Children Fevers and Infections

CHILDREN FEVERS AND INFECTIONS

Small children can very easily develop a high temperature without being particularly ill. The most common cause of fever is infec­tion, usually of the throat or nose. Increasing the temperature is one way the body tries to resist infectious bacteria and viruses.

A baby’s temperature typically ranges between 97.5°F and 99.5°F. Some children have even greater changes in their normal body temperature. Temperatures are lowest at night and highest in the afternoon. Putting your hand on a child’s forehead is not a reli­able way to measure temperature. Your baby will have to get used to having his or her tem­perature taken with a thermometer inserted into the rectum (bottom) or in the armpit.

Of even greater importance than measur­ing the temperature is observing your baby. Signs that he or she may not be well include the following: appearing “limp” and slug­gish; not wanting to sit up, to talk, to play, or to eat or drink; and not getting any better after receiving fever-reducing medicines.

Children with fever have poor appetite. Don’t force your child to eat, but do make sure that he or she drinks plenty of fluids (liquids).

When children are vomiting or have diarrhea. the fluid intake must be increased even more to replace the fluids they are losing. Weak tea, mineral water, or water with sugar are recom­mended. Avoid milk and juices.

If your child is nauseous, give fluids in small amounts. It may be easier for him or her to take sips through a straw than straight out of a glass. Older children can suck on ice chips, too. Popsicles frozen snacks and carbonated bever­ages (such as soda) contain useful amounts of fluids and may be more appetizing to a sick child than many other foods. It’s more impor­tant for your child to drink than to eat. When he or she is no longer nauseous, you can give crack­ers, pretzels, mashed potatoes, or dry white toast, then gradually progress to the normal diet.

If your baby or child refuses to stay in bed with a fever, it’s probably fine to let him or her get up for a while. However, he or she shouldn’t be allowed outdoors and shouldn’t be exposed to hot or cold rooms. Dress the baby warmly enough, but not too warmly.

It is not always necessary to use fever-reduc­ing medicines. In many cases, babies can maintain a surprisingly good state of well-being even with a temperature of 104°F! However, you should contact your doctor to make sure. To bring down fevers, you may be told to put your child into a tub of room-temperature water. It’s also important to keep an eye out for symptoms of serious infections. For example, infections such as meningitis (an inflammation of the brain covering) can seem like regular viral infections at first.

Often, appetite and fluid intake improve with fever-reducing medicines such as aceta­minophen. (Aspirin is not recommended.) Store medicines safely and follow the recom­mended dosages exactly. Giving too much medicine — or the right amount too fre­quently — can cause serious poisoning!

Febrile seizures

Approximately 1 out of 20 infants and toddlers will have at least one febrile (fever) seizure from high body temperature. Febrile seizures usually affect children between the ages of 6 months and 5 years. During that period, the brain is especially sensitive to high temperature, particularly if the temper­ature is rising rapidly. The child stiffens and may faint, the eyes roll, the jaws clench tight­ly together, and the body jerks. Such an attack may last from a few seconds to 10 or 15 minutes.

Treatment of febrile seizures usually consists of cooling the child down. Undress your child and place a towel with cool (but not freezing) water on the forehead or around the body, especially in the armpits, around the neck, and on the groin. Don’t put your finger or other object into his or her mouth. Do turn the child onto one side so that he or she doesn’t choke on or breathe in any vomit. Call the doctor, who will give other emergency advice and will try to determine the cause of the fever. He or she will probably tell you to give the child a fever-reducing medicine such as acetaminophen. If your child has had febrile seizures before, the doctor may have prescribed medicine to be inserted into the rectum. This treatment usual­ly works within a short time.

Infections

Most infections are caused by viruses or by bacteria. Children can become infected even before or during birth. Premature babies and those who had complicated births are partic­ularly vulnerable.

Toward the end of pregnancy, you pass a range of antibodies to your baby. The anti­bodies provide temporary protection against certain infections, especially against “child­hood diseases” such as measles, mumps, rubella, and chickenpox. However, the natur­al protection only lasts about 2 months —after that, vaccination is essential (see Chapter 14, “Baby’s Checkups and Immunizations,” pages 91 to 95.) Children who are breast-fed receive specific antibodies through moth­er’s milk, which also provides protection against digestive system infections.

Because of the antibodies, breast-fed new­borns seldom get infectious illnesses other than colds and some infections of the digestive system. Most nose and throat infections during this period are caused by viruses, which means that antibiotics are rarely needed.

It’s hard to prevent all infections in infants and toddlers. Babies who have older sisters and brothers, in particular, are con­stantly exposed to infectious substances. It may be comforting to know that babies do gradually build up their own defense sys­tem against infections.