Fever and Your Baby
Your child's normal temperature vary with his age, activity, and the time of day. Infants tend to have higher temperatures than older children, and everyone’s temperature is highest between late afternoon and early evening and lowest between midnight and early morning.
Fever and Your Baby Your child's normal temperature will vary with his age, activity, and the time of day. Infants tend to have higher temperatures than older children, and everyone’s temperature is highest between late afternoon and early evening and lowest between midnight and early morning. Ordinarily, a rectal reading of 100.4 degrees Fahrenheit (38 degrees Celsius) or less, or an oral reading of 99 degrees Fahrenheit (37.2 degrees Celsius) or less, is considered normal, while higher readings indicate fever. By itself, fever is not an illness. Rather, it is a sign or symptom of sickness. In fact, usually it is a positive sign that the body is fighting infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria. The fever may actually be important in helping your child fight his infection. However, fever can make your child uncomfortable. It increases his need for fluids and makes his heart rate and breathing rate faster. Fever most commonly accompanies respiratory illnesses such as croup or pneumonia, ear infections, influenza (flu), severe colds, and sore throats. It also may occur with infections of the bowel, blood, or urinary tract, inflammation of brain and spinal cord (meningitis), and with a wide variety of viral illnesses. In children between six months and five years, fever can trigger seizures, called febrile convulsions. These convulsions tend to run in families, and usually happen during the first few hours of a febrile illness. Children may look “peculiar” for a few moments, then stiffen, twitch, and roll their eyes. They will be unresponsive for a short time, and their skin may appear to be a little darker than usual during the episode. The entire convulsion usually lasts less than one minute, and may be over in a few seconds, but it can seem like a lifetime to a frightened parent. Although uncommon, convulsions can last for up to fifteen minutes or longer. It is reassuring to know that febrile convulsions almost always are harmless—they do not cause brain damage, nervous system problems, paralysis, mental retardation, or death—although they should be reported promptly to your pediatrician. If your child is having trouble breathing or the convulsion (also referred to as a seizure) does not stop within fifteen minutes, call 911. Children younger than one year at the time of their first simple febrile convulsion have approximately a 50 percent chance of having another such seizure, while children over one year of age when they have their first seizure have about a 30 percent chance of having a second one. Nevertheless, febrile convulsions rarely happen more than once within a twenty-four-hour (one-day) period. Although many parents worry that a febrile convulsion will lead to epilepsy, keep in mind that epileptic 18/02/2013 07:53 PM Pdf créé avec la version d'essai pdfFactory Pro www.pdffactory.com seizures are not caused by a fever, and children with a history of feverrelated convulsions have only a slightly higher likelihood of developing epilepsy by age seven. A rare but serious problem that is easily confused with fever is heat-related illness, orheatstroke. This is not caused by infection or internal conditions, but by surrounding heat. It can occur when a child is in a very hot place—for example, a hot beach in midsummer or an overheated closed car on a summer day. Leaving children unattended in closed cars is the cause of several deaths a year; never leave an infant or child unattended in a closed car, even for a few minutes. Heatstroke also can occur if a baby is overdressed in hot, humid weather. Under these circumstances, the body temperature can rise to dangerous levels (above 105 degrees Fahrenheit [40.5 degrees Celsius]), which must be reduced quickly by cool- water sponging, fanning, and removal to a cool place. After the child has been cooled, he should be taken immediately to a pediatrician or emergency room. Heatstroke is an emergency condition. Whenever you think your child has a fever, take his temperature with a thermometer. Feeling the skin (or using temperature sensitive tape) is not accurate, especially when the child is experiencing a chill. Fever Without Fear A fever in a newborn should not be taken lightly but it helps to know when to take action and when to let it run its course. Let’s face it, fevers can be scary for parents. But even though infants get their share of colds and fevers, fevers should be taken more seriously. When your baby is burning up, it can be hard to think straight and make important decisions. Learning what causes fevers and how to treat them will ease your anxiety and help you take control of the situation. What Causes a Fever? “Fever is usually, but not always, an indication of some infection in the body,” explains Dennis Vickers, M.D., FAAP, chairman of pediatrics at Sinai Health Systems in Chicago. “It is the body’s first line of defense in fi ghting infection.” Everyone has his or her own internal “thermostat” that regulates body temperature, and normal body temperature is around 98.6 degrees Fahrenheit plus or minus about one degree (37 degrees Celsius, plus or minus about 0.6 degrees). When the body 18/02/2013 07:53 PM Pdf créé avec la version d'essai pdfFactory Pro www.pdffactory.com detects an infection or other illness, the brain responds by raising the body temperature to help fight the condition. “Any rectal temperature over 100.4 is generally considered a fever,” says Barbara Huggins, M.D., FAAP, professor of pediatrics at the University of Texas Health Center at Tyler. “A fever itself doesn’t necessarily warrant a call to the doctor. It depends on the age of the child and his other symptoms. Managing the Fever A fever can’t always be detected by feeling your infant’s forehead. It’s usually necessary to take his temperature as well. Although there are numerous thermometers on the market that measure temperature in different areas, parents should use rectal thermometers with their babies for the most accurate reading. “The ‘gold standard’ measurement is still the rectal temperature,” says Dr. Vickers. Once you’ve identified a fever, you can begin treating it if needed based on your child’s age and other symptoms. While you may instinctively want to bring your child to the doctor’s office, it may not be necessary, especially if the child seems fine once the fever is reduced. “What I tell parents when they call me in the middle of the night is, ‘Don’t panic.’ Fever by itself is not something to panic about. I ask them how the child looks and how they’re acting—are they behaving normally?” says Dr. Huggins. “Then we focus on how to get the fever down. With the vast majority of viral infections, once you get the fever down, everything’s better.” Keeping Fever at Bay Although not every fever needs to be treated, there are some things you can do to help make your child more comfortable. Giving a child acetaminophen or ibuprofen will usually reduce a fever. “Make sure you’re giving the appropriate dose,” advises Dr. Huggins. “Refer to the label and if they’re under two years old, contact your pediatrician or pharmacist.” Common sense is equally important for treating fevers, says Dr. Vickers. “Use your head. Don’t overdress the child, no matter what grandma says.” The same goes for giving baby an alcohol bath, an old practice that is no longer recommended. A fever will also cause a child to lose fluids more quickly, so offer your baby plenty of fluids to avoid dehydration. Signs of dehydration include crying without tears, a dry mouth, and fewer wet diapers. Being prepared can help take the fear out of fever. Keep your digital thermometer ready and accessible so you don’t have to search for it once your child is ill. Have children’s acetaminophen or ibuprofen on hand. And make sure your pediatrician’s phone number is handy. When to Call the Doctor • Your child is younger than 2 to 4 months old and has a fever. 18/02/2013 07:53 PM Pdf créé avec la version d'essai pdfFactory Pro www.pdffactory.com • Your child is lethargic, unresponsive, refuses to eat, has a rash, or is having difficulty breathing. • You observe signs of dehydration, such as a dry mouth, a sunken soft spot, or significantly fewer wet diapers. • Your child’s fever lasts more than a few days. • Your child experiences a febrile seizure How to Take a Rectal Temperature Taking a rectal temperature is the most accurate way to measure a young child’s true body temperature. The American Academy of Pediatrics encourages parents to remove mercury thermometers from their homes to prevent accidental exposure and poisoning. Here are the steps for taking a rectal temperature: 1. Use a rectal thermometer (preferably digital) that has a round bulb at the end. 2. Clean the tip of the thermometer with rubbing alcohol or soap and water. 3. Lubricate the tip with a water-soluble lubricant. 4. Place your baby on his stomach across a firm surface or your lap. Or, if your child is more comfortable on her back, gently lift her legs and proceed to step 6. 5. Stabilize your child by placing one hand on his lower back just above the buttocks. If your child is wiggling, ask someone to help you restrain him. 6. Slowly insert the lubricated thermometer into the anal opening about one-half inch, stopping if you feel any resistance. Never force the thermometer. 7. Gently hold the thermometer in place between your index and forefinger while keeping your hand against your baby’s bottom. 8. Wait until your thermometer beeps or signals that it’s done. A reading of 100.4 degrees Fahrenheit or more is generally considered to be a fever. Febrile Seizures What are they? A febrile seizure is a relatively common and harmless side effect of fevers in young children. What does it look like? It’s a full-body seizure where your child may be unresponsive, look strange, twitch, stiffen or roll his eyes. What should you do? Remain calm and move your child to a safe place where he can’t hurt himself. Do not put anything in his mouth. Febrile seizures usually last less than one minute, but can last up to 15 minutes. Call 911 if the seizure lasts longer than a few minutes. Follow up with your pediatrician for all febrile seizures. This article was featured in Healthy Children Magazine. To view the full issue 18/02/2013 07:53 PM Pdf créé avec la version d'essai pdfFactory Pro www.pdffactory.com