Did you know that bathing a feverish child in cold water can actually make them hotter?

Cold water to treat a fever is one of the many medical misconceptions in our society.

Healthcare researcher, pharmacist and pharmacology lecturer Dr Bonnie Bereznicki (University of Tasmania School of Medicine) leads a team investigating the burden of childhood fever on Tasmanian families and the Royal Hobart Hospital’s Emergency Department, in a project funded by the RHH Research Foundation.

Dr Bereznicki said it wasn’t common knowledge what an acceptable temperature was for a sick child.

“Parents aren’t really sure. If their child is warm and they take their temperature, and they don’t really know what to do, they often end up going to the doctor or hospital.

Our project is aiming to find out about parents’ experiences with feverish children, and how that is impacting our local healthcare system.

Dr Bereznicki first got the idea to start a project into temperatures after seeing medical misinformation being shared online.

“My interest in this was sparked as a healthcare professional, researcher and a parent.

“As a member of a Facebook parenting group, I started noticing some of the health-related questions that were asked, like ‘what is a normal temperature’ and ‘my child has a temperature of this, what should I do’ and sometimes incorrect advice being given in response.

“Some parents shared their own experiences, or even shared advice they were given from a health professional. But the danger is when this advice gets distorted, because of course not every child has the exact same medical condition.  

Based on questions that are often asked on parenting forums, we knew that people wanted and needed to know more about how to treat childhood fever in the home. However, we wanted to collect some more solid evidence to support this.

Project investigators (left to right): A/Prof Luke Bereznicki, Dr Bonnie Bereznicki (lead), A/Prof Graeme Zosky, A/Prof Sean Beggs.

Dr Bereznicki said there is a lot of literature about “fever phobia,” which was first described in the 1980s.

“This means parents were very anxious about what to do when a child has a fever, and that their perceptions of the damage a fever might cause were skewed.

“There was a perception for example that fevers could cause brain damage, which isn’t true.”

Dr Bereznicki said anecdotal evidence showed some common fever treatments were in use that were medically unsound.

“People are using ‘treatments’ that have been around for a while, which can actually drive the fever higher."

For example, putting your child in a cold bath or sponging your child with a cold washcloth, has been shown to actually raise the temperature. While this makes the skin cold, it then loses less heat because the blood vessels in the skin constrict, and then the temperature can go up. It just makes the child more uncomfortable.

“The reason anyone gets a fever is because their immune system is fighting off an infection, so the temperature resets at a higher level. It is the body’s response to infection.

“We will look at how many children were admitted and how many could be treated in the home, to see if there was burden to the emergency department.

Even the idea of a “safe” temperature can be problematic.

“It isn’t that simple. People say ‘what temperature should I be worried about’ but the recommendations are all based on symptoms. 

A child who has a temperature of 38.5 might be very unwell, but a child who has a temperature of 38.9 might be OK, it depends on the individual’s condition. If the child is becoming dehydrated, that’s more of a tell-tale sign of whether they need medical attention or not.

To fill this knowledge gap, the research team is asking Tasmanian parents to complete a short online survey about their children and their experiences with fever, including their management of fevers.

“We know that parents, especially parents of young kids, tend to be active on social media as a way of connecting with other parents,” Dr Bereznicki said.

The fever survey will be combined with another part of a larger project which is looking at hospital records of parents bringing children with fevers to the RHH emergency department, and how many were admitted.

“We will be looking at the burden on the emergency department, plus the knowledge and management in the community, to see how we can design an educational intervention for parents.

Dr Bereznicki said there could be scope in the future for addressing other common childhood ailments, such as colds and nappy rash, that could be treated effectively at home rather than seeing GPs.

“Then when people actually do need to be in the emergency room or the doctor’s, they will be seen quicker,” she said. 

We know parents are keen for this kind of advice, and by researching this we can hopefully help parents and our healthcare system at the same time.

You can complete the survey here.

Interested in conducting your own research? Apply now to become a research student.