Putting Parents in Control

In his book How to Raise a Healthy Child...In Spite of Your Doctor, Robert Mendelsohn MD, a traditionally trained pediatrician, makes a strong case for his belief that most childhood illnesses can be treated competently within the home by informed and caring parents.

Although Mendelsohn advises parents to "avoid your doctor whenever you can," his suggestions require parents to know their children well, both physically and emotionally, and to be present to them both in sickness and in health. We've found his book to be packed full of common sense and practical experience, even if a bit heretical.

What's The New Fever Pitch?

True or false: "If your child contracts an infection, the fever accompanying it is a blessing, not a curse." Believe it or not, this statement, made in the 1980s by a pediatrician, is generally true.

Historical Perspective: Even harder for most of us to believe is this statement from the 1600s: "Fever is nature's engine which she brings into the field to remove her enemy."

The debate over the relative benefits of fever is actually nothing new. Until the late 1800s, when animal experiments that artificially raised the body temperatures of lab animals resulted in brain damage and death, fever was considered a normal and healthy response to infection. The idea that fever could produce similar results in humans led to a widespread fear of fever, especially of fever in children.

Source of Anxiety? More and more studies indicate that fever should not be cause for alarm. Indeed, fever is the body's mechanism for fighting a bacterial or viral infection by creating an environment too hot for the foreign organisms to survive.

At the same time, the chemical that raises body temperature also lowers the levels of iron in the blood. This works against the bacteria because they need iron to survive.

In their book Why We Get Sick, doctors Randolph Nesse and George Williams suggest that this ability of our body to remove iron from the blood when bacteria and viruses are present "is but one specific illustration of the broader principle that we should be careful to distinguish defenses from other manifestations of infectionsŠin short, we should respect the evolved wisdom of the body." It follows that using Tylenol or other suppressive medications to treat the fever actually limit the body's natural ability to fight infection.

Two important things to remember when your child develops a fever are, first, that the body is doing its part to fight the infection and usually will win the battle on its own; second, that the human body has a built-in mechanism regulating temperature. This mechanism is what keeps the body's temperature from getting too high.

We often assume that there is a relationship between how high the fever is and the severity of the illness. But a very high fever may accompany a mild illness, while a life-threatening illness may produce only low fevers or none at all.

Observe the Whole Child, Treat the Whole Child

This leads to the most important point about fever - and, in fact, illness in general: when a child is sick, parents should look at the "whole child" to assess the severity of the illness. A child with a 104-degree fever who is running and playing is probably going to be fine. But a child whose illness is obviously not improving with time, displays listlessness, or is inconsolable, even with a low-grade fever, should seek a medical evaluation.

Ads frequently portray "smart moms" as those who instinctively reach for the drugs. Does this new "Fever Pitch" mean that we should never give fever-reducing medication? No. There are occasions when reaching for the Tylenol is a lifesaver when it comes to discomfort or just needing some sleep. But understand that in giving fever-reducing medications, you may be compromising the body's ability to fight the infection.

You can truly make a big difference in how you're your child does during an illness by updating your knowledge about fever and cultivating new methods of supportive care before your child gets sick. That's what we love doing! When you bring your child to our office, we are trained in how to treat the whole child and we acknowledge that fever is just one manifestation of a disease process. In fact, we have observed that an occasional fever can strengthen immunity. Some children even experience a developmental leap following a fever.

Parenting a sick child can be hard work and there's plenty to know. We are not advocating a cavalier attitude. But instead of giving drugs out of a sense of panic, educate yourself with common sense strategies for nurturing strong, healthy children.

Get Smart About Antibiotics

We all know that you can grab people's attention by triggering fear. That's why the "Get Smart about Antibiotics" campaign has inflammatory captions such as "Will he reach 20?"

We've been talking about the overuse of antibiotics for about a decade now. Are people listening? Apparently not. The CDC is launching these campaigns to get the word out because antibiotics continue to be over prescribed.

As an alternative practitioner, it's affirming to see the CDC espousing what we've been telling patients for years. However, I'm a bit disturbed by the tactics. The culture of fear that permeates medicine leaves us in a bind-now afraid of taking, or not taking, an antibiotic. Where do we go from here?

Antibiotics First Introduced When antibiotics were first introduced, they were indeed miracle drugs. But the more doctors prescribed antibiotics, the more bacteria mutated and became resistant. Although there are many different kinds of antibiotics available, there are now bacteria - sometimes known as "superbugs" - resistant to all but the most powerful drugs available.

The creation of drug-resistant bacteria is the responsibility of both doctors and patients. Patients show up at a doctor's office feeling awful-and often fearful of where the disease is headed-and want something that will heal them quickly. Usually they're looking for an antibiotic. And in a culture that expects doctors to produce fast and positive results, doctors often write the prescription. The result is that in nearly 50 percent of the cases where antibiotics are prescribed they are in fact unnecessary.

Chronic Infections

Children often suffer from chronic strep throat or ear infections that are treated with antibiotics. Studies have shown that repeat infections are in fact more likely to occur when the first infection is treated promptly with an antibiotic.

One reason antibiotics become less effective is that they sometimes compromise the immune system. According to Marc Lappe in his book When Antibiotics Fail, doctors originally believed that for antibiotics to be effective in eradicating harmful bacteria, they would need the help of the body's natural defenses. But when some antibiotics were shown to actually suppress the immune system, this inconsistency was ignored.

We now know that antibiotics are not the ultimate answer we once thought they were. But instead of fueling a culture of fear, we advocate a different understanding of the disease process.

Most of the illnesses we've been talking about are inflammations. Our bodies are constantly renewing themselves, especially during childhood, but this occurs in adults as well. Every renovation requires some demolition. It is the immune system that does the breaking down by creating fever and inflammation to destroy foreign and outmoded bodily material. And it is the immune system that works to push it out of the body. What we experience as symptoms is frequently a strong effort by the human organism to remodel ourselves.

The inflammatory response rarely gets out of control in healthy people. In such cases an antibiotic is indicated. But remember that although an antibiotic may be life saving, it never heals an inflammation; it only suppresses it.

The Good News

The good news is that if unnecessary use of anti- biotics decreases, the resistance rate will go down. And the good news is that we can often make a difference in our dependence on antibiotics by how we take care of our children or ourselves during an illness. Here's how:

• Act swiftly to take measures that support your immune system at the onset of an illness (fluids, eat wisely and sparingly, take a hot bath and go to bed).
• Avoid OTC drugs that advertise themselves as "medication for the fast relief of all of your symptoms." Using suppressive medications can weaken the body's ability to fight an infection.
• Utilize methods of treating yourself/your child that promote the cleansing process and help the illness to work its way out of the body. Call us for individualized direction.