Neonatal fever is often related to infection, but it should also be ruled out whether it is caused by too much clothing. Common neonatal infections, such as sepsis, meningitis, omphalitis, pneumonia, osteomyelitis, suppurative arthritis, urinary tract infection, etc. , may cause a fever; Especially for babies before 2 years old, fever caused by urinary tract infection is very common, but it must be known through urine test. In addition, persistent fever is common in viral and bacterial infections, and some viral infections can lead to high fever of 40.5℃. Although temperature is not a reliable indicator of potential infection, higher body temperature may bring higher risk to infants under two years old.
Throughout the year, the common fever factor baby has a fever, which season should we pay special attention to? Dr. Yang said that before winter in autumn, the weather changes rapidly, and the temperature difference between morning and evening is also large. Therefore, the baby often has a fever and accidentally catches a cold. Especially before six months to three years old, some babies even need to pay attention to hip problems. Viruses and bacteria are particularly active in winter, so influenza, common cold, viral gastroenteritis and other diseases are prevalent, including non-bacterial pneumonia, which mostly occur in colder months. The route of infection is mainly through close contact with droplets. In late winter and early spring, bacterial pneumonia is common in boys, so parents should pay special attention. However, under the high temperature and heat in summer, enterovirus infection prevails. However, due to the unclear seasons in Taiwan Province Province, acute bronchiolitis caused by respiratory fusion virus is a threat to babies before the age of two, so parents should be careful.
How to judge whether the baby has a fever? Dr. Yang Changyou pointed out that a baby born within one month has a fever if the temperature measured by an ear thermometer exceeds 37.8℃. However, how to help your baby measure his temperature correctly? Dr. Yang suggested that parents should choose ear temperature and anal temperature when measuring their baby's temperature, and the test results are usually the most accurate. However, although the anal temperature is accurate (note: it is usually 0.25℃ higher than the oral temperature and armpit temperature), you should be extra careful when measuring so as not to damage the mucosa around your baby.
Moreover, special attention should be paid to helping the baby take his temperature; For example, if you help an older child to measure the temperature of the mouth or armpit, in principle, you should measure it for 5 minutes before seeing if the temperature will be more accurate; If you help the baby to measure the anal temperature, it takes about 2 minutes to measure the standard temperature. So when measuring different parts, there are some tips that must be paid attention to, otherwise the measured temperature will be wrong.
SOS novice parents must read! Baby fever exercises collective sense measurement! Don't touch your forehead. In addition, touching the baby's forehead can simply judge whether the baby has a fever? Dr. Yang replied that the body temperature of hand contact varies from person to person, and the normal body temperature of children is higher than that of adults. If you have no experience, it is easy to misjudge a fever by touching. Because the body temperature is usually between 36.5℃ and 37℃, but if the weather is hot or after exercise, the body temperature will rise, but no matter how much the normal body temperature increases, it will not exceed the standard of fever, so it can only be regarded as a fever if it exceeds the temperature index of fever.
In addition, the temperature in different places is also different. For example, measuring oral temperature or ear temperature, 38℃ is a fever; Axillary temperature is less than 0.5℃, that is, even if you have a fever, it is 37.5℃; Anal temperature should be 0.5℃ higher than oral temperature and ear temperature, which is 38.5℃, in order to have a fever.
Measurement of ear temperature gun Dr. Yang said that different brands of ear temperature guns and protective covers have different thicknesses, so try to correct them before use. If you suspect that you have a fever, you can take it several times, usually the one with the highest temperature. If the measured body temperature is lower than 35℃, it may be caused by improper use of ear thermometer. In addition, some babies may have a bent ear canal and more earwax, so blocking infrared rays will affect the results. The probe earmuffs of the ear thermometer should be discarded after use to prevent bacterial infection. But at present, earmuffs are in short supply, and many people disinfect them with alcohol. However, if alcohol is not completely volatilized, it will be put into the ear canal for measurement, which may also lead to temperature difference.
Finally, when measuring the ear temperature, straighten the originally curved ear cavity, so that the ear thermometer can correctly detect the eardrum and obtain a more accurate temperature. In addition, some ear thermometer guns are used too many times, generally more than 1000 times, and the temperature may be inaccurate!
The baby has a fever, will it burn his head? SOS novice parents must read! Can the baby fever problem set take antipyretics immediately? Dr. Yang said that as long as the child has a fever, it can cause discomfort. This situation requires medicine, but how do you know that he is uncomfortable? The method of judgment is simple. As long as you see a child crying and fidgeting, you can't sleep all the time, and you will also have a headache. When complaining a lot, it means that he is not feeling well and needs to take the initiative to reduce his fever and let him take antipyretic drugs.
Commonly used antipyretic drugs for children have two components, one is the component of Punatone, which is the most commonly used first-line acetaminophen, and the other is the component of painkiller, called diclofenac. Because of the different ways of action, it takes time to exert the efficacy. It is safer to take the two drugs at least 1.5 hours apart. The American Academy of Pediatrics recommends acetaminophen (Anjiage/Punafen) and ibuprofen (Shuyitong/Magaixian/Ipafen) as effective and safe antipyretic drugs for children. Among them, ibuprofen is not recommended for infants under six months or dehydrated children, because reducing renal blood flow sometimes hurts the kidneys, so parents should be especially careful!
Besides taking medicine, what other ways to reduce fever are there? If the child is ill, he may have a fever at any time, and the fever may recur. Therefore, parents are advised to learn several convenient skills to deal with fever:
(1) When the body temperature is between 38 and 38.4℃, one or two clothes should be missing, and the quilt should be covered thinner. Then open the window to keep indoor air circulation, which is beneficial to the baby's heat dissipation.
(2) When the body temperature is between 38.5 and 39℃, you can take antipyretics; Let children sleep on water pillows (less than 3 months) or ice pillows (more than 3 months). When using ice pillows, be sure to wrap them with dry towels.
(3) When the body temperature exceeds 39℃, use * * plug to reduce fever according to the doctor's advice, and children can also take a warm bath to help the body dissipate heat. Before soaking in warm water, parents can try the temperature of water with their elbows. If you don't feel hot or hot, you can let your child soak for 20 to 30 minutes.
If the baby's fever does not exceed 40.5℃, you may wish to give some oral antipyretics first (* * * is uncomfortable, use less), then take a warm bath at 29℃ to 32℃ to cool down, or turn on air conditioning and other physical means. As for whether to use an ice pillow to reduce the fever? Dr. Yang said that if children under the age of 5 have a fever, ice is usually not recommended, especially if they are infected with the virus. Ice can even cause headaches and make your baby more uncomfortable!
In addition, when the baby has a fever, the first thing to do is to replenish water. The easiest way is to drink water. Babies under two years old sometimes have so-called "dehydration fever" because of insufficient water intake. Fever needs more water, but as long as the baby can eat, there is no need to drip. Only when the baby is not active enough, it is necessary to inject glucose water or saline.
SOS novice parents must read! The baby has a fever. Why does it cause chills? Chilling and shivering is another manifestation of fever. Because the human body's feeling of cold and heat is regulated by nerve receptors in the skin and pituitary gland in the central system of the brain. This system is sensitive to the difference between body temperature and outside temperature. So we can cool the body by lowering the ambient temperature or raising the body temperature.
The body's response to a fever is similar to the response to a drop in the outside temperature. Including shivering, chills and goose bumps, all normal self-protection systems of the body can properly make the body generate heat energy to avoid temperature loss. Moreover, food is also considered as a good way to raise body temperature, so a person who is afraid of cold and shivering may feel hungry. In order to conserve heat, the body will promote the contraction of blood vessels in the skin, so the human body will curl up into a ball. However, when the child has a fever and causes chills, don't wrap the baby in a blanket, because it will make the body temperature higher and hotter.
If SOS appears, please seek medical attention immediately.
* The baby's temperature exceeds 37.7℃ within one week.
* Children's body temperature exceeds 38℃ within three months.
* The temperature of children under two years old exceeds 39℃.
* If the family treatment measures fail, the temperature still exceeds 40.5℃.
* Body temperature is as high as 465438 0.65438 0℃.
* Fever lasts for more than five days.
SOS novice parents must read! Baby fever problem set doctor's health tips If the baby at home has a fever again, parents should remember not to panic like headless flies, because fever is a reaction of the body and disease, and it is more important to actively find out the cause of the child's fever than to rush to reduce it. Especially in the middle of the night, if you find that your child has a fever, you don't have to rush to the doctor first. If your child can still sleep peacefully, let him have a good rest and sleep until dawn. Or the embolic agent can be directly applied. If it is noisy, you can follow the above steps and take it to the doctor after dawn. Parents should understand that there is a certain process for a baby to get sick and have a fever. As long as you follow the pediatrician's instructions on medication, dosage and frequency, after a period of rest, the child will naturally recover!
Secondly, babies younger than 5 years old have fever, and usually have complications of thermal cramps (cramps), which most often occur in infants between 6 months and 5 years old. When the body temperature exceeds 38.5℃, it often occurs within 24 hours after fever, which is generally benign, and the convulsion time will not exceed 10 minutes. However, children with heat spasm constitution are advised to take antipyretic drugs first, and then take them immediately.
Yang Changyou
Education background: Department of Medicine, Kaohsiung Medical University
Experience: Clinical research physician of newborns at Children's Hospital of Los Angeles, USA, and visiting scholar of pediatrics at Keck Medical College, University of Southern California, USA.
Current position: Attending physician in Department of Neonatology, Chang Gung Memorial Hospital, Linkou, Director of Infant Ward, Chang Gung Memorial Hospital.