhood fevers has long been a source of anxiety for parents. Are you nursing a fever or starving it? (Spoiler: Sick children need to eat and drink enough to keep their bodies hydrated and well-nourished, doctors say.)

But in September, when President Donald Trump told pregnant women to “fight like hell not to take” Tylenol following unfounded claims that it was linked to autism, the ongoing debate over what has long been considered a standard of care for childhood fever reignited.

“A friend’s baby (7 months) had a fever of 101 Friday night and she texted me, ‘Sure, now I’m afraid to give him Tylenol,'” a Reddit user recently posted.

A person identifying themselves as a medical professional posted in another Reddit thread last month that a patient “brought his baby in with a fever of 103 and said he was too scared to give him acetaminophen.”

The president, who has no medical training, has repeatedly said that pregnant women and their children should “tough it out” instead of taking painkillers.

Acetaminophen is the generic name for Tylenol and is an ingredient in various medications. According to experts, there is no credible data showing that the fever reducer is unsafe when used correctly. The American Academy of Pediatrics wrote last week that studies do not find a “causal link” between acetaminophen and autism in children or during pregnancy. “Misleading claims that the drug is unsafe and linked to increased rates of autism send a confusing and dangerous message to parents and expectant parents,” the group wrote.

What is fever for?

When a new, potentially dangerous germ invades our immune system, the body responds by increasing its core temperature. Viruses and bacteria tend not to thrive in warm environments.

That’s not necessarily a bad thing — within reason, said Dr. Molly O’Shea, a Michigan pediatrician and spokesperson for the American Academy of Pediatrics.

“Fever has value in fighting infection,” she said. “But there is a critical point where that value is lost.”

This is when the child is so uncomfortable that he does not want to eat or drink.

“That’s when it makes sense to reduce the temperature,” she said. “Dehydration could cause more damage.”

Is a high fever always dangerous?

When Seth Creech caught the flu during the 2009 H1N1 pandemic, when he was 6 years old, his fever spiked to 106 degrees Fahrenheit.

This is a scary temperature that would freak most parents out.

Seth’s father, Dr. Buddy Creech, a professor of pediatric diseases at Vanderbilt University Medical Center in Nashville, Tennessee, had a different view.

“As a pediatrician, I knew the 106 wouldn’t harm him,” he said. “In a normal, healthy child, the body is really well calibrated to maintain this temperature within a range that will not be harmful to the child. It is important for parents to be aware of this.”

What was concerning, Creech said, was how her son behaved when he was sick. “It looked horrible,” he said. “His eyes were glassy. He didn’t want to move.”

Fever medications like acetaminophen and ibuprofen brought Seth’s fever down to around 101 degrees. “He was completely fine at that point,” Creech said. “He was golden, playing Legos and video games.”

Seth Creech has recovered and is now a 22-year-old college student.

“If the child looks good and feels good and is playful and active, you really don’t have to do anything,” Buddy Creech said. “Part of it you can use is to see how they’re doing and let the fever increase the pressure on the germ so it dies.”

O’Shea supported the idea that a child’s behavior is critical in determining how to respond to high temperatures. Treatable signs of fever include unusual sleepiness, grumpiness, and refusal to eat and drink.

Still, the AAP recommends calling the pediatrician for advice when a child’s fever reaches 104 degrees.

The threshold for babies younger than 3 months is much lower, according to the group, at 100.4 degrees.

Creech said there is no evidence that giving children Tylenol or other medications to relieve their pain or fever will prolong their illness.

“Parents should feel very safe giving their children Tylenol when they need it,” he said.