Foods and Beverages to Avoid During Fever in Children
Soft drinks and beverages high in simple sugars should be avoided in febrile children, as these are hyperosmolar and can worsen dehydration. 1
Beverages to Avoid
Soft drinks/carbonated beverages are specifically not recommended due to their high osmolality, which can exacerbate fluid losses and worsen the clinical course 1
Beverages with high simple sugar content should be avoided as they contribute to hyperosmolarity and do not provide appropriate electrolyte replacement 1, 2
Cola drinks are inappropriate for hydration in febrile children because they contain insufficient sodium and excessive osmolar load 3
100% fruit juice should be limited or avoided during acute febrile illness, particularly when accompanied by gastrointestinal symptoms 1, 4
Foods to Avoid
Foods high in simple sugars and fats should be avoided as they can worsen gastrointestinal symptoms that may accompany fever 4, 2
Unpasteurized milk, dairy products, and beverages must be avoided due to increased infection risk in any child with compromised immune function during illness 1
Foods with added sugars or artificial sweeteners are not recommended during acute illness 1
What Should Be Offered Instead
The evidence strongly supports continued feeding during febrile illness rather than restricting intake 1, 2:
Water is the preferred beverage for maintaining hydration 1
Oral rehydration solutions (ORS) should be used if dehydration is present or developing, with appropriate sodium concentrations (75-90 mEq/L for rehydration, 40-60 mEq/L for maintenance) 5
Cereal-based gruels, soup, and rice water are appropriate home-prepared fluids that support hydration 1
Breast milk should be continued on demand for nursing infants 1, 4
Regular diet including starches, cereals, yogurt, fruits, and vegetables should be maintained, as continued feeding improves outcomes 4, 2
Critical Clinical Pitfalls
The most dangerous mistake is restricting all oral intake based on outdated "gut rest" principles, as this can worsen nutritional status and delay recovery 1. The evidence clearly demonstrates that continued feeding during illness shortens duration of symptoms and prevents malnutrition 1, 3.
Parents often inappropriately give soft drinks thinking they help with hydration, when in fact these beverages can worsen the child's condition due to their osmolar load 1, 3. Clear education about appropriate fluid choices is essential.