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Infant Fevers (ER)
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| Tuesday, December 30th, 2008 | | CWK Producer |
“Any child less than 6 weeks of age that has a fever over 100.6 degrees, you should bring them to the doctor.”
– Carden Johnston, M.D., pediatric emergency room physician.
Three-week-old Mya has the symptoms of a cold, but what worries her mom is Mya’s fever. “I brought her to the doctor,” Donyell James says, “because she was running a fever of 101. And how old is she? Three weeks. She was just crying like she was hurting.”
Is it a cold? Or something else? In a very young baby a hurting cry and a fever may be the only signs of a serious illness. So in Mya’s case, the doctors check her blood for infection.
“Very few of the children with over 101 (degrees) will have bacteria in the bloodstream,” says Dr. Carden Johnston, a pediatric emergency room physician at Alabama Children’s Hospital in Birmingham. “But if they have (an infection), they can’t fight it off very well, and there’s a good chance they’ll be very ill and even die.”
So Mya undergoes blood and urine tests, even a spinal tap, and is kept in the hospital overnight for the lab results. “I’ll just be glad when it’s all over,” says Mya’s mother, “when we can go home.”
It is a lot to put such a young baby through, but Dr. Johnston says it was smart for Mya’s mother to bring her in, because at her age, the risk is too high. “Any child less than six weeks of age,” Dr. Johnston says, “that has a fever over 100.6 (degrees), you should bring them to the doctor.”
Doctors also say it’s important to check your young baby’s temperature before you call your physician. “Because if it’s 101,” Dr. Johnston says, “it’s different than 100.2. And your doctor would like to know.”
Mya’s tests turned out fine. All she had was a cold and she was able to go home in a couple of days.
What We Need To Know
By itself, fever is not an illness. In fact, the American College of Emergency Physicians (ACEP) says elevated body temperature is one of the ways the body fights infection, which is often the cause of fever. The ACEP says fever is one of the most common reasons that parents bring their children to the doctor.
In young children fever is defined as a rectal temperature of 100.4 degrees Fahrenheit or an oral temperature above 99.5 degrees Fahrenheit.
The ACEP recommends parents call a doctor if the child’s fever is above 102 degrees Fahrenheit, or if a fevered child:
- Is under two months of age (Infants don’t have well-developed immune systems and could have serious infections. Even if they don’t look sick, they can get sick very quickly).
- Looks very sick, is poorly responsive, uninterested in surroundings, sluggish, won’t suck on breast or bottle.
- Cries constantly without relief.
- Is difficult to awaken.
- Has a stiff neck.
- Has purple spots on the skin.
- Has difficulty breathing.
- Has difficulty swallowing.
- Drools excessively.
- Has symptoms of an earache or sore throat.
- Has a limp, or will not use an arm or leg.
- Has significant abdominal pain.
- Has painful urination or difficulty urinating.
- Has any redness or swelling.
- Has a seizure.
Do not give aspirin to children under the age of 16. It has been linked to Reye’s Syndrome, which can be fatal. In some cases, acetaminophen is effective. However, for most low grade fevers, no medication is necessary. Children’s Hospital of Denver recommends extra fluids and less clothing as a general treatment for all fevers.
- Give cold fluids orally in unlimited amounts. Good hydration replaces sweat and improves heat loss.
- Dress in one layer of lightweight clothing and sleep with one blanket (avoid bundling) because overheated infants can't undress themselves.
- For fevers 100-102 degrees Fahrenheit, this is the only treatment necessary.
If the fever lasts more than 72 hours, call a doctor. And be aware that fever accompanied by other severe symptoms can indicate a life-threatening disease known as bacterial meningitis. If your child has a fever above 101 degrees Fahrenheit accompanied by severe, sudden headache and mental changes, neck or back stiffness, or rashes (small and tiny red, purple-black spots resembling bruises and usually found on the armpits, groin, ankles and areas where pressure may be applied), go to the emergency room immediately. Bacterial meningitis requires urgent medical treatment and antibiotics, because it can be fatal or cause severe handicaps, such as deafness or brain injury.
Resources
- Alabama Children’s Hospital in Birmingham
- American College of Emergency Physicians
- American Academy of Family Physicians
- Children’s Hospital of Denver
